Sherman Deborah W, McGuire Deborah B, Free David, Cheon Joo Young
University of Maryland School of Nursing, Baltimore, Maryland, USA.
University of Maryland School of Nursing, Baltimore, Maryland, USA.
J Pain Symptom Manage. 2014 Sep;48(3):385-99.e1-2. doi: 10.1016/j.jpainsymman.2013.09.006. Epub 2013 Dec 2.
Pancreatic cancer presents a wide spectrum of significant symptomatology. The high symptom burden, coupled with a rapidly fatal diagnosis, limits preparation or time for adjustment for both patients and their family caregivers. From the initial diagnosis and throughout the illness experience, the physical and emotional demands of caregiving can predispose caregivers themselves to illness and a greater risk of mortality. Understanding the negative and positive aspects of caregiving for patients with advanced pancreatic cancer will inform interventions that promote positive caregiver outcomes and support caregivers in their role.
To provide feasibility data for a larger, mixed methods, longitudinal study focused on the experience of family caregivers of patients with advanced pancreatic cancer and preliminary qualitative data to substantiate the significance of studying this caregiver population.
This was a mixed methods study guided by the Stress Process Model. Eight family caregivers of patients with advanced pancreatic cancer from oncology practices of a university-affiliated medical center were surveyed.
The pilot results supported the ability to recruit and retain participants and informed recruitment and data collection procedures. The qualitative results provided preliminary insights into caregiver experiences during the diagnosis and treatment phases. Key findings that substantiated the significance of studying these caregivers included the caregiving context of the history of sentinel symptoms, the crisis of diagnosis, the violation of assumptions about life and health, recognition of the circle of association, and contextual factors, as well as primary and secondary stressors, coping strategies, resources, discoveries, gains and growth, associated changes/transitions, and unmet caregiver needs.
Findings indicated caregivers' willingness to participate in research, highlighted the negative and positive aspects of the caregiver experience, and reinforced the significance of the future study and the need to develop interventions to support family caregivers in their roles.
胰腺癌呈现出广泛的严重症状。高症状负担,再加上快速致命的诊断,限制了患者及其家庭照顾者进行准备或调整的时间。从最初诊断到整个疾病经历过程中,照顾的身体和情感需求可能使照顾者自身易患疾病并面临更高的死亡风险。了解晚期胰腺癌患者照顾的消极和积极方面将为促进照顾者获得积极结果并支持照顾者履行其职责的干预措施提供依据。
为一项更大规模的、混合方法的纵向研究提供可行性数据,该研究聚焦于晚期胰腺癌患者家庭照顾者的经历,并提供初步的定性数据以证实研究这一照顾者群体的重要性。
这是一项以压力过程模型为指导的混合方法研究。对来自一所大学附属医疗中心肿瘤科室的8名晚期胰腺癌患者的家庭照顾者进行了调查。
试点结果支持了招募和留住参与者的能力,并为招募和数据收集程序提供了信息。定性结果对诊断和治疗阶段照顾者的经历提供了初步见解。证实研究这些照顾者重要性的关键发现包括前哨症状史的照顾背景、诊断危机、对生活和健康假设的违背、对关联圈子的认识、背景因素,以及主要和次要压力源、应对策略、资源、发现、收获和成长、相关变化/转变以及未满足的照顾者需求。
研究结果表明照顾者愿意参与研究,突出了照顾者经历的消极和积极方面,并强化了未来研究的重要性以及开发干预措施以支持家庭照顾者履行其职责的必要性。