Impacto sobre el cuidador principal de una intervención realizada a personas mayores dependientes / Impact on the primary carer of an intervention carried out on depenedent elderly people

Objetivos: Evaluar el impacto de un programa de atención domiciliaria de personas mayores dependientes sobre el cuidador principal.DiseñoEstudio de intervención «antes-después».EmplazamientoAtención primaria.ParticipantesCuidadores principales de personas dependientes mayores de 65 años incluidas en un programa de atención domiciliaria (n=156; 7,8% de pérdidas durante el seguimiento).IntervencionesPrograma de atención domiciliaria de personas mayores dependientes.Mediciones principalesSe realizó una medición basal y una evaluación al año de seguimiento. Se evaluaron la salud percibida, la frecuentación, y la satisfacción con la atención recibida, y se administraron los cuestionarios de calidad de vida de Nottingham, de salud psíquica de Golberg, de apoyo social de Duke-UNC y de sobrecarga del cuidador de Zarit).ResultadosNo se observó una modificación significativa de la salud percibida. Mejoraron (p<0,05) las esferas de energía, sueño, emocional y relación social de la calidad de vida. Disminuyó la frecuentación (8,4 vs 7,5; p<0,05) y el porcentaje de hiperfrecuentadores (30,1% vs 6,9%; p<0,01). Se redujo el porcentaje que expresan escaso apoyo social (8,3 vs 2,8%; p<0,05) y sobrecarga del cuidador (56,4 vs 44,4%; p<0,05). El 90,3% consideran que la asistencia mejoró, con mejora significativa de la asistencia recibida global, médica y de enfermería (7,6 vs 8,4; 7,9 vs 8,5 y 7 vs 8,5; p<0,05).ConclusionesLa incorporación a un programa de atención domiciliaria de personas dependientes repercute positivamente sobre su cuidador principal, mejorando su percepción sobre la asistencia recibida, reduciendo su utilización de los servicios sanitarios, disminuyendo el grado de sobrecarga y su percepción de falta de apoyo social(AU)

Objective: To evaluate the impact of joining a home care program on primary caregivers of dependent elderly people.DesignNon-randomised “before-after” intervention study.SettingPrimary Care.ParticipantsPrimary carers of elderly dependent people included in a home care program (n=156; 7.8% loss to follow up).InterventionsInclusion in a home care program for chronically dependent elderly and the assessment of the primary carer in the same year.Variables assessedperceived health, frequency of visits, questionnaires of quality of life (Nottingham questionnaire), psychological health (Goldberg questionnaire), social support (Duke-UNC scale) and overburden of caregivers (Zarit questionnaire) and satisfaction with care received.ResultsThere were no significant changes in perceived health. Improvement in the areas of energy, sleep, emotional and social relationship of the quality of life. Decreased attendance (8.4 vs. 7.5, p<0.05) and the percentage of overusers (30.1 vs 6.9%, P<.01). A reduced percentage of caregivers expressed low social support (8.3 vs 2.8%, P<.05) and caregiver overburden (56.4 vs 44.4%, P<.05). 90.3% of caregivers believed that care had improved at the end of intervention, with a significant improvement of satisfaction of overall medical and nursing care received (7.6 vs 8, 4, 7.9 vs 8.5 and 7 vs 8.5; P<.05).ConclusionsJoining a home care program for dependents has a positive impact on their primary caregiver and improves their perception of care received, reducing their use of health services, reducing the level of overburden and their perceived lack of social support(AU)

[Impact on the primary carer of an intervention carried out on dependent elderly people]. / Impacto sobre el cuidador principal de una intervención realizada a personas mayores dependientes.

