ABSTRACT
Resumen Los familiares de personas con enfermedad de Parkinson (EP) se enfrentan a una variedad de situaciones estresantes como consecuencia del desempeño de su rol de cuidadores. Esto puede tener un impacto negativo en su calidad de vida. Un mayor conocimiento de la relación entre las variables evaluadas en los cuidadores puede ser importante de cara a implementar programas de intervención eficaces. El objetivo fue explorar la personalidad y las estrategias de afrontamiento en familiares cuidadores de personas con EP, estudiando su relación con el malestar psicológico y el grado de implicación en los cuidados. Se trabajó con una muestra de 106 cuidadores que completaron los cuestionarios de personalidad NEO-FFI, estrategias de afrontamiento COPE-28, malestar psicológico CORE-OM y un instrumento para evaluar la implicación del cuidador realizado a partir del índice Katz. El análisis de regresión logística mostró que las personas con puntuaciones por encima de la media en neuroticismo y por debajo en el resto de factores de personalidad y estrategias de afrontamiento tenían más riesgo de padecer malestar psicológico (OR = 9.250; p < .001) y una menor implicación en los cuidados (OR = 4.125; p < .001). Estos resultados sugieren que la personalidad y las estrategias de afrontamiento pueden contribuir a identificar estilos para los cuidados más eficientes, que impliquen una mayor participación en los cuidados con un menor impacto negativo.
Abstract Carers of people with Parkinson's disease (PD) experience stressful situations as a result of performing their role as caregivers. This can have a negative outcome on their quality of life. A greater understanding of the relationship between the variables assessed in caregivers can be important in implementing effective intervention programs. The aim of this study was to explore the personality and coping strategies used by family caregivers of people with PD, analyzing their relationship with psychological distress and the carer involvement. A cross-sectional study based on a sample of 106 caregivers of people with Parkinson's disease tested the hypothesis that personality and coping strategies can contribute to identifying differences in carer involvement and psychological distress. Caregiver psychological distress was assessed using the CORE-OM questionnaire. The CORE-OM is able to distinguish the population within the clinical and non-clinical range. NEO Five-Factor Inventory (NEO-FFI) was used to assess personality. Coping strategies were evaluated with the COPE-28 inventory. An operational measure of the carer involvement was also used. For this purpose, an adaptation of the Katz index assessing basic functional capacity was made. Results: First, all cases were clustered according to personality variables and coping strategies. A K-means cluster analysis was performed and two groups were requested. After this, binary logistic regression analysis was used to test the research hypothesis. The resulting clusters in the above analysis were selected as predictors. Two analyses were performed. In the first, the dependent variable in logistic regression analysis was the psychological distress of the caregivers (dichotomized variable: clinical and non-clinical). Results showed that people clustered within cluster 1 had a 9.250 times higher risk of psychological distress than those included in cluster 2 (OR = 9.250; p < .001). In a second logistic regression analysis, the dependent variable was participation in care (dichotomized variable: low - high carer involvement). The group of people belonging to cluster 1 showed a carer involvement 4.125 times lower than the people grouped in cluster 2 (OR = 4.125; p < .001). The results of this research suggest the existence of a relationship between psychological variables and carer involvement, showing two different styles of care, which are described based on the personality and coping strategies of the family caregivers. In addition, we found that these styles of care show clear differences in efficiency, reflected in greater carer involvement and a lower psychological distress. The results reported that the cluster of people with below-average scores on neuroticism and above-average scores on the other personality factors (extraversion, openness to experience, agreeableness, and conscientiousness) and coping strategies (planning; active coping; emotional support; social support; positive re-evaluation and acceptance) were associated with increased carer involvement and reduced risk of psychological distress. It has already been suggested that high scores in neuroticism may affect the need to take on a large number of care-related tasks or manage stressful situations in people with PD (Tew et al., 2013). However, our results indicate that the definition of different types of caregivers, where other care-related variables are also included, can help define more efficient styles of care. This is associated with increased carer involvement and minor psychological distress. We propose that in the future these variables be investigated in order to know the outcome of carer involvement and psychological distress, contributing to the description of more efficient care styles in family caregivers.
