Erschöpfung und Überlastung pflegender Angehöriger von Krebspatienten in der palliativen Situation

 

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Zusammenfassung

Pflegende Angehörige von häuslich versorgten Palliativpatienten wurden zu 2 Messzeitpunkten befragt. Es wurden u. a. Symptome von Erschöpfung und Überlastung (Copenhagen Burnout Inventory, CBI) sowie Daten zur Belastung durch die Pflegesituation (Häusliche Pflegeskala, HPS-10) erhoben. Die körperliche und emotionale Erschöpfung der Angehörigen nahm im Pflegeverlauf zu, unabhängig von Alter, Geschlecht, Bildung und Religion. Pflegende Partner sowie Angehörige mit finanziellen Belastungen durch die Pflegesituation waren erschöpfter und überlasteter als andere Pflegende. Das Konstrukt „Erschöpfung und Überlastung“ war eng mit psychischer Belastung, Lebensqualität und Kohärenzsinn verbunden. Ein psychologisches Unterstützungsangebot für pflegende Angehörige sollte fester Bestandteil der ambulanten Palliativversorgung sein. Weiterhin ist es wichtig, dass zu Beginn der häuslichen Versorgung die finanzielle Situation mit dem Angehörigen besprochen wird, um bei Bedarf an geeignete Unterstützungsstellen verweisen zu können.

Abstract

Family caregivers of terminal ill cancer patients receiving home based palliative care were interviewed at 2 measurement points. Symptoms of exhaustion and overload (Copenhagen Burnout Inventory, CBI) and caregiver burden (German version of the “Burden Scale for Family Caregivers“, BSFC-10) were assessed. The physical and emotional exhaustion of the family caregivers increased over the time of care, regardless of age, gender, education and religion. Caring partners as well as caregivers with financial burden due to the care situation were more exhausted and overloaded than other caregivers. The construct “exhaustion and overload” was closely associated with psychological distress, quality of life and sense of coherence. Offering psychological support for family caregivers should be an integral part of outpatient palliative care. Furthermore it is important to discuss the financial situation of family caregivers at the beginning of home care and refer them to appropriate support services if needed.

