Department of Pediatrics, McMaster University, ON, Canada.
Int J Cancer. 2011 Sep 1;129(5):1190-8. doi: 10.1002/ijc.25737. Epub 2010 Dec 17.
Research with parents of children with cancer has identified factors related to their adjustment and coping, but it is not fully understood why some parents do well and others do not. Guided by a stress process model, we examined the interrelationships among a comprehensive set of factors to identify the most important determinants of health-related quality of life (HRQoL) in parents of children in active treatment for cancer. A cross-sectional survey of 411 parents (80% response rate) of children receiving cancer treatment in Canada was conducted between November 2004 and February 2007. The following constructs were measured: background and context factors, child characteristics, family-centered service delivery, caregiver strain, intrapsychic factors, coping/supportive factors and parental HRQoL. The model was evaluated using structural equation modeling. Analysis was stratified by time since diagnosis (i.e., <12 months and ≥12 months). For those within 12 months of their child's diagnosis, family-centred service provision, caregiver strain, and self-perception accounted for 58% of the variation in psychosocial health, whereas caregiver strain and social support explained 50% of the variation in physical health. For parents in the >12 month group, caregiving strain was the only factor with a direct relationship with parental psychosocial and physical health, accounting for 66% and 55% of the variance in these constructs, respectively. Our findings reinforce the need for health professionals to be particularly attuned to family caregivers in the early stages of treatment and identify potential areas for interventions to promote parental health.
对癌症患儿父母的研究已经确定了与他们的适应和应对相关的因素，但为什么有些父母适应得好，而有些父母则不然，还不完全清楚。本研究以压力过程模型为指导，考察了一整套因素之间的相互关系，以确定儿童癌症治疗期父母健康相关生活质量（HRQoL）的最重要决定因素。2004 年 11 月至 2007 年 2 月期间，在加拿大对 411 名正在接受癌症治疗的儿童的父母（80%的回复率）进行了横断面调查。该研究测量了以下结构：背景和环境因素、儿童特征、以家庭为中心的服务提供、照顾者压力、内在心理因素、应对/支持因素和父母 HRQoL。使用结构方程模型评估模型。分析按诊断后时间（即<12 个月和≥12 个月）进行分层。对于那些在孩子诊断后 12 个月内的父母，以家庭为中心的服务提供、照顾者压力和自我认知占心理社会健康变化的 58%，而照顾者压力和社会支持解释了身体变化的 50%健康。对于诊断后>12 个月的父母，照顾者压力是与父母心理和身体健康直接相关的唯一因素，分别占这些结构的 66%和 55%。我们的研究结果强调了卫生专业人员在治疗早期特别关注家庭照顾者的必要性，并确定了促进父母健康的潜在干预领域。
