Department of Family Medicine and Health Promotion Center, Seoul National University Hospital, Seoul, Korea ; Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul, Korea.
Department of Counseling Psychology, Hanyang Cyber University, Seoul, Korea.
Cancer Res Treat. 2016 Jan;48(1):384-92. doi: 10.4143/crt.2014.280. Epub 2015 Mar 13.
This study aimed to examine the following questions: to what extent do patients and caregivers perceive their family members to be avoidant of communication regarding patient's cancer, and to what extent do these perceptions interrelate; and how do such perceptions influence their own and each other's communication behaviors, communication outcome, mental health, and quality of life.
A national survey was performed with 990 patient-caregiver dyads (participation rate, 76.2%). To examine the dyadic interaction, we developed linked patient and family member questionnaires, including the Family Avoidance of Communication about Cancer (FACC) scale.
The mean scores (standard deviations) of patient- and caregiver-perceived FACC were low at 10.9 (15.5) and 15.5 (17.5), respectively (p < 0.001), and concordance was low, a well (Spearman's rho, 0.23). Patient-perceived FACC was associated with lower levels of disclosure and behaviors of holding back communication, as well as lower levels of mental health outcome and quality of life. The same was true for caregivers (all p < 0.05). Patient-perceived FACC was associated with caregiver holding back, caregiver's depression level, and caregiver quality of life (all p < 0.05). Both patient- and caregiver-perceived FACC were independently associated with communication difficulty within the family.
Future research would benefit from the measurement of FACC from both patients and caregivers, and promote family intervention to enhance openness to communication, which would be helpful for improving mental health and quality of life for both patients and caregivers.
本研究旨在探讨以下问题：患者和照护者在多大程度上认为其家庭成员回避与患者癌症相关的沟通，以及这些看法在多大程度上相互关联；这些看法如何影响他们自己和彼此的沟通行为、沟通结果、心理健康和生活质量。
我们对 990 对患者-照护者进行了全国性调查（参与率为 76.2%）。为了检验这种双重关系，我们开发了患者和家庭成员之间相互关联的调查问卷，包括家庭回避癌症沟通量表（FACC）。
患者和照护者感知到的 FACC 的平均得分（标准差）分别为 10.9（15.5）和 15.5（17.5）（p<0.001），且一致性较低（Spearman's rho，0.23）。患者感知到的 FACC 与较低水平的沟通揭示、抑制沟通行为以及较低水平的心理健康结果和生活质量相关。照护者也存在同样的情况（均 p<0.05）。患者感知到的 FACC 与照护者抑制沟通、照护者的抑郁水平和照护者的生活质量有关（均 p<0.05）。患者和照护者感知到的 FACC 均与家庭内部的沟通困难独立相关。
未来的研究将受益于患者和照护者双方对 FACC 的测量，并促进家庭干预以增强沟通的开放性，这将有助于改善患者和照护者的心理健康和生活质量。
