ABSTRACT
Objetivo: Estudiar el riesgo de maltrato en una población de pacientes con demencia por parte de sus cuidadores principales, su correlación con otros factores y sus posibles indicadores predictivos. Metodología: Estudio transversal y observacional sobre 143 pacientes con demencia, con 4-6 en la Escala de Deterioro Global de Reisberg (GDS), y sus cuidadores principales. El riesgo de maltrato por parte del cuidador se evaluó con el Caregiver Abuse Screen (CASE). Se analizaron otras variables demográficas, clínicas, cognitivas, psicopatológicas y funcionales en pacientes y cuidadores. Resultados: La edad media de los pacientes fue de 77,53 ± 7,4 años (67,1% diagnosticados de probable enfermedad de Alzheimer). La edad media de los cuidadores fue de 57,69 ± 15,39 años (68,5% mujeres; 49% hijos del paciente; 30,1% cónyuges). El 21% de los pacientes con demencia tenían riesgo de sufrir maltrato, según el CASE. El estudio de regresión lineal mostró que la sobrecarga del cuidador y su impulsividad, junto a la agresividad y comorbilidad psiquiátrica del paciente, aumentaban el riesgo de maltrato del cuidador al paciente (R2=0,671; p<0,001). Conclusiones: La agresividad en la relación paciente-cuidador dentro de la demencia es bidireccional. La agresividad del paciente, la sobrecarga del cuidador y su impulsividad fueron los principales factores de riesgo de maltrato al paciente en este estudio(AU)
Objective: To study the risk of abuse in a population of patients with dementia by their primary caregivers, its correlation with other factors and possible predictive indicators. Methods: Transversal and observational study on 143 patients with dementia, GDS 4-6, and their primary caregivers. The risk of abuse by the caregiver was assessed with the Caregiver Abuse Screen (CASE). Other demographic, clinical, cognitive, psychopathological and functional variables were analyzed in patients and caregivers. Results: The mean age of patients was 77.53 ± 7.4 years (67.1 % diagnosed with probable Alzheimer's disease). The average age of caregivers was 57.69 ± 15.39 years (68.5% women; 49% children of the patient, 30.1 % spouses). Twenty-one percent of patients with dementia were at risk of being abused, according to CASE. The linear regression analysis showed that caregiver burden and impulsivity, patients aggressive behavior and psychiatric comorbidity increased the risk of abuse of the caregiver to the patient (R2=0.671, P<0.001). Conclusions: Aggression in the patient-caregiver relationship in dementia is bidirectional. Patient aggressiveness, and caregiver burden and impulsivity were the main risk factors for patient abuse in this study(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Patient Advocacy/psychology , Patient Advocacy/trends , Patient Rights/standards , Patient Rights/trends , Mentally Ill Persons/legislation & jurisprudence , Mentally Ill Persons/psychology , Psychopathology/methods , Psychopathology/trends , Aggression/psychology , Risk Factors , Patients/legislation & jurisprudence , /standards , /trends , Cross-Sectional Studies/methods , Cross-Sectional Studies/trends , Comorbidity , Caregivers/psychologyABSTRACT
Early recognition of psychopathological symptoms (PSs) after stroke is important because they greatly influence the recovery of patients. The aim of this study was to investigate the predictive factors of PSs occurring in patients with ischemic stroke. Eighty-nine patients were prospectively evaluated upon admission and 4, 12, and 26 weeks later with the Neuropsychiatric Inventory, Hamilton's Rating Scales for Depression and Anxiety, and a battery of neuropsychological and functional scales. Depression and apathy were the most frequent PSs detected after stroke. Premorbid psychopathologies and right-hemisphere location were the main predictive indicators of early and long-term PSs.
