Milberg Anna, Wåhlberg Rakel, Krevers Barbro
Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden; Palliative Education and Research Centre in the County of Östergötland, Norrköping, Sweden; LAH Öst, Vrinnevi Hospital, Norrköping, Sweden.
Psychooncology. 2014 Dec;23(12):1340-9. doi: 10.1002/pon.3564. Epub 2014 May 13.
Mutual support within the family is of great importance to maintain its proper functioning. The study aim, which was based on a family system approach, was to evaluate which variables are associated with patients' sense of support within the family in the palliative care context.
We recruited 174 adult patients (65% of those eligible) from six palliative home care units, who had non-curable disease with an expected short-term survival, such as disseminated cancer or non-malignant diagnosis. The relationship between the endpoint and individual factors were evaluated in a stepwise model-building procedure using generalised linear model (ordinal multinomial distribution and logit link).
The respondents' ratings of their sense of support within the family ranged from 1 (never) to 6 (always), with a mean value of 5.2 (standard deviation 1.06). Patients who less frequently sensed family support experienced more often stress, worry about their private economy, lower self-efficacy, lower sense of security with palliative care provided (lower ratings on subscales of care interaction, mastery and prevailed own identity), more often anxiety, less often perceived general well-being for closest ones and less often sense of support from more distant family members. In the model building, three variables were selected to predict the patients' sense of support within the family.
The dying patients' sense of support within the family related to several factors, and these may help the palliative care teams to identify patients at risk and to alleviate suffering, for example, through supporting the closest family members.
家庭内部的相互支持对于维持家庭的正常运转至关重要。本研究基于家庭系统方法，旨在评估在姑息治疗背景下，哪些变量与患者在家庭中的支持感相关。
我们从六个姑息家庭护理单位招募了174名成年患者（占符合条件者的65%），这些患者患有无法治愈的疾病且预期短期存活，如转移性癌症或非恶性诊断。在逐步模型构建过程中，使用广义线性模型（有序多项分布和logit链接）评估终点与个体因素之间 的关系。
受访者对其在家庭中支持感的评分范围为1（从不）至6（总是），平均值为5.2（标准差1.06）。较少感受到家庭支持的患者更常经历压力、对个人经济状况的担忧、较低的自我效能感、对所提供姑息治疗的安全感较低（在护理互动、掌控和保持自身身份的子量表上评分较低）、更常焦虑、较少感受到最亲近的人的总体幸福感，以及较少感受到来自较远家庭成员的支持感。在模型构建中，选择了三个变量来预测患者在家庭中的支持感。
临终患者在家庭中的支持感与几个因素相关，这些因素可能有助于姑息治疗团队识别有风险的患者并减轻痛苦，例如，通过支持最亲近的家庭成员。
