Moffitt Cancer Center, Tampa, FL, USA.
University of Pittsburgh, Pittsburgh, PA, USA.
Psychooncology. 2018 Feb;27(2):607-612. doi: 10.1002/pon.4527. Epub 2017 Aug 31.
There is a growing literature on the effects of cancer caregiving on the well-being of informal family caregivers. However, there has been little longitudinal research on caregivers of patients with the complex, rapidly-changing disease of primary malignant brain tumor.
Our objective was to model longitudinal relationships between caregiver burden, social support, and distress within caregivers of patients with primary brain tumor.
Caregiver participants were recruited from a neuro-oncology clinic. Caregiver questionnaire data, including sociodemographics, social support, depression, anxiety, and caregiving burden, were collected at 4 time points (diagnosis, +4, +8, and +12 mo). Using the stress process model as a guide, we hypothesized that early burden would predict later depression and anxiety, and this would be mediated by social support.
Using data from 147 participants, we found support for the stress process model in caregivers of patients with primary brain tumor. Greater burden at diagnosis was associated with lower social support at 4 months, and lower social support was related to higher depression and anxiety at 8 months, as well as to changes in anxiety between 8 and 12 months.
We found evidence of the stress process model in caregivers of primary brain tumor patients unfolding over the course of a year after diagnosis. Our findings emphasize the potential importance of early programs for caregivers to ensure low initial levels of burden, which may have a positive effect on social support, depression, and anxiety.
关于癌症照护对非正式家庭照护者健康的影响,文献资料日益丰富。然而,对于原发性恶性脑肿瘤这种病情复杂、变化迅速的患者的照护者,纵向研究却很少。
我们的目的是建立原发性脑肿瘤患者照护者的照护负担、社会支持和痛苦之间的纵向关系模型。
从神经肿瘤学诊所招募了照护者参与者。在 4 个时间点(诊断时、+4 个月、+8 个月和+12 个月)收集了包括社会人口统计学、社会支持、抑郁、焦虑和照护负担在内的照护者问卷数据。以应激过程模型为指导,我们假设早期负担会预测后期的抑郁和焦虑,而社会支持则会起到中介作用。
利用来自 147 名参与者的数据,我们发现原发性脑肿瘤患者照护者的应激过程模型得到了支持。诊断时的负担越大,4 个月时的社会支持越低,而较低的社会支持与 8 个月时的抑郁和焦虑较高有关,并且与 8 至 12 个月之间的焦虑变化有关。
我们发现,在诊断后一年的时间里,原发性脑肿瘤患者照护者的应激过程模型得到了证实。我们的研究结果强调了早期为照护者提供计划的重要性,以确保低初始负担,这可能对社会支持、抑郁和焦虑产生积极影响。