Bachner Yaacov G, Yosef-Sela Nili, Carmel Sara
Author Affiliations: Department of Public Health and the Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
Cancer Nurs. 2014 Jan-Feb;37(1):50-8. doi: 10.1097/NCC.0b013e31827b5c7a.
Studies document that caregivers face severe difficulties in communicating with their loved ones about both illness and death. To date, a paucity of studies has examined caregiver-patient communication at the end of life within the context of ethnic origin.
This study compares the level of open communication between caregivers from 2 ethnic groups and examines the contribution of different caregiver characteristics and situational variables to the explanation of open communication.
A total of 77 spouse caregivers of terminally ill cancer patients (comprising 41 Jews of Sephardi origin and 36 Jews of Ashkenazi origin) participated in the study. The questionnaire included measures of caregiver communication, caregiver characteristics (ie, age, gender, education level, optimism, self-efficacy), and situational variables (ie, duration and intensity of care).
Spouses of Ashkenazi origin communicated more with their loved ones about illness and death compared with their Sephardi counterparts. Ethnic origin accounted for 16.6% of the explained variance, caregiver characteristics added 20.3%, and situation variables lent a modest contribution of 3.5%. Four variables emerged as significant predictors of caregivers' level of open communication: self-efficacy (β = .33, P < .05), gender (β = .32, P < .01), ethnic origin (β = .25, P <.05), and duration of care (β = .20, P < .05).
These findings demonstrate the importance of ethnic origin to caregivers' open communication with terminal cancer patients about illness and death. Moreover, communication level with patients is mostly explained by the caregiver characteristics.
Caregiver characteristics should be considered by nurses when developing intervention programs for increasing caregivers' level of open communication with dying patients.
研究表明，在与亲人谈论疾病和死亡方面，照顾者面临着严重困难。迄今为止，在种族背景的背景下，很少有研究探讨临终时照顾者与患者之间的沟通情况。
本研究比较了两个种族的照顾者之间的开放沟通水平，并探讨了不同照顾者特征和情境变量对开放沟通解释的贡献。
共有77名晚期癌症患者的配偶照顾者（包括41名西班牙裔犹太人及36名阿什肯纳兹犹太人）参与了本研究。问卷包括照顾者沟通、照顾者特征（即年龄、性别、教育水平、乐观主义、自我效能感）及情境变量（即照顾时长及强度）的测量。
与西班牙裔照顾者相比，阿什肯纳兹裔配偶与亲人就疾病和死亡进行的沟通更多。种族背景占解释变异的16.6%，照顾者特征增加了20.3%，情境变量贡献了适度的3.5%。四个变量成为照顾者开放沟通水平的显著预测因素：自我效能感（β = 0.33，P < 0.05）、性别（β = 0.32，P < 0.01）、种族背景（β = .25，P < 0.05）及照顾时长（β = 0.20，P < 0.05）。
这些发现表明种族背景对于照顾者与晚期癌症患者就疾病和死亡进行开放沟通的重要性。此外，与患者的沟通水平大多由照顾者特征来解释。
护士在制定干预计划以提高照顾者与临终患者的开放沟通水平时，应考虑照顾者特征。
