Study On The Care Burden And Its Influencing Factors Of Primary Caregivers Of Patients With Parkinson’s Disease

Background:Parkinson’s disease(PD)is the second most common neurodegenerative disorder.The incidence of PD is increasing worldwide due to industrialization and aging population.With the continuous loss of dopaminergic neurons in the substantia nigra,patients with PD will develop motor and non-motor symptoms,resulting in motor function impairment,mental and emotional disorders,cognitive impairment.Due to the lack of definitive treatment for the disease,such symptoms will be increasingly aggravated and patients will become dependent on others for care.Relatives of patients usually serve as caregivers to provide support and help.However,heavy and long-term care tasks are likely to place a heavy burden on caregivers and affect their physical and mental well-being,which in turn has a negative impact on the effectiveness and endurance of family care.In the past,people paid attention to the management and support of patients instead of caregivers.With the increasing understanding of disease burden,the international community has gradually begun to focus on related situation of caregivers of PD.However,domestic related research started late with few research on the burden of caregivers of PD.In a bid to provide effective support to caregivers,it is of great significance to explore caregivers’burden and related influencing factors.Objective:This study aims to inquire about the burden of PD caregivers and analyze related influencing factors,so as to provide theoretical support for the measures to reduce the burden of PD caregivers.Methods:In this study,68 pairs of PD patients and caregivers in the first affiliated Hospital of Nanchang University were included with general data of both parties being collected.Patients were assessed for motor and non-motor symptoms.Motor symptoms were assessed with Movement Disorder Society Unified Parkinson’s Disease Rating Scale part III(MDS-UPDRS-Ⅲ)and Hoehn and Yahr(H&Y)stage.Activities of Daily Living(ADL)was assessed with Barthel index scale.Non-motor symptoms were assessed with Mini Mental State Examination(MMSE),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and Fatigue Severity Scale(FSS).Caregivers’burden was assessed with Zarit Caregiver Burden Interview(ZBI).Results:(1)68 caregivers had a median ZBI score of 32.5(17.25,49.75).Female caregivers accounted for 60.3%of all caregivers.61.8%of caregivers were spouses of patients.The average age of the caregivers was younger than that of the patients;(2)The ZBI score was positively correlated with the age,course of disease,equivalent dose of levodopa,degree of motor disorder,anxiety,depression,fatigue of PD patients and the total care time of caregivers,and negatively correlated with the MMSE score and ADL score.(P<0.05);(3)Factors that enter into the multiple linear regression model include MDS-UPDRS-III,ADL and Fatigue.The adjusted R~2=0.856(F=36.638,P<0.05).The model can explain 85.6%variation of ZBI.Conclusion:Caregivers of PD patients shoulder care burden of different degrees,which deserve the attention of all sectors of society.Such burden is correlated with many factors,in which the degree of motor disorder,ADL and fatigue are the influencing factors of caregiver burden.