Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Depression, Anxiety and Health Related Quality of Life in the Caregivers of the Persons with Chronic Neurological Illness
Kronik Nörolojik Hastalığı Olan Kişilere Bakım Verenlerde Depresyon, Anksiyete ve Yaşam Kalitesi
Sibel Aksu YILDIRIMa, Suzan ÖZERb, Öznur YILMAZa, Tülin DÜGERa, Muhammed KILINÇa
aDepartment of Physical Therapy and Rehabilitation, Hacettepe University Faculty of Health Sciences, bDepartment of Psychiatry, Hacettepe University Faculty of Medicine, Ankara
Turkiye Klinikleri J Med Sci. 2009;29(6):1535-42
Article Language: EN
Full Text
ABSTRACT
Objective: This study was designed to determine the emotional status and health related quality of life (HRQOL) of caregivers of mild to moderately dependent patients with chronic neurological disorders and to compare them with the patients themselves, and to reveal the influence of factors related to physical stressors and emotional status on HRQOL of caregivers. Material and Methods: Fifty two patients with chronic neurological illness and their caregivers (n= 52) were recruited. The Functional Independence Measurement (FIM) was used to evaluate the dependence of patients in daily living activities. Patients and their caregivers were assessed with the Beck Depression Inventory (BDI), the State Trait Anxiety Inventory (STAI) and the Nottingham Health Profile (NHP). Results: No significant difference was found between the patients and the caregivers with respect to BDI and STAI scores (p> 0.05). The significant correlates of NHP and FIM locomotion (which showed a trend toward significance) were added simultaneously in a multivariate model. BDI score of the caregivers was the only predictor of their NHP score (model R2= 0.45). When all of the variables were entered sequentially in a stepwise analysis, it was found that FIM locomotion, as well as BDI score of the caregivers contributed significantly to the explanatory power of the model. Our final model explained 43% of the variance in QOL of the caregivers of which BDI score of the caregivers accounted for 36%. Conclusion: Health care professionals should apply a holistic care approach in the rehabilitation of mildly dependent patients with chronic neurological illness including the psychiatric management of caregivers in the process.

Keywords: Depression; anxiety; quality of life; caregivers; nervous system diseases
ÖZET
Amaç: Bu çalışmanın amacı, kronik nörolojik bozuklukları olan hafif-orta düzeyde bağımlı hastalara bakım verenlerde emosyonel durum ve yaşam kalitesini hastalarınki ile karşılaştırarak değerlendirmek ve fiziksel stresörler ve emosyonel durumla ilgili faktörlerin bakım verenlerin yaşam kaliteleri üzerindeki etkisini saptamaktır. Gereç ve Yöntemler: Çalışmaya 52 kronik nörolojik bozukluğu olan hasta ve onların 52 bakım vereni alınmıştır. Hastaların günlük yaşam aktivitelerinde bağımlılık düzeyini değerlendirmek için Fonksiyonel Bağımsızlık Ölçeği (FBÖ) kullanılmıştır. Hastalar ve bakım verenleri Beck Depresyon Envanteri (BDE), Durumluk Sürekli Kaygı Envanteri (DSKE) ve Nottingham Sağlık Profili (NSP) kullanılarak değerlendirilmiştir. Bulgular: BDE ve DSKE puanları bakımından hastalar ve bakım verenleri arasında anlamlı fark bulunmamıştır (p> 0.05). Hastalar ve bakım verenlerin DSKE (sürekli) puanları ilişkili bulundu (?= 0.35, p< 0.05). Bakım verenlerin NSP puanları ile FBÖ toplam puanı ve alt grupları bağıntılı değildi, ancak FBÖ lokomosyon için anlamlılık düzeyine yaklaşmaktaydı (?= -0.27, p= 0.053). Bakım verenlerin NSP puanlarının bağıntılı bulunduğu değişkenler ve FBÖ lokomosyon (bağıntı için eğilim gösteren) regresyon analizine aynı anda sokulmuştur. Bakım verenlerin BDE puanları NSP puanlarının tek yordayıcısı olarak saptanmıştır (model R2= 0.45). Değişkenlerin hepsi aşamalı regresyon analizine sokulduğunda, BDE puanları ile birlikte FBÖ lokomosyonun da eşitliğe girdiği görülmüştür. Son model varyansın %43'ünü (BDE puanları varyansın %36'sını) açıklamaktadır. Sonuç: Sağlık profesyonellerinin kronik nörolojik bozukluğu olan hafif-orta düzeyde bağımlı hastalarda, süreç içerisinde bakım verenlerin psikiyatrik durumlarının ele alınmasını da içeren bütüncül bir yaklaşım uygulamaları gereklidir.

Anahtar Kelimeler: Depresyon; bunaltı; yaşam kalitesi; bakımverenler; nörolojik bozukluk

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