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晚期癌症患者家庭照顾者的家庭关系与心理社会功能障碍

Family Relationships and Psychosocial Dysfunction Among Family Caregivers of Patients With Advanced Cancer.

作者信息

Nissen Kathrine G, Trevino Kelly, Lange Theis, Prigerson Holly G

机构信息

Department of Psychology, Copenhagen University, Denmark.

Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York City, New York and the Center for Research on End of Life Care, Cornell University, Ithaca, New York, USA.

出版信息

J Pain Symptom Manage. 2016 Dec;52(6):841-849.e1. doi: 10.1016/j.jpainsymman.2016.07.006. Epub 2016 Aug 9.

Abstract

CONTEXT

Caring for a family member with advanced cancer strains family caregivers. Classification of family types has been shown to identify patients at risk of poor psychosocial function. However, little is known about how family relationships affect caregiver psychosocial function.

OBJECTIVES

To investigate family types identified by a cluster analysis and to examine the reproducibility of cluster analyses. We also sought to examine the relationship between family types and caregivers' psychosocial function.

METHODS

Data from 622 caregivers of advanced cancer patients (part of the Coping with Cancer Study) were analyzed using Gaussian Mixture Modeling as the primary method to identify family types based on the Family Relationship Index questionnaire. We then examined the relationship between family type and caregiver quality of life (Medical Outcome Survey Short Form), social support (Interpersonal Support Evaluation List), and perceived caregiver burden (Caregiving Burden Scale).

RESULTS

Three family types emerged: low-expressive, detached, and supportive. Analyses of variance with post hoc comparisons showed that caregivers of detached and low-expressive family types experienced lower levels of quality of life and perceived social support in comparison to supportive family types.

CONCLUSIONS

The study identified supportive, low-expressive, and detached family types among caregivers of advanced cancer patients. The supportive family type was associated with the best outcomes and detached with the worst. These findings indicate that family function is related to psychosocial function of caregivers of advanced cancer patients. Therefore, paying attention to family support and family members' ability to share feelings and manage conflicts may serve as an important tool to improve psychosocial function in families affected by cancer.

摘要

背景

照顾患有晚期癌症的家庭成员会给家庭照顾者带来压力。研究表明,家庭类型的分类有助于识别心理社会功能较差风险的患者。然而,对于家庭关系如何影响照顾者的心理社会功能,我们知之甚少。

目的

研究通过聚类分析确定的家庭类型,并检验聚类分析的可重复性。我们还试图研究家庭类型与照顾者心理社会功能之间的关系。

方法

对622名晚期癌症患者的照顾者(癌症应对研究的一部分)的数据进行分析,使用高斯混合模型作为主要方法,根据家庭关系指数问卷确定家庭类型。然后,我们研究了家庭类型与照顾者生活质量(医学结果调查简表)、社会支持(人际支持评估清单)和感知照顾负担(照顾负担量表)之间的关系。

结果

出现了三种家庭类型:低表达型、疏离型和支持型。方差分析及事后比较表明,与支持型家庭类型的照顾者相比,疏离型和低表达型家庭类型的照顾者生活质量和感知社会支持水平较低。

结论

该研究在晚期癌症患者的照顾者中确定了支持型、低表达型和疏离型家庭类型。支持型家庭类型与最佳结果相关,疏离型与最差结果相关。这些发现表明,家庭功能与晚期癌症患者照顾者的心理社会功能有关。因此,关注家庭支持以及家庭成员分享感受和处理冲突的能力,可能是改善受癌症影响家庭心理社会功能的重要工具。

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