BACKGROUND:The trend of patients who are invasively ventilated to prefer home care is one that benefits both the patient and the health care system. However, this assumes a role for patients' family members to become informal caregivers. OBJECTIVE:To explore the impact of caring for a ventilator-assisted individual on informal caregivers. METHODS:A descriptive design with semistructured caregiver interviews and the Caregiver Burden Inventory were used. Participants were informal caregivers of a family member with a progressive neuromuscular disease on invasive ventilation for at least six months. Transcript coding was performed and regularly reviewed, and recruitment continued until data saturation. Qualitative analysis was based on 'thematic analysis'. RESULTS:A total of 21 caregivers were interviewed. Five themes developed: a sense of duty; restriction of day-to-day life; physical and emotional burden; training and education; and the need for more paid support. Caregivers described a sense of duty to take care of loved ones, but suffered a significant restriction of their own time with a negative impact on their physical and mental health. The initial transfer home was highlighted as the most stressful part of the process. The Caregiver Burden Inventory scores supported a high level of burden: median 49 (interquartile range 39.5 to 53.0) of a maximum 96. CONCLUSION:Homecare for ventilator-assisted individuals with progressive neuromuscular disease causes significant burden to informal caregivers. Approaches to lessen this burden, such as increased paid care, improved professional support and respite care, may enable home ventilation to be a more sustainable modality of care.

译文

背景:有创通气的患者倾向于家庭护理的趋势是既有利于患者又有利于医疗保健系统的趋势。但是,这假定患者的家庭成员成为非正式的护理人员。
目的:探讨护理呼吸机辅助人员对非正式护理人员的影响。
方法:采用半结构照料者访谈和照料者负担量表的描述性设计。参加者为有创神经肌肉疾病家族成员的有创通气治疗,至少持续六个月。进行成绩单编码并定期进行审查,并继续招募直至数据饱和。定性分析基于“主题分析”。
结果:共采访了21名护理人员。形成了五个主题:责任感;责任感。限制日常生活;身心负担;培训和教育;以及需要更多有偿支持的需求。照顾者描述了照顾亲人的责任感,但是他们自己的时间受到了极大的限制,对他们的身心健康产生了负面影响。最初的转移家园是该过程中最紧张的部分。照顾者负担清单得分支持较高的负担水平:中位数49(四分位数范围为39.5至53.0),最高为96。
结论:对于进行性神经肌肉疾病的呼吸机辅助患者的家庭护理给非正式护理人员带来了沉重负担。减轻这种负担的方法,例如增加付费护理,改善专业支持和暂缓护理,可能使家庭通风成为一种更可持续的护理方式。

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