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中国学术型医院中初诊急性淋巴细胞白血病患儿父母的照护负担及其预测因素

Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

作者信息

Wang Jingting, Shen Nanping, Zhang Xiaoyan, Shen Min, Xie Anwei, Howell Doris, Yuan Changrong

机构信息

School of Nursing, Second Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.

Department of Nursing, Shanghai Children's Medical Center, Shanghai, China.

出版信息

Support Care Cancer. 2017 Dec;25(12):3703-3713. doi: 10.1007/s00520-017-3796-3. Epub 2017 Jul 16.

Abstract

PURPOSE

Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors.

METHODS

A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis.

RESULTS

The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001).

CONCLUSION

The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

摘要

目的

对于没有医学专业背景的父母而言,照顾急性淋巴细胞白血病(ALL)患儿是一段痛苦的经历。这种经历会导致父母的照料负担。本研究探讨了ALL患儿父母的照料负担及其相关因素。

方法

采用 Zarit 负担量表(ZBI)、领悟社会支持量表(PSSS)、zung 自评焦虑量表(SAS)、zung 自评抑郁量表(SDS)、医学结局研究简表 36(SF-36)以及一份特定研究的人口统计学信息问卷,对总共 130 名父母进行了调查。数据分析采用独立样本 t 检验、单因素方差分析、Pearson 相关分析和多元线性回归分析(逐步法)以及二项逻辑回归。

结果

父母总体照料负担的平均得分为 37.74 ± 16.57,17 名(13.08%)负担很少或没有负担,57 名(43.85%)有轻度至中度负担,44 名(33.84%)有中度至重度负担,12 名(9.23%)有重度负担。回归分析表明,日常照料时间、焦虑、总体健康状况、家庭月平均收入、社会支持以及共同照料者数量是与照料负担相关的因素。这些变量解释了照料负担变异的 51%。父母和孩子的其他人口统计学信息、抑郁以及 SF-36 的其他维度与照料负担无关。与负担很少或没有负担的组相比,重度负担水平与情绪困扰风险增加相关(OR = 37.500,95%CI = 4.515 - 311.348,P = 0.001)。

结论

结果表明,新诊断 ALL 患儿父母的照料负担较高。照料负担水平较低的父母往往日常照料时间较少、共同照料者较多、收入较高、焦虑较少、总体健康状况较好且有社会支持。需要采取策略来帮助减轻父母的照料负担。

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