Kim Youngmee, Shaffer Kelly M, Carver Charles S, Cannady Rachel S
Department of Psychology, University of Miami.
American Cancer Society.
J Consult Clin Psychol. 2014 Feb;82(1):1-8. doi: 10.1037/a0035116. Epub 2013 Dec 23.
Few studies address the longer term psychological adjustment of family caregivers who provide care to a relative with cancer. This study aimed to document levels of depressive symptoms among caregivers 5 years after their relative's initial diagnosis and to identify psychosocial factors that may prospectively predict caregivers' depressive symptoms at that time.
Cancer caregivers participated in a prospective longitudinal study (N = 416; mean age = 55, 65.4% female, 92.9% non-Hispanic White). Demographics and caregiving experiences were measured 2 years after their relative's cancer diagnosis at Time 1 (T1). Depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression scale (Radloff, 1977) at T1 and again at 5 years postdiagnosis (T2). By T2, caregivers had emerged into 3 groups: former caregivers whose recipients were now in remission, current caregivers, and bereaved caregivers.
Controlling for T1 depressive symptoms, T1 caregiving stress and lack of social support were both significant prospective predictors of greater depressive symptoms at T2 (ps < .02). Independently, bereaved caregivers reported the greatest depressive symptoms both prior to and after the relative's death. Those who were actively caregiving at T2 displayed the largest increase in depressive symptoms from T1 to T2 (p < .001).
The findings highlight the importance of caregiving stress and social support early in caregivership, even for outcomes that emerge 3 years later. Findings suggest that family members who are actively involved in cancer care at the 5-year mark may benefit from programs designed to improve their adjustment to long-term caregiving.
很少有研究探讨为癌症亲属提供护理的家庭照顾者的长期心理调适情况。本研究旨在记录照顾者在其亲属初次诊断后5年的抑郁症状水平，并确定可能前瞻性预测彼时照顾者抑郁症状的心理社会因素。
癌症照顾者参与了一项前瞻性纵向研究（N = 416；平均年龄 = 55岁，65.4%为女性，92.9%为非西班牙裔白人）。在其亲属癌症诊断后2年的时间1（T1）测量人口统计学和护理经历。在T1以及诊断后5年（T2）时，用流行病学研究中心抑郁量表（拉德洛夫，1977年）评估抑郁症状。到T2时，照顾者分为3组：接受者目前已缓解的 former 照顾者、现任照顾者和丧亲照顾者。
控制T1时的抑郁症状后，T1时的护理压力和缺乏社会支持都是T2时抑郁症状加重的显著前瞻性预测因素（p < .02）。单独来看，丧亲照顾者在亲属去世前后都报告有最严重的抑郁症状。在T2时仍在积极提供护理的人从T1到T2的抑郁症状增加幅度最大（p < .001）。
研究结果突出了在照顾初期护理压力和社会支持的重要性，即使是对于3年后出现的结果。研究结果表明，在5年时积极参与癌症护理的家庭成员可能会从旨在改善他们对长期护理调适的项目中受益。