OBJECTIVE: To evaluate the impact of joining a home care program on primary caregivers of dependent elderly people. DESIGN: Non-randomised "before-after" intervention study. SETTING: Primary Care. PARTICIPANTS: Primary carers of elderly dependent people included in a home care program (n=156; 7.8% loss to follow up). INTERVENTIONS: Inclusion in a home care program for chronically dependent elderly and the assessment of the primary carer in the same year. VARIABLES ASSESSED: perceived health, frequency of visits, questionnaires of quality of life (Nottingham questionnaire), psychological health (Goldberg questionnaire), social support (Duke-UNC scale) and overburden of caregivers (Zarit questionnaire) and satisfaction with care received. RESULTS: There were no significant changes in perceived health. Improvement in the areas of energy, sleep, emotional and social relationship of the quality of life. Decreased attendance (8.4 vs. 7.5, p<0.05) and the percentage of overusers (30.1 vs 6.9%, P<.01). A reduced percentage of caregivers expressed low social support (8.3 vs 2.8%, P<.05) and caregiver overburden (56.4 vs 44.4%, P<.05). 90.3% of caregivers believed that care had improved at the end of intervention, with a significant improvement of satisfaction of overall medical and nursing care received (7.6 vs 8, 4, 7.9 vs 8.5 and 7 vs 8.5; P<.05). CONCLUSIONS: Joining a home care program for dependents has a positive impact on their primary caregiver and improves their perception of care received, reducing their use of health services, reducing the level of overburden and their perceived lack of social support.

El rol de Cuidador de personas dependientes y sus repercusiones sobre su calidad de vida y su salud / The caregiver burden and its repercussions on quality of life and health

Objetivo. Conocer la sobrecarga sentida por los cuidadores y las repercusiones que este rol representa sobre su calidad de vida, su salud en las esferas física, psíquica y social y su necesidad de utilización de los recursos sanitarios (frecuentación). Diseño. Estudio observacional y analítico de casos y controles Emplazamiento. Centro de salud de características urbanas. Participantes. El grupo de estudio fue formado por 156 cuidadores principales y el grupo control por 156 personas adscritas al centro de salud que no realizaban funciones de cuidador principal, emparejadas por edad, sexo y número de patologías crónicas padecidas. Mediciones. Características clínicas y sociodemo gráficas, datos relativos al rol de cuidador (parentesco, tiempo de desempeño del rol de cuidador, etc.), sobrecarga del cuidador (escala de Zarit), frecuentación, salud percibida, calidad de vida subjetiva (cuestionario de salud de Nottingham), presencia de sintomatología, ansiedad y depresión (EADG-18), función familiar (APGAR familiar y apoyo social percibido (cuestionario de Duke-UNC).Resultados. El 66,4% de los cuidadores presentaba sobrecarga en el test de Zarit. El 48,1% los cuidadores respondió que su salud era mala o muy mala, frente al 31,4% del grupo control (OR = 2,02; IC 95%: 1,27 - 3,21). La frecuentación media en el último año fue de 8,37 visitas/año en el grupo de cuidadores y de 7,12 visitas/año en el grupo control (p<0,01). Se observó una mayor prevalencia de ansiedad y depresión en el grupo de cuidadores, así como una mayor frecuencia de posible disfunción familiar y de sensación de apoyo social insuficiente. Conclusiones. Los resultados indican la necesidad de actuaciones multidisciplinarias encaminadas a apoyar a los cuidadores tanto de forma preventiva como de soporte (AU)

Objective. To determine caregiver burden and its repercussions on quality of life, physical and mental health and social life and the use for healthcare resources (frequency).Design. Observational, analytical, case control study. Setting. Primary Health Care Centre in an urban setting. Participants. The case group was made up of 156 primary caregivers and the control group of 156personas assigned to the Primary Health Care Centre who were not primary care givers. They were paired by age, gender and number of chronic diseases. Measurements. Clinical and socio-demographic characteristics, caregiver role characteristics (kinship, time performing role of caregiver, etc.), caregiver burden (Zarit scale), frequency, perceived health, subjective quality of life (Nottingham Health Profile), presence of anxiety and depression symptoms(GADS-18), family functioning (Family APGAR) and perception of family and social support (Duke-UNC questionnaire).Results. According to the Zarit scale, burden was present in 66.4% of caregivers. Compared to31.4% of persons in the control group, 48.1% of caregivers considered their health was poor or very poor (OR = 2.02; 95% CI: 1.27 – 3.21). The mean frequency in the last year was 8.37 visits/year in the caregiver group and 7.12 visits/year in the control group (p<0.01). A higher prevalence of anxiety and depression was observed in the caregiver group, and a greater frequency of possible family dysfunction and sensation of insufficient social support. Conclusions. The results indicate the need for multidisciplinary supportive and preventive interventions for caregivers. Such interventions have obtained positive results in several aspects both for the caregiver and the person cared for person. These interventions need to be adapted to the specific characteristics and needs of each caregiver (AU)