ABSTRACT
Background: Parkinson disease (EPI) patients often require being assisted by others. These caregivers are exposed to a decrease in their quality of Ufe. Aim: To explore Parkinson disease patient features associated with a greater burden among their caregivers. Material ana Methods: Fifty one patients with Parkinson disease (aged 67 ± 12years, 29 men, with 8 ± 5years of disease) and their caregivers, were studied. Patients were assessed with the Unified Parkinson Disease Rating Scale III, the Hoehn & Yahr stage standardization, Parkinson s minimental test, the neurop-sychiatric inventory and the Beck Depression Inventory (IDB). The Zarit Burden Interview (ESZ) was applied to caregivers. Results: According to IDB, 45% of patients whose caregiverspresented little or no burden had a depression, compared to 78% of those whose caregivers had modérate or intense burden. (p < 0.01). The ESZ score of caregivers correlated significantly with Parkinson patients' age, IDB and axial involvement in the UPDRS-III (correlation coefficients ofOAp < 0.01, 0.6p < 0.01 and 0.46p < 0.01, respectively). Conclusions: Motor alterations, cognitive impairment and most importantly depression of patients with Parkinson disease are deteminants of burden for their caregivers.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Caregivers/psychology , Cost of Illness , Depression/psychology , Parkinson Disease/nursing , Caregivers/statistics & numerical data , Depression/epidemiology , Psychiatric Status Rating Scales , Quality of Life/psychology , Surveys and Questionnaires , Risk FactorsABSTRACT
The International Classification of Functioning, Disability, and Health (ICF) aims to supply a reliable, standardized and common language that can be applied in different cultures allowing a description of human functioning and disability, using a universal view of disability. It belongs to a group of classifications from the World Health Organization providing an integral approach to the patient. It establishes a paradigm which approaches the problems of the patient linking the different components of functionality in a circular way where one system influences others, with mutual relationships between them. The model is established with two main parts: the first part includes the functioning and disability with two components a) body structure and function and b) activities and participation. The second part includes the so called contextual factors with two components c) environmental factors and d) personal factors. Each part is divided in domains and these in structures giving a branched structure to the classification. The usefulness of this classification is multiple. It can be used in various disciplines and also across them. It looks for providing a scientific basis for the understanding and study of health and the states related to it, to improve communication among users, such as health professionals, investigators, designers of health policies, and general population, including disabled people. It allows the comparison of data between countries, sanitary disciplines, services, and different periods of time. It gives a system of codification to be applied in the systems of sanitary information and clinical practice.
La actual Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud también conocida como CIF, tiene como objetivo aportar un lenguaje común, fiable, estandarizado y aplicable transculturalmente, que permita describir el funcionamiento humano y la discapacidad, utilizando una visión universal de la discapacidad. Forma parte de la familia de clasificaciones de la organización mundial de la salud que proporcionan un marco conceptual uniforme de clasificación. La mayor virtud de esta clasificación es que provee un abordaje integral del paciente, estableciendo un paradigma que aborda la problemática de los pacientes enlazando los diferentes componentes de la funcionalidad en forma circular donde un sistema influye sobre el otro, implicándose e imbricándose entre ellos. El Modelo se establece en dos grandes partes: la primera que agrupa el Funcionamiento y Discapacidad con dos componentes (a) Funciones y Estructuras Corporales y (b) Actividades y Participación. Una segunda parte en que se agrupan los llamados Factores Contextuales con dos componentes (c) Factores Ambientales y (d) Factores Personales. A su vez cada constructo es dividido en dominios y estos en constructos, dando una estructura arborifera a la clasificación. Las utilidades de esta clasificación son múltiples: puede ser utilizada en varias disciplinas y transectorialmente; busca proporcionar una base científica para la comprensión y el estudio de la salud y los estados relacionados con ella y establecer un lenguaje común para describir la salud y los estados relacionados con ella; para mejorar la comunicación entre distintos usuarios, tales como profesionales de la salud, investigadores, diseñadores de políticas sanitarias y la población general, incluyendo a las personas con discapacidades; permitir la comparación de datos entre países, entre disciplinas sanitarias, entre los servicios, y en diferentes momentos a lo largo del tiempo; proporcionar un esquema de codificación sistematizado para ser aplicado en los sistemas de información sanitaria y en la practica clinica.