慢性病患者照护者照护积极度的研究进展及护理启示

doi:10.3761/j.issn.0254-1769.2025.18.020

摘要/Abstract

摘要：

慢性病患者照护者照护积极度强调照护者在管理患者健康状况和医疗需求时的主观能动性和准备程度。照护积极度高的照护者能够更有效地参与患者疾病管理，提升照护质量，同时对其自身心理健康及生活质量产生积极影响。该文围绕慢性病患者照护者照护积极度的概念和内涵、测量工具、现状、影响因素及提升策略进行综述，并提出对护理的启示，旨在为开展照护者照护积极度相关研究及实践探索提供参考。

关键词: 照护者, 患者, 积极度, 综述, 护理

Abstract:

Caregivers for chronic disease patients of caregiver activation emphasizes the subjective initiative and preparedness of caregivers in managing patients’ health conditions and medical needs. Caregivers with high activation levels can participate more effectively in disease management，significantly improve the quality of care，and have a positive impact on their own mental health and quality of life. This article reviews the concept，assessment tools，current situation，influencing factors，and intervention strategies of caregiver activation，and proposes future research directions，aiming to provide references for conducting research and practical exploration related to caregiver activation.

Key words: Caregiver, Patient, Activation, Review, Nursing Care

李军莉, 李培官, 侯延菊, 唐信强. 慢性病患者照护者照护积极度的研究进展及护理启示[J]. 中华护理杂志, 2025, 60(18): 2300-2305.

LI Junli, LI Peiguan, HOU Yanju, TANG Xinqiang. Research progress on caregivers for chronic disease patients of caregiver activation and nursing implica-tions[J]. Chinese Journal of Nursing, 2025, 60(18): 2300-2305.

