Girgis Afaf, Abernethy Amy P, Currow David C
Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Liverpool, NSW, Australia.
Division of Medical Oncology, Department of Medicine, Duke University Medical Centre, Durham, USA Discipline, Palliative & Supportive Services, School of Medicine, Flinders University, Daw Park, South Australia, Australia.
BMJ Support Palliat Care. 2015 Dec;5(5):513-7. doi: 10.1136/bmjspcare-2013-000495. Epub 2014 Jan 22.
Cancer is one of the most common health conditions in receipt of informal caregiving. This study compares key characteristics of caregivers who cared for someone with cancer until death with caregivers of people with other life-limiting illnesses and their care recipients irrespective of health service utilisation.
Data were analysed from annual state-wide South Australian Health Omnibus Surveys (2000-2007) involving 14,624 respondents, regarding end of life care. Descriptive and comparative data are presented.
Almost a third of respondents (32%; participation rate 72%) had someone close to them die from an 'expected' death in the preceding 5 years. One in 10 (10%) respondents reported providing hands-on care predominantly for someone with cancer. Compared with non-cancer caregivers, cancer caregivers cared for someone who was significantly younger (mean age 66 (95% CI 64 to 67) years vs 74 (95% CI 72 to 77) years; one-way analysis of variance p<0.0001) and were more likely to report having a hospice/palliative care service involved in the care of the deceased (65% (95% CI 63 to 67) compared with 39% (95% CI 37 to 42). In the Australian context, this may mean contact with inpatient, outpatient and community-based services.There were no differences between the needs which caregivers perceived to be unmet or the perceptions that no additional supports were required between the two groups.
Informal caregivers perform a critical social and economic role in care provision. Cancer caregivers are a proportionally larger cohort than non-cancer caregivers. With the increasing incidence of cancer, the sustainability of a voluntary cancer caregiving workforce will be reliant upon minimising the burden of care.
癌症是接受非正式照料的最常见健康状况之一。本研究比较了照料癌症患者直至其死亡的照料者与照料其他患有危及生命疾病患者的照料者及其照料对象的关键特征，且不考虑卫生服务的利用情况。
对南澳大利亚州年度综合健康调查（2000 - 2007年）中涉及14624名受访者的临终关怀数据进行分析。呈现描述性和对比性数据。
近三分之一的受访者（32%；参与率72%）在过去5年中有亲近的人死于“预期”死亡。十分之一（10%）的受访者报告主要为癌症患者提供实际照料。与非癌症照料者相比，癌症照料者照料的对象明显更年轻（平均年龄66岁（95%置信区间64至67岁）对74岁（95%置信区间72至77岁）；单因素方差分析p<0.0001），且更有可能报告在照料死者过程中有临终关怀/姑息治疗服务参与（65%（95%置信区间63至67），相比之下为39%（95%置信区间37至42））。在澳大利亚的背景下，这可能意味着与住院、门诊和社区服务有接触。两组之间在照料者认为未得到满足的需求或认为不需要额外支持的看法方面没有差异。
非正式照料者在提供照料方面发挥着关键的社会和经济作用。癌症照料者在数量上比非癌症照料者占比更大。随着癌症发病率的上升，志愿性癌症照料劳动力的可持续性将依赖于尽量减轻照料负担。
