Woudstra, D.J. (Dyane) (2016) Mantelzorgers van patiënten op een geheugenpolikliniek: de subjectieve belasting en een analyse naar risicofactoren voor overbelasting. thesis, Medicine.
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Abstract
Abstract Objective The aim of this study was to determine the degree of subjective informal caregiver burden at the patients first visit to a memory clinic and to identify factors correlating with this burden and therefore increase the risk of overburdening. Methods This was a retrospective, cross-sectional study, investigating the subjective burden of informal carers. Various clinical and demographic data of the patients visiting the memory clinic of Medical Centre Leeuwarden for the first time were collected from May 2013 to January 2016 trough a search of the patients medical record and included into a database. Among these data were the scores of the questionnaire on informal burden (based on the Zarit Burden Interview, ZBI), which was the outcome measure, and the Dutch Informant Questionnaire on Cognitive Decline in the Elderly (IQ-CODE-N), both completed by the informal caregiver escorting the patient. Caregiver characteristics and their relationship to the patient were also included in the database. With these data the prevalence of heavy- and overburdening, and associations between factors and subjective burden were investigated. To examine an association between the risk factors and higher burden, univariable and multivariable binary logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs). Results 466 dyads of patients and their informal carer were included in the analysis. Prevalence of a more than average burden (ZBI score ≥ 46) was almost 12% in this population, with 3,9% of all carers experiencing a ‘high’ burden. ADL-dependence (OR: 2.35; 95% CI: 1.04-5.34), presence of neuropsychiatric symptoms (OR: 2.99; 95% CI: 1.32-6.78), duration of symptoms in months (OR: 1.01; 95% CI: 1.00-1.02), anosognosia by the patient (OR: 2.72; 95% CI: 1.05-7.08), hearing problems (OR: 2.60; 95% CI: 1.14-5.95) and risk of falling by the patient (OR: 7.97; 95% CI: 1.57-40.44) significantly increased the risk of a higher burden. In case of a dementia diagnosis with CDR classification after first consultation, a CDR of 2 or 3 (OR: 4.52; 95% CI: 1.55-13.19) and longer duration of the symptoms (OR:1.02; 95% CI: 1.00-1.03) increased the risk of a heavy burden. Conclusion Visiting the memory clinic for the first time, some informal caregivers experienced considerable burden. A prolonged presence of cognitive impairment and resultant symptoms are associated with higher burden. A more severe dementia is also a risk factor for high burden. By identifying characteristics that increased subjective burden, a better risk assessment can be made to identify even in an early stage who will benefit from extra help and guidance to prevent potential overburdening.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Hempenius, dr. L. and klinisch geriater and Locatie onderzoek: Klinische Geriatrie, Medisch Centrum Leeu |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:57 |
| Last Modified: | 25 Jun 2020 10:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1786 |
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