Abstract |
Demographic and epidemiological change has led to an aging population and an
increase in those suffering from chronic health problems. Infections are still the
leading cause of death. The consequence of the above is the increase in the number of
people in need of care (PNC). In addition to the formal caregivers of established
health structures (FC) there are also informal caregivers (IC). The latter are relatives,
friends, neighbors or professionals who are paid for their services. But not only PNCs,
but also ICs are vulnerable. Caregiver burden has been associated with the ability to
perform simple and specialized activities of daily living (ADLs, iADLs) from PNC.
Caregiving can cause tension and depression in ICs by affecting the immune system
and making them vulnerable to infections. Protection against vaccine-preventable
diseases (VPDs) is important for both IC and PNC, either directly or through the
“cocooning” strategy. The Formal Caregivers (FC) interacts with the PNC-IC dyad.
The present cross-sectional observational study was conducted in an area of Crete
where the population has easy access to the health structures of all levels of the public
health system, but also to the private sector. The study involved 141 ICs tasked with
caring for 141 PNCs in a one-to-one match. The majority of ICs are women (75.9%),
people up to 60 years old (61.2%) and 43.8% have completed basic education. Of the
141 ICs, 71 (52.6%) do not have any profession. Regarding chronic diseases, 15.7%
report DM, 27% CAD, 9.2% PD and 10.6% RD. Of the PNCs, the majority belong to
the 75-90 age group (43.4%). Of the 141, 31 (22.3%) are fully dependent on IC. The
dyad vaccination rates for influenza, pneumococcal, herpes zoster, SARS-CoV-2,
tetanus, and hepatitis vaccines were recorded for ICs 69.7%, 50.8%, 22.6%, 91.3%, 38.8% and 34.4% respectively. The corresponding percentages for PNC were 89%,
77.1%, 31.9%, 92%, 17.2% and 21.9%. Of the ICs who have not been vaccinated with
one or more vaccines, the reason given was that they were not informed (22.2%), that
they did not have time (1.9%), that they neglected it (25.9%) and that they did not
considered it important (27.8%). Ninety seven (71.9%) of the ICs receive consultation
about their health from the same professional from whom they receive instructions on
PNC. These ICs were better vaccinated for pneumococcal disease (p=0.023).
Additionally the median value of vaccination between them and those who do not
receive health consultation was statistically significant (p=0.035). The PNCs of these
caregivers were better vaccinated against pneumococcus (p=0.049) and against
SARS-CoV-2 (p=0.041). The difference in median values was also statistically
significant (p=0.013). The role of the sensible and educated health professional in
promoting the health of the PNC-IC dyad through vaccination is confirmed. There is
also the need to turn the health system to the dyad through better interaction with the
FC, with a tool for recording both the vaccination of adults and this vulnerable group
of the population.
|