Burton Allison M, Haley William E, Small Brent J, Finley Margaret R, Dillinger-Vasille Marie, Schonwetter Ronald
Center for Health Services Research in Primary Care, Durham VAMC/Duke University Medical Center, Durham, North Carolina 27705, USA.
Palliat Support Care. 2008 Jun;6(2):149-58. doi: 10.1017/S1478951508000230.
The current literature on caregiving and bereavement indicates that the relationship between these two common life events is complex and needs to be further studied in order to gain a more comprehensive understanding of their interaction.
In the current project, 50 spouses of hospice patients with end-stage lung cancer or dementia were assessed while caregiving and at an average of 4 months after the death on a variety of measures, including caregiving stressors, appraisals, social resources, and well-being. A stress process model was utilized in order to examine which preloss factors were associated with postloss depression, life satisfaction, and grief.
Our results indicated that patient diagnosis (cancer or dementia) and caregiver appraisals (stressfulness of functional impairment and positive aspects of caregiving) were not predictors on any of our well-being outcomes. However, fewer months caregiving was a significant predictor of both higher depression and grief postloss. Additionally, lower levels of social activities, smaller social networks, and lower satisfaction with social support were significantly associated with higher postloss depression.
Results support both the resource depletion and anticipatory grief hypotheses and suggest that short-term bereavement outcomes are different than factors that predict well-being while caregiving. Future studies should address whether long-term bereavement outcomes differ by baseline caregiving characteristics to guide intervention research.
当前关于照护与丧亲之痛的文献表明，这两种常见生活事件之间的关系复杂，需要进一步研究，以便更全面地理解它们之间的相互作用。
在当前项目中，对50名患有晚期肺癌或痴呆症的临终关怀患者的配偶在照护期间以及平均在患者死亡后4个月时进行了多种测量评估，包括照护压力源、评估、社会资源和幸福感。采用压力过程模型来检验哪些丧亲前因素与丧亲后的抑郁、生活满意度和悲伤情绪相关。
我们的结果表明，患者诊断（癌症或痴呆症）和照护者评估（功能损害的压力程度和照护的积极方面）并非我们任何幸福感指标的预测因素。然而，照护的月数越少，丧亲后抑郁和悲伤情绪越高的显著预测因素。此外，社交活动水平较低、社交网络较小以及对社会支持的满意度较低与丧亲后较高的抑郁情绪显著相关。
结果支持资源耗竭假说和预期性悲伤假说，并表明短期丧亲结果与预测照护期间幸福感的因素不同。未来的研究应探讨长期丧亲结果是否因基线照护特征而异，以指导干预研究。
