Schumacher Karen L, Stewart Barbara J, Archbold Patricia G
College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198-5330, USA.
Nurs Res. 2007 Nov-Dec;56(6):425-33. doi: 10.1097/01.NNR.0000299852.75300.03.
Family caregiving researchers have explored the moderating or stress-buffering effects of variables such as coping and social support. However, the quality of the family caregiver-patient relationship and preparedness for caregiving have received little attention as potential moderators.
To explore whether relationship quality and preparedness moderate the effects of caregiving demand on caregiver outcomes during cancer treatment.
Eighty-seven family caregivers of patients receiving treatment for cancer completed the Demand and Difficulty subscales of the Caregiving Burden Scale, Mutuality and Preparedness Scales of the Family Care Inventory, and the short form of the Profile of Mood States. Using hierarchical multiple regression analyses, caregiving difficulty and total mood disturbance were regressed on two- and three-way interaction terms for demand, mutuality, and preparedness, controlling for caregiver age and gender, and the simple effect of each independent variable.
Negligible effects for two-way interactions were found. However, the three-way interaction between demand, mutuality, and preparedness explained statistically significant variance in both perceived difficulty of caregiving and total mood disturbance. High mutuality in combination with high preparedness protected caregivers from adverse outcomes when demand was high. When either mutuality or preparedness was low, caregivers were at greater risk for negative outcomes when demand was high, but not when demand was low. When both mutuality and preparedness were low, caregivers were at risk for mood disturbance even when demand was low.
Analysis of three-way interactions provided new theoretical insights into the protective effects of mutuality and preparedness and demonstrated conditions under which caregivers are at increased risk for negative outcomes.
家庭照护研究人员探讨了应对方式和社会支持等变量的调节或压力缓冲作用。然而,家庭照护者与患者关系的质量以及照护准备情况作为潜在调节因素却很少受到关注。
探讨关系质量和准备情况是否会调节癌症治疗期间照护需求对照护者结局的影响。
87名正在接受癌症治疗患者的家庭照护者完成了照护负担量表的需求和困难分量表、家庭照护量表的相互性和准备情况量表以及情绪状态剖面图简表。使用分层多元回归分析,将照护困难和总体情绪困扰分别对需求、相互性和准备情况的双向及三向交互项进行回归分析,同时控制照护者的年龄和性别以及每个自变量的简单效应。
未发现双向交互作用有显著影响。然而,需求、相互性和准备情况之间的三向交互作用在照护的感知困难和总体情绪困扰方面均解释了具有统计学意义的方差。当需求较高时,高相互性与高准备情况相结合可保护照护者免受不良结局的影响。当相互性或准备情况较低时,需求较高时照护者出现负面结局的风险更大,但需求较低时则不然。当相互性和准备情况都较低时,即使需求较低,照护者也有情绪困扰的风险。
对三向交互作用的分析为相互性和准备情况的保护作用提供了新的理论见解,并证明了照护者出现负面结局风险增加的条件。