Kim Youngmee, Wellisch David K, Spillers Rachel L, Crammer Corinne
Behavioral Research Center, American Cancer Society, Atlanta 30303, USA.
Support Care Cancer. 2007 Dec;15(12):1367-74. doi: 10.1007/s00520-007-0265-4. Epub 2007 May 22.
This study examined the effects of the survivor's cancer type (gender-specific vs nongender-specific) and the female caregiver's spirituality and caregiving stress on the caregiver's psychological distress. Cancer caregivers, who were nominated by cancer survivors, participated in a nationwide quality-of-life survey with 252 caregivers providing complete data for the variables.
Breast and ovarian cancer were categorized as gender-specific types of cancer (GTC+), whereas kidney, lung, non-Hodgkin's lymphoma (NHL), and skin melanoma cancers were GTC-. Spirituality, caregiving stress, and psychological distress were measured using the functional assessment of chronic illness therapy--spiritual well-being, stress overload subscale, and profile of mood states--short form, respectively.
Hierarchical regression analyses revealed that female caregivers whose care recipient was diagnosed with a nongender specific type of cancer (GTC- group) reported higher psychological distress than did the GTC+ group. The GTC- group also reported lower spirituality and higher caregiving stress related to higher psychological distress than did the GTC+ group. In addition, the beneficial effect of spirituality on reducing psychological distress was more pronounced among the GTC- group or when caregiving stress increased.
Our findings suggest that female caregivers of survivors with a nongender-specific cancer may benefit from programs designed to reduce their psychological distress, and caregivers who are low in spirituality need help to derive faith and meaning in the context of cancer care.
本研究考察了幸存者的癌症类型(性别特异性与非性别特异性)以及女性照料者的精神性和照料压力对其心理困扰的影响。由癌症幸存者提名的癌症照料者参与了一项全国性的生活质量调查,其中252名照料者提供了关于这些变量的完整数据。
乳腺癌和卵巢癌被归类为性别特异性癌症类型(GTC+),而肾癌、肺癌、非霍奇金淋巴瘤(NHL)和皮肤黑色素瘤则为GTC-。精神性、照料压力和心理困扰分别使用慢性病治疗功能评估——精神健康、压力过载分量表和情绪状态剖面图——简表进行测量。
分层回归分析显示,照料对象被诊断为非性别特异性癌症类型的女性照料者(GTC-组)报告的心理困扰高于GTC+组。与GTC+组相比,GTC-组在心理困扰方面也表现出较低的精神性和较高的照料压力。此外,精神性对减轻心理困扰的有益作用在GTC-组或照料压力增加时更为明显。
我们的研究结果表明,患有非性别特异性癌症幸存者的女性照料者可能会从旨在减轻其心理困扰的项目中受益,而精神性较低的照料者在癌症照料背景下需要帮助以获得信念和意义。