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患癌儿童的祖父母:生活质量、药物治疗与住院情况。

Grandparents of children with cancer: Quality of life, medication and hospitalizations.

作者信息

Wakefield C E, Fardell J E, Doolan E L, Drew D, De Abreu Lourenco R, Young A L, Cohn R J

机构信息

Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, New South Wales, Australia.

Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.

出版信息

Pediatr Blood Cancer. 2017 Jan;64(1):163-171. doi: 10.1002/pbc.26153. Epub 2016 Jul 21.

Abstract

BACKGROUND

Grandparents can play a crucial role of providing emotional and practical support for families facing childhood cancer. Yet, many have their own healthcare needs. This controlled study systematically assesses the impact of childhood cancer on grandparents' quality of life (QOL). Our objective was to compare QOL in grandparents of children with and without cancer and to identify factors associated with grandparents' QOL.

PROCEDURE

Grandparents (N = 222) completed two patient-reported outcome (PRO) measures assessing QOL: EQ-5D-5L and WHOQOL-BREF. Secondary endpoints included sleep, medications and hospitalizations. We used independent samples t-tests and multivariate linear regression to assess between-group differences and identify predictors.

RESULTS

Grandparents of children with cancer (n = 89) reported significantly worse QOL than controls (n = 133) [mean WHOQOL-BREF score: 75.6 (SD = 17.6) vs. 81.5 (15.6), P = 0.007; mean EQ-5D-5L index value: 0.777 (0.20) vs. 0.874 (0.14), P < 0.001)]. They also reported more problems with anxiety and depression (47.2 vs. 21.8%, P < 0.001) and pain (64.8 vs. 49.6%, P = 0.031). Grandparents of children with cancer reported taking longer to fall asleep [mean: 30.4 min (55.6) vs. 18.2 (20.2), P = 0.011] and taking more medications in the last 4 weeks [mean: 2.9 (SD = 3.8) vs. 1.8 (SD = 2.3), P = 0.012]. Hospitalizations were comparable across groups. Grandmothers, those living in urban locations, and retired/unemployed grandparents experienced reduced QOL.

CONCLUSIONS

Grandparents are significantly affected by childhood cancer. The impact appears across many domains of life and results in meaningful QOL differences. Given that four or more individuals may be affected per child, and that grandparent well-being can influence the whole family, interventions targeting at-risk grandparents are needed.

摘要

背景

祖父母可以在为面临儿童癌症的家庭提供情感和实际支持方面发挥关键作用。然而,许多祖父母自身也有医疗保健需求。这项对照研究系统地评估了儿童癌症对祖父母生活质量(QOL)的影响。我们的目标是比较患癌儿童和未患癌儿童的祖父母的生活质量,并确定与祖父母生活质量相关的因素。

程序

祖父母(N = 222)完成了两项评估生活质量的患者报告结局(PRO)指标:EQ - 5D - 5L和世界卫生组织生活质量简表(WHOQOL - BREF)。次要终点包括睡眠、用药情况和住院情况。我们使用独立样本t检验和多元线性回归来评估组间差异并确定预测因素。

结果

患癌儿童的祖父母(n = 89)报告的生活质量明显低于对照组(n = 133)[世界卫生组织生活质量简表平均得分:75.6(标准差 = 17.6)对81.5(15.6),P = 0.007;EQ - 5D - 5L指数平均值:0.777(0.20)对0.874(0.14),P < 0.001]。他们还报告了更多的焦虑和抑郁问题(47.2%对21.8%,P < 0.001)以及疼痛问题(64.8%对49.6%,P = 0.031)。患癌儿童的祖父母报告入睡时间更长[平均:30.4分钟(55.6)对18.2(20.2),P = 0.011],并且在过去4周内服用更多药物[平均:2.9(标准差 = 3.8)对1.8(标准差 = 2.3),P = 0.012]。各组间住院情况相当。祖母、居住在城市地区的祖父母以及退休/无业的祖父母生活质量较低。

结论

祖父母受到儿童癌症的显著影响。这种影响体现在生活的许多方面,并导致有意义的生活质量差异。鉴于每个患癌儿童可能会影响四个或更多人,并且祖父母的幸福会影响整个家庭,需要针对有风险的祖父母采取干预措施。

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