• Literatur

• 1 Backes GM, Amrhein L, Wolfinger M. Gender in der Pflege. Herausforderungen für die Politik. Bonn: Friedrich-Ebert-Stiftung; 2011
  Google Scholar
• 2 Köhler N, Perner A, Anders D et al. Gesundheitsbezogene Lebensqualität und Pflegebelastung von Angehörigen palliativer Tumorpatienten in häuslicher Versorgung. Psychother Psychosom Med Psychol 2012; 62: 157-162
  Article in Thieme ConnectPubMedGoogle Scholar
• 3 Cora A, Partinico M, Munafo M et al. Health risk factors in caregivers of terminal cancer patients: a pilot study. Cancer Nurs 2012; 35: 38-47
  CrossrefPubMedGoogle Scholar
• 4 Ross S, Mosher CE, Ronis-Tobin V et al. Psychosocial adjustment of family caregivers of head and neck cancer survivors. Support Care Cancer 2010; 18: 171-178
  CrossrefPubMedGoogle Scholar
• 5 Asai M, Akechi T, Nakano T et al. Psychiatric disorders and background characteristics of cancer patients’ family members referred to psychiatric consultation service at National Cancer Center Hospitals in Japan. Palliat Support Care 2008; 6: 225-230
  PubMedGoogle Scholar
• 6 Akechi T, Akizuki N, Okamura M et al. Psychological distress experienced by families of cancer patients: preliminary findings from psychiatric consultation of a Cancer Center Hospital. Jpn J Clin Oncol 2006; 36: 329-332
  CrossrefPubMedGoogle Scholar
• 7 Pitceathly C, Maguire P. The psychological impact of cancer on patients’ partners and other key relatives: a review. Eur J Cancer 2003; 39: 1517-1524
  CrossrefPubMedGoogle Scholar
• 8 Zapf D, Seifert C, Schmutte B et al. Emotion work and job stressors and their effects on burnout. Psychol Health 2001; 16: 527-545
  CrossrefPubMedGoogle Scholar
• 9 Hagedoorn M, Sanderman R, Bolks HN et al. Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychol Bull 2008; 134: 1-30
  CrossrefPubMedGoogle Scholar
• 10 Nijboer C, Tempelaar R, Triemstra M et al. The role of social and psychologic resources in caregiving of cancer patients. Cancer 2001; 91: 1029-1039
  CrossrefPubMedGoogle Scholar
• 11 Borritz M, Bultmann U, Rugulies R et al. Psychosocial work characteristics as predictors for burnout: Findings from 3-year follow up of the PUMA study. J Occup Environ Med 2005; 47: 1015-1025
  CrossrefPubMedGoogle Scholar
• 12 Schaufeli WB, Greenglass ER. Introduction to special issue on burnout and health. Psychol Health 2001; 16: 501-510
  CrossrefPubMedGoogle Scholar
• 13 Zapf D. Emotion work and psychological well-being: a review of the literature and some conceptual considerations. Hum Resour Manage Rev 2002; 12: 237-268
  CrossrefPubMedGoogle Scholar
• 14 Morais HC, Soares AM, Oliveira AR et al. Burden and modifications in life from the perspective of caregivers for patients after stroke. Rev Lat Am Enfermagem 2012; 20: 944-953
  CrossrefPubMedGoogle Scholar
• 15 Nübling M, Stößel U, Hasselhorn H-M et al. Methoden zur Erfassung psychischer Belastungen Bremerhaven: Wirtschaftsverlag NW (Schriftenreihe der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin) 2005;
  PubMed
• 16 Kristensen TS, Borritz M, Villadsen E et al. The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work and Stress 2005; 19: 192-207
  CrossrefPubMedGoogle Scholar
• 17 Maslach C, Jackson SE. Maslach Burnout Inventory manual. Second edition Palo Alto, CA: Consulting Psychologists Press; 1986
  Google Scholar
• 18 Gräßel E, Leutbecher M. Häusliche-Pflege-Skala HPS zur Erfassung der Belastung bei pflegenden oder betreuenden Personen. Ebersberg: Vless Verlag; 1993
  Google Scholar
• 19 Herrmann C, Buss U, Snaith RP. HADS-D, Hospital Anxiety and Depression Scale – deutsche Version. Bern: Hans Huber; 1995
  Google Scholar
• 20 Aaronson NK, Ahmedzai S, Bergman B et al. The European Organiza­tion for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85: 365-376
  CrossrefPubMedGoogle Scholar
• 21 Schumacher J, Wilz G, Gunzelmann T et al. Die Sense of Coherence Scale von Antonovsky. Teststatistische Überprüfung in einer repräsentativen Bevölkerungsstichprobe und Konstruktion einer Kurzskala. Psychother Psychosom Med Psychol 2000; 50: 472-482
  Article in Thieme ConnectPubMedGoogle Scholar
• 22 Schumacher J, Gunzelmann T, Brähler E. Deutsche Normierung der Sense of Coherence Scale von Antonovsky. Diagnostica 2000; 46: 208-213
  CrossrefPubMedGoogle Scholar
• 23 Kim Y, Carver CS, Rocha-Lima C et al. Depressive symptoms among caregivers of colorectal cancer patients during the first year since diagnosis: a longitudinal investigation. Psychooncology 2013; 22: 362-367
  PubMedGoogle Scholar
• 24 Siminoff LA, Wilson-Genderson M, Baker Jr S. Depressive symptoms in lung cancer patients and their family caregivers and the influence of family environment. Psychooncology 2010; 19: 1285-1293
  CrossrefPubMedGoogle Scholar
• 25 Östlund U, Wennman-Larsen A, Persson C et al. Mental health in significant others of patients dying from lung cancer. Psychooncology 2010; 19: 29-37
  CrossrefPubMedGoogle Scholar
• 26 Oechsle K, Goerth K, Bokemeyer C et al. Symptom burden in palliative care patients: perspectives of patients, their family caregivers, and their attending physicians. Support Care Cancer 2013; 21: 1955-1962
  CrossrefPubMedGoogle Scholar
• 27 Perz J, Ussher JM, Butow P et al. Gender differences in cancer carer psychological distress: an analysis of moderators and mediators. Eur J Cancer Care (Engl) 2011; 20: 610-619
  CrossrefPubMedGoogle Scholar
• 28 Chai H, Guerriere D, Zagorski B et al. The magnitude, share and determinants of unpaid care costs for home-based palliative care service provision in Toronto, Canada. Health Soc Care Community 2013; 22: 30-39
  PubMedGoogle Scholar
• 29 Guerriere DN, Zagorski B, Fassbender K et al. Cost variations in ambulatory and home-based palliative care. Palliat Med 2010; 24: 523-532
  CrossrefPubMedGoogle Scholar