Hsu Tina, Loscalzo Matthew, Ramani Rupal, Forman Stephen, Popplewell Leslie, Clark Karen, Katheria Vani, Feng Tao, Strowbridge Rex, Rinehart Redmond, Smith Dan, Matthews Keith, Dillehunt Jeff, Hurria Arti
Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California.
Cancer. 2014 Sep 15;120(18):2927-35. doi: 10.1002/cncr.28765. Epub 2014 Jun 4.
Older adults with cancer are vulnerable to functional decline, which places greater onus on caregivers. Few studies have prospectively examined burden in caregivers of older cancer patients. The objective of this study was to determine the factors associated with high caregiver burden.
In total, 100 caregivers of patients aged ≥65 years with cancer, who were recruited at a single institution, completed questionnaires gauging their perception of the patient's physical, emotional, and social health. The association between these items, cancer-related factors, sociodemographic factors, and caregiver burden (measured using the Caregiver Strain Index [CSI]) was determined through multivariate analysis.
The median patient age was 70 years (range, 65-91 years), 70% of patients had advanced disease, and 98% were receiving treatment. Caregivers were mostly women (73%), spouses (68%), and lived with the patient (79%). The median amount of care provided was 10 hours per week. The mean CSI score (± standard deviation) was 3.1 ± 3.2. Most caregivers (75%) reported some burden, with 15% reporting high caregiver burden (CSI score, ≥7). In multivariate analysis, employed caregivers (odds ratio, 4.5; 95% confidence interval, 1.1-18.4; P = .04) and those caring for patients who required more help with instrumental activities of daily living (Older Americans Resources and Services-Instrumental Activities of Daily Living score, <12 of a possible 14; odds ratio, 12.4; 95% confidence interval, 2.4-62.5; P < .001) were more likely to experience high caregiver burden (CSI score, ≥7).
Caregiver burden is common in those who care for older cancer patients. High burden is more likely in employed caregivers and in those who care for patients who require increased functional assistance. Further studies are needed to determine the unique challenges experienced by caregivers of older adults with cancer and potential interventions to alleviate burden in these caregivers.
老年癌症患者易出现功能衰退,这给照料者带来了更大的负担。很少有研究前瞻性地考察老年癌症患者照料者的负担情况。本研究的目的是确定与照料者高负担相关的因素。
总共招募了100名在单一机构就诊的年龄≥65岁癌症患者的照料者,他们完成了问卷,以评估其对患者身体、情感和社会健康状况的认知。通过多变量分析确定这些项目、癌症相关因素、社会人口学因素与照料者负担(使用照料者压力指数[CSI]进行测量)之间的关联。
患者的中位年龄为70岁(范围为65 - 91岁),70%的患者患有晚期疾病,98%的患者正在接受治疗。照料者大多为女性(73%)、配偶(68%),且与患者同住(79%)。每周提供照料的中位时长为10小时。CSI评分的平均值(±标准差)为3.1±3.2。大多数照料者(75%)报告有一定负担,15%报告有高照料者负担(CSI评分≥7)。在多变量分析中,有工作的照料者(比值比,4.5;95%置信区间,1.1 - 18.4;P = 0.04)以及那些照料在日常生活工具性活动方面需要更多帮助的患者的照料者(美国老年人资源与服务 - 日常生活工具性活动评分,可能的14分中<12分;比值比,12.4;95%置信区间,2.4 - 62.5;P < 0.001)更有可能经历高照料者负担(CSI评分≥7)。
照料老年癌症患者的照料者负担普遍存在。有工作的照料者以及照料需要更多功能协助患者的照料者更有可能负担沉重。需要进一步研究以确定老年癌症患者照料者所面临的独特挑战以及减轻这些照料者负担的潜在干预措施。