Grimm P M, Zawacki K L, Mock V, Krumm S, Frink B B
St. Joseph Medical Center, Towson, Maryland, USA.
Cancer Pract. 2000 May-Jun;8(3):120-8. doi: 10.1046/j.1523-5394.2000.83005.x.
This longitudinal, descriptive outcomes study was conducted to compare the emotional responses and needs of the caregivers of patients who undergo bone marrow transplantation (BMT) for hematologic malignancies, as observed in an inpatient/outpatient (IPOP) setting with those in an inpatient setting.
A convenience sample of 43 caregivers for patients undergoing either autologous or allogeneic BMT was selected from both the inpatient unit (n = 26) and the IPOP ambulatory setting (n = 17). Emotional responses were measured by the Profile of Mood States. The importance and satisfaction of informational, patient-care, and psychological needs were assessed with the Caregiver Needs Survey, a modified version of the Home Cancer Caregiver Needs Survey. Data were collected at six points across the BMT trajectory, from before the procedure to 12 months after. Descriptive statistics were used to report sample characteristics, emotional responses, and needs. Nonparametric statistics were used to compare the IPOP and inpatient caregiver groups, and to identify relationships between emotional responses and needs within groups.
IPOP caregivers were found to have significantly less mood disturbance at points before discharge. Both groups showed a decrease in mood disturbance 6 and 12 months after BMT. IPOP caregivers had higher levels of satisfaction of their informational and psychological needs at day 21. Significant correlations between total mood disturbance and satisfaction of informational, psychological, and patient-care needs were found for inpatient caregivers across treatment time points.
These findings support the IPOP model of care as being less emotionally distressing for and better meeting the needs of family caregivers. Specific implications for practice include the importance of caregiver education in the area of patient-care information and of assessment and intervention to meet caregiver psychological needs. Continued evaluation of the impact of changes in care delivery on family caregivers is essential for the provision of comprehensive cancer care.
本纵向描述性结局研究旨在比较血液系统恶性肿瘤患者接受骨髓移植（BMT）时，住院/门诊（IPOP）环境下与住院环境下患者照料者的情绪反应和需求。
从住院部（n = 26）和IPOP门诊环境（n = 17）中选取了43名接受自体或异基因BMT患者的照料者作为便利样本。通过情绪状态剖面图测量情绪反应。使用照料者需求调查问卷（家庭癌症照料者需求调查问卷的修订版）评估信息、患者护理和心理需求的重要性及满意度。在BMT过程的六个时间点收集数据，从手术前到术后12个月。使用描述性统计报告样本特征、情绪反应和需求。使用非参数统计比较IPOP和住院照料者组，并确定组内情绪反应与需求之间的关系。
发现IPOP照料者在出院前各时间点的情绪困扰明显较少。两组在BMT后6个月和12个月时情绪困扰均有所下降。IPOP照料者在第21天时对信息和心理需求的满意度较高。在整个治疗时间点，住院照料者的总体情绪困扰与信息、心理和患者护理需求满意度之间存在显著相关性。
这些发现支持IPOP护理模式对家庭照料者而言情绪困扰较小且能更好地满足其需求。对实践的具体启示包括在患者护理信息领域进行照料者教育以及进行评估和干预以满足照料者心理需求的重要性。持续评估护理模式变化对家庭照料者的影响对于提供全面的癌症护理至关重要。
