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头颈癌患者照料者的担忧:幸存者因素、护理相关压力源及孤独感在预测复发恐惧中的作用

Worry in Head and Neck Cancer Caregivers: The Role of Survivor Factors, Care-Related Stressors, and Loneliness in Predicting Fear of Recurrence.

作者信息

Maguire Rebecca, Hanly Paul, Balfe Myles, Timmons Aileen, Hyland Philip, O'Sullivan Eleanor, Butow Phyllis, Sharp Linda

机构信息

Rebecca Maguire, PhD, is Lecturer in Psychology, National College of Ireland, Dublin. Paul Hanly, PhD, is Lecturer in Economics, National College of Ireland, Dublin. Myles Balfe, PhD, is Lecturer in Sociology, University College Cork, Ireland. Aileen Timmons, PhD, is Researcher, National Cancer Registry Ireland, Cork. Philip Hyland, PhD, is Senior Lecturer in Psychology, National College of Ireland, Dublin. Eleanor O'Sullivan, PhD, is Senior Lecturer in Dental Surgery, University College Cork, Ireland. Phyllis Butow, PhD, is Professor and Senior Principal Research Fellow, Psycho-oncology Co-operative Group, and Co-Director, Centre for Medical Psychology and Evidence-Based Decision-making, University of Sydney, Australia. Linda Sharp, PhD, is Professor in Cancer Epidemiology, Newcastle University, Newcastle upon Tyne, United Kingdom.

出版信息

Nurs Res. 2017 Jul/Aug;66(4):295-303. doi: 10.1097/NNR.0000000000000223.

Abstract

BACKGROUND

Fear of recurrence (FOR) is a primary concern for both cancer survivors and their caregivers, yet little is known about what care-related factors exacerbate this worry.

OBJECTIVES

This study aimed to establish the role of care-related stressors-as distinct from survivor characteristics-in predicting FOR in head and neck cancer caregivers.

METHODS

HNC survivor-caregiver dyads took part in a mailed survey. Survivors provided information on health and quality of life (using the Functional Assessment of Cancer Therapy Questionnaire). Caregivers provided sociodemographic information, impact of caring on their time and finances, as well as their level of social support (Oslo Support Scale), loneliness (3-point loneliness scale), and completed the Worry of Cancer Scale (to measure FOR).

RESULTS

Data from 180 dyads were available for analysis. Multiple regression analysis was used to examine the role of caregiver stressors, social support, and loneliness while controlling for caregiver and survivor characteristics. The model explained 28% of the variance in Worry of Cancer scores (FOR). Caregivers who reported more loneliness, spent more time caring, and had greater financial stress from caring had higher scores on Worry of Cancer (FOR). Female caregivers, those caring for younger survivors, and those with survivors who had undergone less extensive forms of surgery also reported higher FOR.

DISCUSSION

A combination of factors place caregivers at greater risk of cancer-related worry, paving the way for designing interventions aimed at reducing FOR in caregivers of patients with head and neck cancers.

摘要

背景

对复发的恐惧(FOR)是癌症幸存者及其护理人员主要关心的问题,但对于哪些护理相关因素会加剧这种担忧,人们知之甚少。

目的

本研究旨在确定护理相关压力源(与幸存者特征不同)在预测头颈癌护理人员的FOR方面所起的作用。

方法

头颈癌幸存者-护理人员二元组参与了一项邮寄调查。幸存者提供了关于健康和生活质量的信息(使用癌症治疗功能评估问卷)。护理人员提供了社会人口统计学信息、护理对其时间和财务的影响,以及他们的社会支持水平(奥斯陆支持量表)、孤独感(3分孤独量表),并完成了癌症担忧量表(以测量FOR)。

结果

180个二元组的数据可供分析。多元回归分析用于检验护理人员压力源、社会支持和孤独感的作用,同时控制护理人员和幸存者的特征。该模型解释了癌症担忧得分(FOR)中28%的方差。报告有更多孤独感、花费更多时间护理且护理带来更大经济压力的护理人员在癌症担忧(FOR)方面得分更高。女性护理人员、照顾较年轻幸存者的护理人员以及其幸存者接受的手术范围较小的护理人员也报告有更高的FOR。

讨论

多种因素使护理人员面临与癌症相关担忧的更大风险,为设计旨在降低头颈癌患者护理人员FOR的干预措施铺平了道路。

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