Caregiver Burden Characteristics and Influencing Factors in Conservative Treatment of Adolescent Idiopathic Scoliosis
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摘要:
目的 探究青少年特发性脊柱侧凸保守治疗患者的主要照顾者照顾负荷情况及影响因素，为临床工作者采取针对性的措施减轻照顾者负荷提供科学依据。 方法 采用横断面调查研究方法，纳入2021年12月至2022年7月在四川大学华西医院就诊符合条件的青少年特发性脊柱侧凸保守治疗患者及其主要照顾者各56例。采用自编问卷调查患者及其照顾者的一般资料；采用照顾者负荷量表（CBI）评估照顾者的照顾负担；采用一般自我效能量表（GSES）评估照顾者的自我效能；使用伯特-索伯恩海姆压力水平问卷-支具（BSSQ-Brace）及压力水平问卷-畸形（BSSQ-Deformity）调查患者穿戴支具及对自己体象的感受；测量并收集患者主弯Cobb角度数。使用SPSS 23.0对所有数据进行统计分析，对一般资料和问卷调查结果采用描述性统计，多变量分析用于评估与照顾者负担相关的因素。 结果 保守治疗6个月后，患者主弯的平均矫正度数为（7.13±5.64）°；主要照顾者的CBI评分为（26.52±10.79）分，多元线性回归分析结果显示其影响因素为GSES评分和BSSQ-Brace评分（R2 = 0.194，F = 7.602， P < 0.01）。 结论 青少年脊柱侧凸患者在保守治疗期间其主要照顾者具有不同程度的压力负担增加，主要与照顾者自我效能和患者接受支具治疗时的压力感受相关。 -
关键词:
- 青少年特发性脊柱侧凸 /
- 保守治疗 /
- 照顾负担
Abstract:Objective The purpose of this study was to investigate the care burden and influencing factors of the primary caregivers for patients with adolescent idiopathic scoliosis （AIS） treated conservatively, and to explore the correlation between care burden and various factors. The results were expected to provide evidence to clinicians for taking targeted measures to reduce the burden of caregivers and improve the quality of medical care. Methods A total of 56 eligible AIS patients and their primary caregivers were enrolled from West China Hospital of Sichuan University from December 2021 to July 2022. The demographic characteristics of patients and their caregivers were surveyed by self-designed questionnaires; the caregiver burden was assessed by the Caregiver Burden Scale （CBI）; the self-efficacy of the caregivers was assessed by the General Self-Efficacy Scale （GSES）. The Sobernheim Stress Level Questionnaire-Brace （BSSQ-Brace） and Stress Level Questionnaire-Deformity （BSSQ-Deformity） were used to investigate the patients’ feelings about wearing the brace and their body image. The Cobb angles of the patient’s main curve were measured and collected. SPSS 23.0 was used for statistics analysis. Descriptive statistics were used for analysing the general information and questionnaire results, and multiple linear regression was used to explore the main influencing factors of caregiver burden. Results After conservative treatment, the mean correction of the patient’s main curve was 7.13±5.64°; the CBI score of the primary caregiver was 26.52±10.79, and the multiple linear regression results showed that the influencing factors were GSES score and BSSQ-Brace score （R2 = 0.194, F = 7.602, P < 0.01）. Conclusions AIS patients have different degrees of increased burden on their primary caregivers during conservative treatment, and the influencing factors significantly related to self-efficacy of the caregivers and patients’ feelings about wearing the brace. -
表 1 患者及照顾者基本信息
Table 1. Basic information about patients and caregivers
项目 组别 n 构成比（%） 性别 男 8 14.3 女 48 85.7 在读情况 小学 6 10.7 初中 32 57.1 高中 18 32.1 住校情况 走读 38 67.9 住校 18 32.1 Cobb角初评度数 20°～45° 54 96.4 45°及以上 2 3.6 主要照顾者 父亲 14 25.0 母亲 42 75.0 家庭情况 双亲（且共同居住） 48 85.7 其他（单亲/分居等） 8 14.3 
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表 2 CBI各维度评分[n = 56，（
$\bar x \pm s $ ）]Table 2. Scores on different dimensions of the CBI scale [n = 56，（
$\bar x \pm s $ ）]维度 评分（分） 时间依赖性负荷 6.09 ± 3.28 发展受限性负荷 3.38 ± 2.52 身体性负荷 3.39 ± 1.75 社交性负荷 7.16 ± 3.76 情感性负荷 6.50 ± 3.37 负荷总分 26.52 ± 10.79
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表 3 CBI影响因素分析[n = 56，（
$\bar x \pm s $ ）]Table 3. Analysis of influencing factors of CBI [n = 56，（
$\bar x \pm s $ ）]因素 n CBI评分（分） t/F P 患者性别 男 8 27.13 ± 14.25 0.206 0.837 女 48 26.27 ± 10.25 矫正效果 有效 37 25.03 ± 9.25 −1.336 0.187 不显效 19 29.05 ± 13.07 在读情况 小学 6 25.50 ± 5.92 0.035 0.965 初中 32 26.69 ± 12.45 高中 18 26.17 ± 8.99 住校情况 住校 18 25.50 ± 8.02 −0.424 0.673 走读 38 26.82 ± 11.90 照顾者身份 父亲 14 30.50 ± 10.53 1.677 0.099 母亲 42 25.02 ± 10.69 家庭情况 双亲（且共同居住） 48 25.67 ± 10.74 −1.431 0.158 其他（单亲/分居等） 8 31.50 ± 10.24
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表 4 照顾者负担的多元线性回归分析（n = 56）
Table 4. Multiple linear regression analysis of caregiver burden （n = 56）
因素 偏回归系数b 标准误 标准回归系数β t P 常量 61.471 9.511 6.463 < 0.001* BSSQ-Brace −1.074 0.398 −0.334 −2.697 < 0.001* GSES总分 −0.672 0.304 −0.273 −2.210 0.031* 校正R2 = 0.194，DW = 1.807，F = 7.602；*P < 0.05。
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