参考文献 26

[1]	万胤辰, 王招娣, 吴坤, 等. 照顾能力干预方案在晚期肺癌患者家庭照顾者中的应用研究[J]. 中华护理杂志, 2024, 59(15):1824-1831. DOI
	Wan YC, Wang ZD, Wu K, et al. An applied study on a care ability intervention scheme for family caregivers of advanced lung cancer patients[J]. Chin J Nurs, 2024, 59(15):1824-1831. DOI
[2]	张荟钦, 刘腊梅, 魏志华, 等. 家庭照顾者对老年失智患者照护抗拒行为应对体验的质性研究[J]. 中华护理杂志, 2024, 59(23):2893-2899. DOI
	Zhang HQ, Liu LM, Wei ZH, et al. The experiences of family caregivers in dealing with care-resistant behaviors in elderly individuals with dementia:a qualitative study[J]. Chin J Nurs, 2024, 59(23):2893-2899.
[3]	Kim Y, Shaffer KM, Carver CS, et al. Quality of life of family caregivers 8 years after a relative’s cancer diagnosis:follow-up of the national quality of life survey for caregivers[J]. Psychoon-cology, 2016, 25(3):266-274.
[4]	Loh AZ, Tan JS, Zhang MW, et al. The global prevalence of anxiety and depressive symptoms among caregivers of stroke survivors[J]. J Am Med Dir Assoc, 2017, 18(2):111-116. DOI PMID
[5]	Hibbard JH, Stockard J, Mahoney ER, et al. Development of the Patient Activation Measure(PAM):conceptualizing and measur-ing activation in patients and consumers[J]. Health Serv Res, 2004, 39(4 Pt 1):1005-1026.
[6]	Parker T. Influence of caregiver activation on health of informal caregivers of persons with Alzheimer’s[D]. Portland: George Fox University, 2015.
[7]	Mausbach BT, Roepke SK, Chattillion EA, et al. Multiple me-diators of the relations between caregiving stress and depre-ssive symptoms[J]. Aging Ment Health, 2012, 16(1):27-38. DOI PMID
[8]	Graffigna G, Barello S, Bonanomi A. The role of Patient Health Engagement Model(PHE-model) in affecting patient activation and medication adherence:a structural equation model[J]. PLoS One, 2017, 12(6):e0179865.
[9]	Carleton-Eagleton K, Walker I, Gibson D, et al. Testing the va-lidation and reliability of the Caregiver-Patient Activation Mea-sure(CG-PAM)[J]. PEC Innov, 2022,1:100098.
[10]	Coleman EA, Ground KL, Maul A. The family caregiver activa-tion in transitions(FCAT) tool:a new measure of family care-giver self-efficacy[J]. Jt Comm J Qual Patient Saf, 2015, 41(11):502-507.
[11]	Gifford A, Green RK, Jacobsohn GC, et al. Scalar assessment of the family caregiver activation in transitions tool:an explo-ratory factor analysis[J]. J Gerontol Nurs, 2022, 48(12):35-42. DOI PMID
[12]	Pennarola BW, Rodday AM, Mayer DK, et al. Factors associa-ted with parental activation in pediatric hematopoietic stem cell transplant[J]. Med Care Res Rev, 2012, 69(2):194-214. DOI PMID
[13]	Pennarola BW, Rodday AM, Bingen K, et al. Changing factors associated with parent activation after pediatric hematopoietic stem cell transplant[J]. Support Care Cancer, 2015, 23(7):1997-2006. DOI PMID
[14]	Sadak T, Korpak A, Borson S. Measuring caregiver activation for health care:validation of PBH-LCI:D[J]. Geriatr Nurs, 2015, 36(4):284-292.
[15]	Borson S, Mobley P, Fernstrom K, et al. Measuring caregiver activation to identify coaching and support needs:extending MYLOH to advanced chronic illness[J]. PLoS One, 2018, 13(10):e0205153.
[16]	Sadak T, Wright J, Borson S. Managing your loved one’s health:development of a new care management measure for demen-tia family caregivers[J]. J Appl Gerontol, 2018, 37(5):620-643.
[17]	Bakker EM, Witkamp FE, Luu KLN, et al. Caregiver activation of relatives of patients with advanced cancer[J]. Eur J Cancer Care, 2022, 31(6):e13656.
[18]	Mazanec SR, Sattar A, Delaney CP, et al. Activation for health management in colorectal cancer survivors and their family caregivers[J]. West J Nurs Res, 2016, 38(3):325-344. DOI PMID
[19]	Tan CE, Hi MY, Azmi NS, et al. Caregiving self-efficacy and knowledge regarding patient positioning among Malaysian caregivers of stroke patients[J]. Cureus, 2020, 12(3):e7390.
[20]	Kessler D, Hauteclocque J, Grimes D, et al. Development of the integrated Parkinson’s care network(IPCN):using co-design to plan collaborative care for people with Parkinson’s disease[J]. Qual Life Res, 2019, 28(5):1355-1364.
[21]	Coller RJ, Lerner CF, Chung PJ, et al. Caregiving and confi-dence to avoid hospitalization for children with medical com-plexity[J]. J Pediatr, 2022,247:109-115.e2.
[22]	Robertson EG, Kelada L, Best S, et al. Quality of life in care-givers of a child with a developmental and epileptic ence-phalopathy[J]. Dev Med Child Neurol, 2024, 66(2):206-215.
[23]	Bender JL, Flora PK, Soheilipour S, et al. Web-based peer na-vigation for men with prostate cancer and their family care-givers:a pilot feasibility study[J]. Curr Oncol, 2022, 29(6):4285-4299.
[24]	Runaas L, Hanauer D, Maher M, et al. BMT roadmap:a user-centered design health information technology tool to promote patient-centered care in pediatric hematopoietic cell trans-plantation[J]. Biol Blood Marrow Transplant, 2017, 23(5):813-819.
[25]	Maher M, Hanauer DA, Kaziunas E, et al. A novel health information technology communication system to increase caregiver activation in the context of hospital-based pediatric hematopoietic cell transplantation:a pilot study[J]. JMIR Res Protoc, 2015, 4(4):e119.
[26]	Wittenberg E, Sullivan SS, Rios M. Improving dementia care-giver activation with a brief communication module[J]. Am J Hosp Palliat Care, 2024, 41(7):805-813.