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首页> 外文期刊>The American journal of hospice and palliative care >Who's caring for whom? Differing perspectives between seriously ill patients and their family caregivers.
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Who's caring for whom? Differing perspectives between seriously ill patients and their family caregivers.

机译：谁照顾谁？重病患者及其家庭护理人员之间的观点不一致。

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Although clinicians and researchers often rely on family members 'reports of a wide range of dying patients' symptoms and care preferences, available data indicate divergences between the two. We used a national sample to analyze patient-caregiver pairs to explore areas of concordance and nonconcordance about physical symptoms, communication with physicians, caregiving needs, and future fears. We also assessed whether identifiable patient or caregiver characteristics were associated with nonconcordance. Our data were from a national, random sample of 988 terminally ill patients, of whom 893 had caregivers who were also interviewed. Frequencies and types of nonconcordance were computed for patient-caregiver pairs. Bivariate associations between patient and caregiver reports on each item were tested. Logistic and conditional logistic regression analyses assessed multiple predictors of nonconcordance for each item. Primary diagnoses included cancer (51.1 percent), heart disease (17. 7 percent), chronic obstructive pulmonary disease (10. 7 percent), and other diseases (20.5 percent). The proportion of concordant reports among pairs of patients and caregivers ranged from 53 percent to 66 percent. Among pairs showing nonconcordant responses, caregivers reported higher levels of pain and disability than patients, lower caregiving needs, and different fears about the future. Few demographic or clinical predictors were associated with nonconcordance. Concordance between patients 'and their caregivers' responses ranged widely, and there were important areas of nonconcordant responses. When responses differed, patients were more likely to express concern about domains that might impose on caregivers, while caregivers were more likely to express concern about patients 'physical suffering. Consistent sociodemographic or clinical predictors of nonconcordant responses were not found. These data suggest important ways that patient and caregiver reports of the same experience vary.
机译：尽管临床医生和研究人员经常依靠家庭成员的报告“许多垂死患者的症状和护理偏爱，但现有数据表明两者之间存在分歧。我们使用了一个全国样本来分析患者-护理人员对，以探索在身体症状，与医生的沟通，护理需求以及未来的恐惧方面一致和不一致的领域。我们还评估了可识别的患者或护理人员特征是否与不一致性相关。我们的数据来自988名绝症患者的全国随机样本，其中893名护理人员也接受了采访。计算了患者护理人员对的频率和不一致性类型。测试了每个项目的患者和护理人员报告之间的双变量关联。逻辑和条件逻辑回归分析评估了每个项目的多个不一致性预测因素。初步诊断包括癌症（51.1％），心脏病（17.7％），慢性阻塞性肺疾病（10.7％）和其他疾病（20.5％）。在成对的患者和护理人员中，一致报告的比例从53％到66％不等。在表现出不一致反应的对中，护理人员报告的疼痛和残疾水平高于患者，护理需求较低，并且对未来的担忧不同。很少有人口统计学或临床预测因素与不一致性相关。患者“和他们的照护者”反应之间的一致性差异很大，并且存在重要的非一致性反应领域。当回答不同时，患者更有可能对可能施加给护理人员的领域表示担忧，而护理人员则更可能对患者的身体痛苦表示担忧。找不到一致的社会人口统计学或临床指标的非一致反应。这些数据表明了患者和护理人员对相同经历的报告发生变化的重要方式。

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