ABSTRACT
In this letter to the editor, the author describes the implications of the dependency of Parkinson'spatients. With this text, the author aims to draw attention to the care needed by people living with thelimitations caused by Parkinson's disease. (AU)
En esta misiva al director, el autor describe las implicaciones que se derivan de la situación dedependencia de los pacientes con Parkinson. El autor con este texto precisa llamar la atención sobre loscuidados que necesitan las personas que viven con las limitaciones que les provoca esta enfermedad. (AU)
Nesta carta ao editor, o autor descreve as implicações da situação de dependência dos doentes deParkinson. Com este texto, o autor pretende chamar a atenção para os cuidados necessários às pessoasque vivem com as limitações causadas pela doença de Parkinson. (AU)
Subject(s)
Humans , Parkinson Disease/therapy , Caregivers , Burnout, PsychologicalABSTRACT
INTRODUCCIÓN Y OBJETIVO: Las enfermedades neurológicas son uno de los principales retos contemporáneos en las sociedades avanzadas. La enfermedad de Parkinson (EP) es una de las enfermedades neurológicas más frecuentes que provocan discapacidad. Constituye un problema de salud, asociado a una disminución de la autonomía personal. Provoca desequilibrios en el ámbito familiar, con un impacto negativo en la calidad de vida. Esta investigación se desarrolló con el propósito de identificar factores de riesgo asociados a la carga psicológica del cuidador. Sujetos y métodos: Estudio ex post facto prospectivo realizado con una muestra de 106 cuidadores de personas con EP avanzada, a los que se les administraron un cuestionario sociodemográfico, los inventarios NEO reducido de cinco factores I (personalidad) y COPE-28 (estrategias de afrontamiento), y una adaptación del índice de Katz para evaluar el grado de implicación del cuidador. Como variable dependiente se utilizó un instrumento diagnóstico estructurado (Clinical Outcomes in Routine Evaluation, Outcome Measure). RESULTADOS: El análisis de regresión múltiple identificó como factores de riesgo el neuroticismo alto; la mala salud percibida del cuidador; la mayor implicación en los cuidados; las estrategias de afrontamiento desadaptativas; y la discapacidad de la persona con EP. Por su parte, las estrategias de afrontamiento adaptativas y el tiempo como cuidador podrían actuar como factores de protección. El modelo resultante explica el 57,1% de la varianza del malestar psicológico del cuidador. CONCLUSIONES: Estos resultados contribuyen a explicar por qué algunas personas se adaptan mejor que otras a la carga de los cuidados. Los hallazgos resaltan la importancia de identificar las variables que influyen en la calidad de la atención a las personas con EP avanzada
INTRODUCTION AND OBJECTIVES. Neurological diseases are one of the main contemporary challenges in advanced societies. Parkinsons disease (PD) is one of the most common neurological diseases causing disability. It is a health problem associated with a decrease in personal autonomy. It causes an imbalance in family functioning, with a negative impact on quality of life. The objective was to identify risk factors associated with the psychological burden of the caregiver. SUBJECTS AND METHODS. Prospective ex post facto research conducted with a sample of 106 caregivers of persons with PD, who were administered a socio-demographic questionnaire, the NEO-FFI (personality) and COPE-28 (coping strategies) inventories, and an adaptation of the Katz index to assess involvement in care. A structured diagnostic instrument (CORE-OM) was used as a dependent variable. RESULTS. Multiple regression analysis identified high neuroticism; poor caregiver perception of health; poor caregiver perception of health; non-adaptive coping strategies; and PD disability as risk factors. In turn, adaptive coping strategies and caregiver time may act as protective factors. The resulting model explains 57.1% of the variance in caregiver psychological distress. CONCLUSIONS. These results help explain why some people adapt better than others to the burden of care. The findings highlight the importance of identifying the variables that influence the quality of care for people with this disease
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Caregivers/psychology , Stress, Psychological/etiology , Stress, Psychological/psychology , Parkinson Disease , Prospective Studies , Risk Factors , Surveys and Questionnaires , Analysis of Variance , Personality Inventory , Protective FactorsSubject(s)
Biofeedback, Psychology , Caregivers , Hypertension/therapy , Cost of Illness , Female , Humans , Middle AgedSubject(s)
Female , Humans , Middle Aged , Biofeedback, Psychology , Caregivers , Hypertension/therapy , Cost of IllnessABSTRACT
La innovación en los servicios sanitarios afronta retos en cuanto a la generación de alternativas eficaces para las crecientes necesidades de la población, así como el desarrollo de metodologías para su evaluación. El propósito de éste estudio fue determinar el retorno social de la inversión (SROI) de un tratamiento psicológico basado en la evidencia. Se llevó a cabo el análisis de un programa de intervención psicológica con un diseño que incluía medidas pre/postratamiento y un grupo control. Como resultado se obtuvo un impacto social positivo: cada euro invertido ofreció un retorno social neto de 2.98€. En conclusión, puede decirse que el SROI puede ofrecer información sobre el impacto social provocado por las intervenciones clínicas, determinando los rendimientos tangibles obtenidos con la inversión
Innovation in health care services generates the development of new initiatives. Research should focus on the development of methodologies that allow the evaluation of interventions and determine the true impact they have. The purpose of this study was to determine the social return of investment (SROI) of a health treatment. An analysis of a psychological intervention program was carried out with a design that included pre/post-treatment measures and control group. As results, a positive social impact was obtained. Each monetary unit spent offered a net social return of 2.98. In conclusion, SROI can offer information about the social impact caused by health care interventions, determining the tangible return obtained with the investment
