The Analysis Of Caregiver Burden Of Parkinson’s Disease

ObjectiveTo understand the current situation of caregiver burden of patients with Parkinson’s disease,and preliminarily analyze the influencing factors of caregiver burden of patients with Parkinson’s disease,so as to find the needs of caregivers early,take effective measures to reduce caregiver burden,improve the quality of life of caregivers,and further explore the best care model for patients with Parkinson’s disease.MethodsA total of 128 patients with Parkinson’s disease and their main caregivers were enrolled in the Department of Neurology of Shandong University Qilu Hospital from March 2017 to October 2019.The general data of patients were collected including their gender,age,past medical history,clinical manifestations,course of disease,body mass index(BMI),etc.,the patients’ motor symptoms,sleep,emotion,neuropsychiatric symptoms and other non-motor symptoms were evaluated.The assessment scale includes Movement Disorder Society Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Hoehn Yahr stage,self-perceived burden scale score,Parkinson’s disease sleep scale(PDSS),Epworth sleepiness scale(ESS),Neuropsychiatric Inventory(NPI),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD).According to the diagnostic criteria of fragmented sleep and the statistics of fragmented sleep in PDSS scale,the patients with fragmented sleep were evaluated.Zarit Caregiver Burden Interview(ZBI)was used to assess the burden of caregivers.Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors on the caregiver burden.At the same time,128 patients were divided into the elderly group and the young and middle-aged group according to their age,and the related influencing factors of caregiver burden of the elderly group and the young and middle-aged group were further studied.Results1.In this study,there were 105 patients in the early stage of Parkinson’s disease,accounting for 82%,and 23 patients in the middle and late stage of Parkinson’s disease,accounting for 18%.The average hoeHN-YAHR grade was(1.98±0.71),and the average hoeHN-YAHR grade was(2.17±0.77)in the elderly group and(1.87±0.65)in the young and middle-aged group.UPDRS III scores averaged(30.66± 15.07)points,including(34.30± 16.11)points in the elderly group and(28.56±14.10)points in the young and middle-aged groups.It is suggested that the severity of disease is more severe in the elderly than in the young and middle-aged groups.The average score of ZBI in this study was(23.19± 16.61),of which 3 1.3%are lightly burdened,15.6%are moderately burdened and 4.7%are heavily burdened.It is suggested that about half of caregivers of PD patients bear a mild to moderate burden.2.Among the neuropsychiatric symptoms,irritability is the most common neuropsychiatric symptom in patients with Parkinson’s disease,followed by depression,anxiety and hallucinations.Irritability is the most severe symptom.Nocturnal behavior is the symptom with the highest frequency and the highest degree of distress for caregivers.3.Single factor analysis results of caregiver burdenThere were statistically significant differences between segmented sleep,disease course,HY stage,UPDRSⅢ,self-perceived burden,Hamilton Anxiety Scale score,Hamilton depression Scale score,Parkinson’s disease sleep Scale(PDSS)score,Epworth sleepiness Scale score,neuropsychiatric burden score and ZBI score.4.Multiple linear regression analysis of caregiver burden① Multiple linear regression analysis shows that,Caregiver burden and self-perceived burden(B=0.786,P<0.001),caregiver neuropsychiatric questionnaire distress(B=0.640,P=0.005),fragmented sleep(B=4.937,P=0.030)and HY staging(B=3.147,P=0.032)were positively correlated.②There was no correlation between caregiver burden and HAMD(B=0.177,P=0.332),PDSS score(B=-0.005,P=0.891),ESS score(B=0.062,P=0.720).5.Multiple linear regression analysis of caregiver burden in older adultsMultiple linear regression analysis showed that caregiver burden was positively correlated with self-perceived burden(B=1.266,P<0.001)and caregiver distress degree of neuropsychiatric questionnaire(B=0.802,P=0.036).6.Multiple linear regression analysis of caregiver burden in middle-aged and young adultsMultiple linear regression analysis showed that caregiver burden was positively correlated with self-perceived burden(B=0.625,P<0.001)and fragmented sleep(B=5.855,P=0.033).Conclusion1.About half of PD patients’ caregivers suffer mild-to-moderate burden;2.Irritability is the most common neuropsychiatric symptom in PD patients,followed by depression,anxiety and hallucinations.Irritability is the most severe symptom.Nocturnal behavior is the symptom with the highest frequency and the highest degree of distress to caregivers.3.Self-perceived burden,caregivers’ neuropsychiatric distress,fragmented sleep and HY stage are the independent influencing factors of caregiver burden of PD patients;4.Self-perceived burden and caregiver neuropsychiatric questionnaire distress are influencing factors for caregiver burden of PD patients in the elderly group;5.Self-perceived burden and fragmented sleep are influencing factors for caregivers of PD patients in young and middle-aged groups.