影响中国晚期癌症患者及其配偶照顾者健康相关生活质量的因素：一项横断面研究。
Factors influencing the health-related quality of life of Chinese advanced cancer patients and their spousal caregivers: a cross-sectional study.
作者信息
Li Qiuping, Xu Yinghua, Zhou Huiya, Loke Alice Yuen
机构信息
Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China.
Wuxi People's Hospital, Wuxi, Jiangsu Province, China.
出版信息
BMC Palliat Care. 2016 Aug 2;15:72. doi: 10.1186/s12904-016-0142-3.
BACKGROUND
Cancer and its treatment have a major impact on the lives of patients and their intimate partners, such as on their health-related quality of life (HRQOL). The aims of this study are to: (i) assess the HRQOL of advanced cancer patients and spousal caregivers, and explore the relationship between the HRQOL of cancer patients and that of their spousal caregivers; (ii) detect factors influencing the HRQOL of cancer patients and spousal caregivers; and (iii) explore the impact of anxiety and depression on the HRQOL of couples.
METHODS
A total of 131 couples where one of the partners was hospitalized for advanced cancer were invited to complete a survey to assess their demographic and background information, HRQOL, and anxiety and depression. HRQOL was measured using the SF-12, while anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Data were analyzed using a T-test, Pearson correlations, multiple linear regressions, and structural equation modeling.
RESULTS
In general, the spousal caregivers had higher levels of HRQOL (seven out of eight SF-12 domains and two SF-12 dimensions) p = 0.038-0.000, anxiety (p = 0.002), and depression (p = 0.011) than patients. Correlations of HRQOL between patients and spouses were small to moderate (r = 0.193-0.398). Multiple independent factors influencing the physical component summary (PCS), mental component summary (MCS), vitality (VT), and role emotional (RE) sections of the SF-12 were identified, including: gender, time since diagnosis, levels of education, working status, the extent to which spousal caregivers were informed about the disease, improved marital relationship after the diagnosis of cancer, and anxiety and depression. For both patients and spousal caregivers, the strongest independent factor influencing HRQOL (SF-12 PCS, MCS, VT, and RE) was anxiety and depression. Anxiety and depression may have both actor and partner effects on the HRQOL of couples to various degrees.
CONCLUSIONS
The findings of this study call attention to the HRQOL of couples and its influencing factors. Individual characteristics of cancer patients and spouses, marital relationship, and anxiety and depression are highlighted as areas in which couples coping with cancer could benefit from interventions to improve their HRQOL.
背景
癌症及其治疗对患者及其亲密伴侣的生活有重大影响，比如对他们的健康相关生活质量（HRQOL）。本研究的目的是：（i）评估晚期癌症患者及其配偶照顾者的HRQOL，并探讨癌症患者与配偶照顾者HRQOL之间的关系；（ii）检测影响癌症患者和配偶照顾者HRQOL的因素；（iii）探讨焦虑和抑郁对夫妻HRQOL的影响。
方法
邀请131对夫妻（其中一方因晚期癌症住院）完成一项调查，以评估他们的人口统计学和背景信息、HRQOL以及焦虑和抑郁情况。使用SF-12量表测量HRQOL，使用医院焦虑抑郁量表测量焦虑和抑郁。采用t检验、Pearson相关性分析、多元线性回归分析和结构方程模型进行数据分析。
结果
总体而言，配偶照顾者在HRQOL（SF-12的八个领域中的七个以及两个维度）方面得分更高（p = 0.038 - 0.000），焦虑水平（p = 0.002）和抑郁水平（p = 0.011）也高于患者。患者与配偶之间的HRQOL相关性为中等到小（r = 0.193 - 0.398）。确定了影响SF-12身体成分总结（PCS）、心理成分总结（MCS）、活力（VT）和角色情感（RE）部分的多个独立因素，包括：性别、确诊后的时间、教育程度、工作状态、配偶照顾者对疾病的了解程度、癌症诊断后婚姻关系的改善情况以及焦虑和抑郁。对于患者和配偶照顾者来说，影响HRQOL（SF-12 PCS、MCS、VT和RE）的最强独立因素是焦虑和抑郁。焦虑和抑郁可能在不同程度上对夫妻的HRQOL产生主体效应和伴侣效应。
结论
本研究结果提醒人们关注夫妻的HRQOL及其影响因素。癌症患者及其配偶的个体特征、婚姻关系以及焦虑和抑郁被强调为应对癌症的夫妻可能从干预措施中受益以改善其HRQOL的领域。
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