【論文紹介】One-Year Outcomes in Caregivers of Critically Ill Patients

投稿者: | 2016-06-21

N Engl J Med. 2016 May 12;374(19):1831-41. doi: 10.1056/NEJMoa1511160.
One-Year Outcomes in Caregivers of Critically Ill Patients.

ICUで人工呼吸を行っていた患者の介護者について、介護うつの発症割合について調べた論文です。
患者側の因子で相関が認められたものはなく、介護者側の因子でうつの発症割合が規定されたのは興味深い結果です。

レターを投稿してみましたが、採択には至らなかったため、掲載致します。
Discussion部分についてのコメントに留まるため、掲載には難しい内容でした。

Cameron et al. 1 reported high prevalence of depressive symptoms among caregivers of critically ill patients, indicating that it was more prevalent compared with those of dementia patients.2 However, caution is needed in interpreting the comparison of these studies. First, the age of caregivers should be taken into account in comparing the prevalence. More depressive symptoms in caregivers were significantly associated with younger caregiver age in the study, whereas the result was opposite in the latter. In addition, the opposite effect of caregiver age on depressive symptoms indicates that the characteristics of care activities that impose a burden on caregivers may differ depending on diseases. For example, previous studies show that invasive care such as tracheostomy care was a risk factor for depression among caregivers of critically ill patients3, while noninvasive but time-consuming care such as care for behavioral disturbances was a risk factor for that of dementia patients.4 Thus, it is important to consider the characteristics of the care activities when preventing caregivers from developing depressive symptoms.

1. Cameron JI, Chu LM, Matte A, et al. One-Year Outcomes in Caregivers of Critically Ill Patients. N Engl J Med 2016;374:1831-41.
2. Covinsky KE, Newcomer R, Fox P, et al. Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of general internal medicine 2003;18:1006-14.
3. Van Pelt DC, Milbrandt EB, Qin L, et al. Informal caregiver burden among survivors of prolonged mechanical ventilation. American journal of respiratory and critical care medicine 2007;175:167-73.
4. Clyburn LD, Stones MJ, Hadjistavropoulos T, Tuokko H. Predicting caregiver burden and depression in Alzheimer’s disease. The journals of gerontology Series B, Psychological sciences and social sciences 2000;55:S2-13.

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