| Objective1.To explore the current situation of caregivers' burden and its main influencing factors in patients with HD during induction period,and to analyze the correlation between caregiver burden and quality of life.2.To explore the current situation of caregivers' burden and its main influencing factors in patients with MHD,and to analyze the correlation between caregiver burden and quality of life.3.The similarities and differences of caregiver burden,influencing factors and quality of life of caregivers during the induction period and maintenance hemodialysis were analyzed and compared.MethodThis study is a cross-sectional descriptive study.From September 2018 to December 2019,patients and caregivers of hemodialysis outpatients and inpatients in the Blood purification Center of the first affiliated Hospital of Zhengzhou University were selected.This study adopts the way of questionnaire survey,including the general situation questionnaire of patients and their caregivers,Caregiver Burden Inventory(CBI),36 Medical Outcomes Study Healthy Status Short Form(SF-36).The collected data were analyzed by IBM SPSS Statistics 21.0 statistical software.The general condition of patients and caregivers is described by descriptive analysis,and continuous data such as age are expressed by(mean ± standard deviation).Occupation,education level and other classified variables such as adoption rate,constituent ratio and so on.T-test was used for comparison between the two groups,one-way ANOVA was used for comparison between groups,counting data was expressed as percentage,and comparison between groups was compared with Chi-2 test.The factors affecting the burden of caregivers were determined by multiple linear regression analysis.Spearman correlation analysis was used to study the correlation among factors.The test standard is a=0.05.ResultsA total of 585 samples were collected,including 267 induction hemodialysis patients and their caregivers,and 318 maintenance hemodialysis patients and caregivers.1.HD caregivers during induction period:(1)Of the 267 caregivers,16(6.1%)indicated no burden,92(34.3%)indicated moderate burden,and 159(59.6%)showed a high level of burden.The scores of caregivers' burden was time-dependent(10.82±5.02),limited development(4.79±2.67),physical burden(15.93±3.25),social burden(9.01±3.97)and affective burden(2.15±2.73).(2)The factors that influence the caregiver's burden include:caregiver's age,occupation,cultural background,marital status,number of children,living area,daily care time,impact of dialysis on economy,family per capita monthly income,relationship with patients,understanding of hemodialysis.The influencing factors of patients' characteristics on caregivers' burden include age,frequency of dialysis,number of complications and hemoglobin.Multiple linear regression analysis showed that the significant influencing factors on caregiver burden were caregiver gender,family per capita monthly income,daily care time,and knowledge of hemodialysis.The regression equation model F=12.588 P=0.000,which showed that the fitting equation was statistically significant(P<0.05),and R2=0.403 showed that the dependent variable could be selected into the independent variable to explain 40.3%.(3)The quality of life of caregivers was lower than that of the general population.The average physiological function dimensions of quality of life of caregivers were(74.20±6.99),physiological function(73.10±36.12),physical pain(65.38±16.13),general health(53.08±16.45),vitality(42.37±25.74),social function(78.11±27.36),emotional function(43.63±36.63),mental health(42.65±27.45).(4)The results of Spearman correlation analysis showed that there was a significant negative correlation between the total score of caregiver burden and the total score of quality of life(r=-0.545,P=0.000),and there was also a significant negative correlation between all dimensions of caregiver burden and quality of life.2.Maintenance hemodialysis caregiver(1)Of the 318 caregivers,185(58.1%)had high burden,126(39.6%)had moderate burden,and 7(2.3%)had no burden.Scores of caregiver burden dimensions:time dependence(4.72±2.60);development limitation(2.34±2.76);physical burden(16.20±3.21);social burden(11.64±4.63);emotional burden(9.49±4.24).(2)The factors that influence the caregiver's burden include age,nationality,occupation,education,marital status,living area,impact of dialysis on economy,family per capita monthly income,medical payment method,relationship with patients,number of patients involved in care,length of care per day,and understanding of hemodialysis.The influencing factors of patients' characteristics on caregivers' burden include age,frequency of dialysis,number of complications and hemoglobin.Multiple linear regression analysis showed that the significant influencing factors on caregiver burden were gender,family per capita monthly income,daily care time and the number of patient complications.The regression equation model:F=21.343,P=0.000,which showed that the fitting equation was statistically significant(P<0.05).R2=0.000 showed that the dependent variable could be selected to explain 49.1%of the independent variable.(3)The quality of life of caregivers was lower than that of the general population.The average score of physiological function dimension of quality of life of caregivers was(80.38±10.23),physiological function(74.53±36.18),physical pain(81.06±21.92),overall health(52.09±15.18),vitality(39.86±27.02),social function(75.79±28.33),emotional function(39.81±31.48),mental health(40.50±28.43).(4)The results of Spearman correlation analysis showed that there was a significant negative correlation between the total score of caregiver burden and the total score of quality of life(r=-0.569,P=0.000),and there was a significant negative correlation between all dimensions of caregiver burden and quality of life.3.There was no significant difference in the caregiver burden(t=1.864,P=0.067)and quality of life(t=0.785,P=0.469)among different hemodialysis stages.Conclusion1.The main factors affecting the burden of hemodialysis caregivers during the induction period were gender of caregivers,lack of knowledge,per capita monthly income and daily care time.2.The main factors affecting the burden of maintenance hemodialysis caregivers are the gender of the caregivers,the per capita monthly income of the family,the time of daily care and the number of complications of patients.3.There was a negative correlation between caregiver burden and quality of life in induction period and maintenance stage.The greater the burden of caregivers,the lower the quality of life.4.The burden and quality of life of caregivers in the induction stage and maintenance stage are similar.We should pay more attention to the caregivers while paying attention to the maintenance hemodialysis patients,especially the caregivers in the induction stage. |
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