Boele Florien W, Given Charles W, Given Barbara A, Donovan Heidi S, Schulz Richard, Weimer Jason M, Drappatz Jan, Lieberman Frank S, Sherwood Paula R
School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Family Medicine, Michigan State University, East Lansing, Michigan.
Cancer. 2017 Mar 1;123(5):832-840. doi: 10.1002/cncr.30428. Epub 2016 Oct 27.
Glioblastoma multiforme (GBM) is associated with a poor prognosis, and patients rely heavily on family caregivers for physical and emotional support. The capability and mental health of family caregivers may influence their ability to provide care and affect patient outcomes. The objective of the current study was to investigate whether caregivers' anxiety, depressive symptoms, burden, and mastery influenced survival in a sample of patients newly diagnosed with GBM.
Baseline data from caregiver-patient dyads participating in a longitudinal study funded by the National Institutes of Health were used. Cox regression analyses were performed to determine whether caregiver anxiety (Profile of Mood States-Anxiety), depressive symptoms (Center for Epidemiologic Studies-Depression Scale), burden (Caregiver Reaction Assessment), and feelings of mastery (Mastery Scale) predicted the survival time of patients with GBM after controlling for known covariates (patient age, Karnofsky performance status, type of surgery, and postsurgical treatment).
A total of 88 caregiver-patient dyads were included. The median overall survival for the sample was 14.5 months (range, 0-88 months). After controlling for covariates, caregiver mastery was found to be predictive of patient survival. With each unit increase in mastery, there was a 16.1% risk reduction in patient death (95% confidence interval, 0.771-0.913; P<.001).
To the authors' knowledge, the results of the current study are among the first to explore the impact of family caregiving on the outcomes of patients with GBM. If these results are supported in other studies, providing neuro-oncology caregivers with more structured support and guidance in clinical practice has the potential to improve caregivers' feelings of mastery, thereby influencing patients' well-being for the better. Cancer 2017;123:832-40. © 2016 American Cancer Society.
多形性胶质母细胞瘤(GBM)预后较差,患者在很大程度上依赖家庭照顾者提供身体和情感支持。家庭照顾者的能力和心理健康状况可能会影响他们提供护理的能力,并进而影响患者的治疗结果。本研究的目的是调查照顾者的焦虑、抑郁症状、负担及掌控感是否会影响新诊断为GBM的患者样本的生存期。
使用了参与一项由美国国立卫生研究院资助的纵向研究的照顾者-患者二元组的基线数据。进行Cox回归分析,以确定在控制已知协变量(患者年龄、卡氏功能状态、手术类型和术后治疗)后,照顾者的焦虑(情绪状态剖面图-焦虑量表)、抑郁症状(流行病学研究中心-抑郁量表)、负担(照顾者反应评估量表)和掌控感(掌控感量表)是否能预测GBM患者的生存时间。
共纳入了88个照顾者-患者二元组。该样本的中位总生存期为14.5个月(范围为0至88个月)。在控制协变量后,发现照顾者的掌控感可预测患者的生存期。掌控感每增加一个单位,患者死亡风险降低16.1%(95%置信区间为0.771至0.913;P<0.001)。
据作者所知,本研究结果是首批探讨家庭照顾对GBM患者治疗结果影响的研究之一。如果这些结果在其他研究中得到证实,那么在临床实践中为神经肿瘤学照顾者提供更具结构性的支持和指导,有可能改善照顾者的掌控感,从而更好地影响患者的福祉。《癌症》2017年;123:832 - 40。©2016美国癌症协会