Shaffer Kelly M, Kim Youngmee, Carver Charles S, Cannady Rachel S
Department of Psychology, University of Miami.
American Cancer Society.
Health Psychol. 2017 Aug;36(8):770-778. doi: 10.1037/hea0000528. Epub 2017 Jun 22.
Cancer caregiving burden is known to vary across the survivorship trajectory and has been linked with caregivers' subsequent health impairment. Little is known, however, regarding how risk factors during long-term survivorship relate to vulnerability to caregivers' health during that period. This study examined effects of caregiving status and depressive symptoms on development of physical morbidity by 5 years postdiagnosis.
Family caregivers (N = 491; Mage = 55.78) completed surveys at 2 (Time 1 [T1]) and 5 years (T2) after their care recipients' cancer diagnosis. Demographic and caregiving context variables known to affect caregivers' health were assessed at T1. Self-reported depressive symptoms and a list of physical morbid conditions were assessed at T1 and T2. Caregiving status (former, current, or bereaved) was assessed at T2.
Hierarchical negative binomial regression revealed that current caregivers at T2 (p = .02), but not those bereaved by T2 (p = .32), developed more physical morbid conditions between T1 and T2 compared with former caregivers, controlling for other variables. Independently, caregivers reporting either newly emerging or chronically elevated depressive symptoms at T2 (ps < .03), but not those whose symptoms remitted at T2 (p = .61), showed greater development of physical morbidity than did those reporting minimal depressive symptoms at both T1 and T2.
Results highlight the roles of long-term caregiving demands and depressive symptoms in cancer caregivers' premature physical health decline. Clinical attention through the long-term survivorship trajectory should be emphasized for caregivers of patients with recurrent or prolonged illness and to address caregivers' elevated depressive symptoms. (PsycINFO Database Record
癌症护理负担在整个癌症幸存者轨迹中有所不同,并且与护理人员随后的健康损害有关。然而,关于长期幸存者期间的风险因素如何与该期间护理人员健康的易损性相关,我们知之甚少。本研究考察了护理状态和抑郁症状对诊断后5年身体疾病发展的影响。
家庭护理人员(N = 491;年龄中位数 = 55.78)在其护理对象癌症诊断后的2年(时间1 [T1])和5年(T2)完成调查。在T1评估已知会影响护理人员健康的人口统计学和护理背景变量。在T1和T2评估自我报告的抑郁症状和一系列身体疾病状况。在T2评估护理状态(曾经是、目前是或已丧亲)。
分层负二项回归显示,在控制其他变量的情况下,与曾经是护理人员相比,T2时的现任护理人员(p = .02),而非T2时已丧亲的护理人员(p = .32),在T1和T2之间出现了更多的身体疾病状况。独立来看,在T2报告新出现或长期抑郁症状的护理人员(p值 < .03),而非那些在T2症状缓解的护理人员(p = .61),与在T1和T2报告最低抑郁症状的护理人员相比,身体疾病的发展更为严重。
结果凸显了长期护理需求和抑郁症状在癌症护理人员过早身体健康下降中的作用。对于患有复发性或持续性疾病患者的护理人员以及处理护理人员抑郁症状加重的情况,应在整个长期幸存者轨迹中强调临床关注。(《心理学文摘数据库记录》