Ellis Katrina R, Janevic Mary R, Kershaw Trace, Caldwell Cleopatra H, Janz Nancy K, Northouse Laurel
School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Psychooncology. 2017 Sep;26(9):1316-1323. doi: 10.1002/pon.4146. Epub 2016 May 5.
This study examined the relationship between the number of co-existing health problems (patient comorbidities and caregiver chronic conditions) and quality of life (QOL) among patients with advanced cancer and their caregivers and assessed the mediating and moderating role of meaning-based coping on that relationship.
Data came from patients with advanced cancers (breast, colorectal, lung, and prostate) and their family caregivers (N = 484 dyads). Study hypotheses were examined with structural equation modeling using the actor-partner interdependence mediation model. Bootstrapping and model constraints were used to test indirect effects suggested by the mediation models. An interaction term was added to the standard actor-partner interdependence model to test for moderation effects.
More patient comorbidities were associated with lower patient QOL. More caregiver chronic conditions were associated with lower patient and caregiver QOL. Patient comorbidities and caregiver chronic conditions had a negative influence on caregiver meaning-based coping but no significant influence on patient meaning based coping. Caregiver meaning-based coping mediated relationships between patient comorbidities and caregiver health conditions and patient and caregiver QOL. No significant moderating effects were observed.
Despite the severity of advanced cancer for patients and caregivers, the co-existing health problems of one member of the dyad have the potential to directly or indirectly affect the wellbeing of the other. Future research should consider how the number of patient comorbidities and caregiver chronic conditions, as well as the ability of patients and caregivers to manage those conditions, influences their meaning-based coping and wellbeing. Copyright © 2016 John Wiley & Sons, Ltd.
本研究探讨了晚期癌症患者及其照顾者并存健康问题的数量（患者共病和照顾者慢性病）与生活质量（QOL）之间的关系，并评估了基于意义的应对方式在该关系中的中介和调节作用。
数据来自晚期癌症（乳腺癌、结直肠癌、肺癌和前列腺癌）患者及其家庭照顾者（N = 484对）。使用actor-partner相互依赖中介模型，通过结构方程模型检验研究假设。采用自抽样法和模型约束来检验中介模型所暗示的间接效应。在标准的actor-partner相互依赖模型中加入一个交互项来检验调节效应。
患者共病越多，患者的生活质量越低。照顾者慢性病越多，患者和照顾者的生活质量越低。患者共病和照顾者慢性病对照顾者基于意义的应对方式有负面影响，但对患者基于意义的应对方式没有显著影响。照顾者基于意义的应对方式介导了患者共病与照顾者健康状况以及患者和照顾者生活质量之间的关系。未观察到显著的调节效应。
尽管晚期癌症对患者和照顾者来说很严重，但二元组中一方成员并存健康问题有可能直接或间接地影响另一方的幸福感。未来的研究应考虑患者共病和照顾者慢性病的数量，以及患者和照顾者管理这些疾病的能力如何影响他们基于意义的应对方式和幸福感。版权所有© 2016约翰威立父子有限公司。
