Kozachik S L, Given C W, Given B A, Pierce S J, Azzouz F, Rawl S M, Champion V L
Walther Cancer Institute in Family Care Studies, Indianapolis, USA.
Oncol Nurs Forum. 2001 Aug;28(7):1149-57.
PURPOSE/OBJECTIVES: Determine the impact of a 16-week supportive nursing intervention on caregivers of patients with newly diagnosed cancer.
Randomized clinical trial.
Two midwestern cancer treatment sites.
Caregivers of newly diagnosed patients. Patients' mean age was 55.73 years; 55% had breast cancer, and 76% were female. Caregivers' mean age was 52.44 years, and 50% were female. 125 dyads consented to participate; 89 dyads completed the study.
A nursing intervention was delivered to the experimental group that emphasized symptom monitoring/management, education, emotional support, coordination of services, and caregiver preparation to care. Nurses made a total of nine contacts, five in person and four by telephone, over 16 weeks. Centers for Epidemiological Studies-Depression (CES-D) and a symptom inventory were used. Medical record audits were conducted retrospectively.
Patient and caregiver depression scores and patient symptom experience.
Baseline caregiver depression and the number of patient symptoms at baseline, 9, and 24 weeks were significant predictors of caregiver depression at 9 and 24 weeks. However, no main effect of the experimental condition existed on caregiver depression. At the final observation, a nonsignificant inverse relationship was found between the number of interventions and depression scores for caregivers.
The intervention appeared to be more effective in slowing the rate of deterioration of depressive symptoms than in decreasing levels of depression in this sample of caregivers. Determining the effectiveness of this intervention in decreasing caregiver depression was difficult because caregivers with higher levels of depression were more likely to withdraw from the study.
Nurses must be vigilant in monitoring caregivers for signs of depression and must intervene to provide emotional support and make appropriate referrals for follow-up care to promote positive outcomes for patients and caregivers.
目的/目标：确定一项为期16周的支持性护理干预对新诊断癌症患者的照顾者的影响。
随机临床试验。
两个中西部癌症治疗场所。
新诊断患者的照顾者。患者的平均年龄为55.73岁；55%患有乳腺癌，76%为女性。照顾者的平均年龄为52.44岁，50%为女性。125对参与者同意参与研究；89对完成了研究。
对实验组实施一项护理干预，该干预强调症状监测/管理、教育、情感支持、服务协调以及照顾者的护理准备。护士在16周内总共进行了9次接触，其中5次面对面，4次通过电话。使用了流行病学研究中心抑郁量表（CES-D）和症状清单。进行了回顾性病历审核。
患者和照顾者的抑郁评分以及患者的症状体验。
基线时照顾者的抑郁情况以及基线、第9周和第24周时患者的症状数量是第9周和第24周时照顾者抑郁的显著预测因素。然而，实验条件对照顾者的抑郁没有主要影响。在最后一次观察中，发现干预次数与照顾者的抑郁评分之间存在不显著的负相关关系。
在这个照顾者样本中，该干预在减缓抑郁症状恶化速度方面似乎比降低抑郁水平更有效。确定该干预在降低照顾者抑郁方面的有效性很困难，因为抑郁程度较高的照顾者更有可能退出研究。
护士必须警惕监测照顾者是否有抑郁迹象，必须进行干预以提供情感支持，并进行适当的后续护理转诊，以促进患者和照顾者的积极结果。
