Lin Ching-Rong, Chen Shu-Ching, Chang Joseph Tung-Chien, Fang Yuan-Yuan, Lai Yeur-Hur
1PhD, RN, Instructor, Department of Nursing, College of Medicine, Chang Gung University;. 2PhD, RN, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology;. 3MD, MHA, Attending Physician, Departments of Radiation Oncology, Chang Gung Medical Foundation, Chang Gung Memorial Hospital, and Professor, Department of Medicine, College of Medicine, Chang Gung University;. 4MSN, RN, Doctoral Student, School of Nursing, College of Medicine, National Taiwan University;. 5PhD, RN, Professor, School of Nursing, College of Medicine, National Taiwan University.
J Nurs Res. 2016 Sep;24(3):240-8. doi: 10.1097/jnr.0000000000000169.
Fear of cancer recurrence (FCR) is a major concern for family caregivers (FCs) caring for patients with head and neck cancers (HNCs).
This study (a) investigated the FCR experience of HNC FCs, (b) compared the differences in the FCR levels of FCs while taking care of patients with different lengths of time since completing major treatments (posttreatment durations), and (c) examined the correlation between FCR and quality of life (QOL) in these FCs.
A cross-sectional study was conducted in the radiation outpatient department of a medical center in northern Taiwan. A set of questionnaires, including the Fear of Cancer Recurrence Inventory-Caregiver version and the Medical Outcomes Short-Form Health Survey, and a background information form were employed. One-way analysis of variance was used to examine the differences in the FCR and QOL among groups of FCs taking care of patients with different posttreatment durations (typically concurrent chemoradiotherapy). Pearson's correlation was used to identify the relationship between FCR and QOL.
Two hundred fifty FCs were recruited in this study. The FCs used several coping and reassurance strategies to address their FCR experiences. Those FCs who cared for patients with short posttreatment durations (3-6 and 6-12 months) showed significantly higher overall FCR levels and higher FCR severity levels than those who cared for patients with long posttreatment durations (more than 5 years). High FCR was negatively correlated with physical and mental QOL.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results suggest that FCs caring for patients with a relatively short posttreatment duration experience higher levels of FCR than those caring for patients with a longer posttreatment duration. In clinical settings, healthcare providers should use posttreatment duration as an indicator of risk of FCR in caregivers to address FCR and provide appropriate support. Future research should develop and examine interventions to help HNC FCs cope effectively with their FCR and improve their QOL.
癌症复发恐惧(FCR)是照顾头颈癌(HNC)患者的家庭照顾者(FC)的主要担忧。
本研究(a)调查HNC家庭照顾者的FCR经历,(b)比较照顾完成主要治疗后不同时长(治疗后时长)患者的家庭照顾者在FCR水平上的差异,以及(c)检验这些家庭照顾者的FCR与生活质量(QOL)之间的相关性。
在台湾北部一家医疗中心的放射门诊进行了一项横断面研究。采用了一套问卷,包括癌症复发恐惧量表-照顾者版和医学结局简表健康调查,以及一份背景信息表。单向方差分析用于检验照顾不同治疗后时长(通常是同步放化疗)患者的家庭照顾者组在FCR和QOL方面的差异。Pearson相关性分析用于确定FCR与QOL之间的关系。
本研究招募了250名家庭照顾者。这些家庭照顾者采用了多种应对和安心策略来处理他们的FCR经历。那些照顾治疗后时长较短(3 - 6个月和6 - 12个月)患者的家庭照顾者,其总体FCR水平和FCR严重程度水平显著高于照顾治疗后时长较长(超过5年)患者的家庭照顾者。高FCR与身体和心理QOL呈负相关。
结论/对实践的启示:结果表明,照顾治疗后时长相对较短患者的家庭照顾者比照顾治疗后时长较长患者的家庭照顾者经历更高水平的FCR。在临床环境中,医疗服务提供者应将治疗后时长作为照顾者FCR风险的指标,以应对FCR并提供适当支持。未来的研究应开发并检验干预措施,以帮助HNC家庭照顾者有效应对其FCR并改善他们的QOL。