Major Abdominal Cerrahi Sonrası Yaşlı Hastalarda Bakıcı Depresyonu ve Yükü, Kötü Fonksiyonel Sonuçlarla İlişkilidir

Öz

Giriş: Bu çalışma, major abdominal cerrahi geçiren yaşlı hastaların bakıcılarında bakıcı yükü ile depresyon arasındaki ilişkiyi araştırmayı ve bunun hastanın ameliyat sonrası fonksiyonel durumu ile ilişkisini değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Tek merkezli olarak yürütülen bu kesitsel çalışmada, 65 hasta-bakıcı çifti dâhil edildi. Hasta fonksiyonel durumu Katz İndeksi ve Lawton-Brody Enstrümantal Günlük Yaşam Aktiviteleri (IADL) Ölçeği kullanılarak değerlendirildi. Bakıcı yükü Zarit Bakıcı Yükü Ölçeği ile, depresyon ise Beck Depresyon Envanteri (BDI) kullanılarak ölçüldü. Olayın etkisi (IES-R) ve yaşam kalitesi (SF-36) verileri de toplandı. Değişkenler arasındaki korelasyonlar Spearman'ın sıra korelasyon katsayısı kullanılarak değerlendirildi. Sonuç: Çalışmaya yaş ortalaması 58.9 ± 13.8 yıl olan bakıcılar ve yaş ortalaması 70.4 ± 5.8 yıl olan hastalar dâhil edildi. Bakıcıların yarısından fazlası (%50.8) BDI'ye göre şiddetli depresyon sergiledi. Bakım yükü ile depresyon arasında güçlü bir pozitif korelasyon bulundu (r = 0.53, p < 0.001). Orta veya şiddetli depresyonu olan bakıcılara sahip hastaların, depresyonu olmayan veya hafif depresyonu olan bakıcılara sahip hastalara kıyasla fonksiyonel durum skorları (Katz İndeksi, p < 0.001) anlamlı derecede düşüktü. Tartışma: Bulgularımız, bakıcı yükü ile depresyon arasında anlamlı bir pozitif ilişki olduğunu ve bunun da hastanın daha kötü fonksiyonel sonuçlarıyla ilişkili olduğunu ortaya koymaktadır. Bu sonuçlar, hem bakıcı hem de hasta sonuçlarını iyileştirmek için bu kırılgan bakıcı popülasyonu için kapsamlı psikolojik destek sistemlerinin uygulanmasının kritik ihtiyacının altını çizmektedir.

Anahtar Kelimeler

• Bakıcı yükü
• depresyon
• genel cerrahi
• yaşam kalitesi

Caregiver Depression and Burden are Associated with Poor Functional Outcomes in Elderly Patients Following Major Abdominal Surgery

Abstract

Aim: This study aimed to investigate the relationship between caregiver burden and depression in caregivers of elderly patients undergoing major abdominal surgery and to evaluate its association with the patient's postoperative functional status. Methods: In this cross-sectional study conducted at a single center, we enrolled 65 patient-caregiver dyads. Patient functional status was assessed using the Katz Index and the Lawton-Brody Instrumental Activities of Daily Living Scale (IADL). Caregiver burden was measured with the Zarit Caregiver Burden Scale, and depression was assessed using the Beck Depression Inventory (BDI). Data on event impact (IES-R) and quality of life (SF-36) were also collected. Correlations between variables were evaluated using Spearman's rank correlation coefficient. Results: The study included caregivers with a mean age of 58.9 ± 13.8 years and patients with a mean age of 70.4 ± 5.8 years. More than half of the caregivers (50.8%) exhibited severe depression according to the BDI. A strong positive correlation was found between caregiving burden and depression (r = 0.53, p < 0.001). Patients with moderately or severely depressed caregivers had significantly lower functional status scores (Katz Index, p < 0.001) compared to patients with non-depressed or mildly depressed caregivers. Conclusions: Our findings reveal a significant positive relationship between caregiver burden and depression, which in turn is associated with poorer patient functional outcomes. These results underscore the critical need for implementing comprehensive psychological support systems for this vulnerable caregiver population to improve both caregiver and patient outcomes.

Keywords

• Caregiver burden
• depression
• general surgery
• quality of life

Kaynakça

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