Faculty of Psychology and Education Sciences of the University of Coimbra,Coimbra,Portugal.
Palliat Support Care. 2019 Jun;17(3):286-293. doi: 10.1017/S1478951518000044. Epub 2018 Feb 26.
The issues surrounding a patient's terminal phase of cancer and the imminent death of the individual represent a major family crisis affecting all its members. The goal of this study was to assess the prevalence of psychological morbidity in family caregivers of persons with terminal cancer in terms of psychological distress, depression, anxiety, somatization, and complicated anticipatory grief, and to determine which factors may influence these responses.
One hundred and twelve family caregivers of individuals with terminal cancer completed an assessment protocol comprising the Brief Symptom Inventory (depression, anxiety, somatization, and a computed score for global distress), the Marwit-Meuser Caregiver Grief Inventory - Short Form (anticipatory grief), the Family Inventory of Needs (importance and satisfaction of needs), and the Systemic Clinical Outcome Routine Evaluation -15 (family functioning). Prevalence of psychological morbidity was determined through descriptive and frequency statistics. Predictors of psychological morbidity were ascertained through structural equation modelling methods.ResultRegarding the prevalence of psychological morbidity in family caregivers, 66.1% reported high levels of distress, 68.8% showed high risk of depression, 72.3% showed high risk of anxiety, 50.9% reported high levels of somatization, and 25.9% showed high risk of complicated anticipatory grief. It was found that the predictors of age, gender, relationship to the family member with terminal cancer, the caregiving role played (i.e., primary vs. nonprimary), the satisfaction of needs by healthcare professionals, and family functioning play an important role in terms of one's risk of developing psychological morbidity.Significance of resultsThis study revealed an alarming prevalence of psychological morbidity in family caregivers of individuals living with terminal cancer, making it crucial to move forward from a patient-centered approach to a family-centrad approach to reduce the risk of family maladjustment when facing the imminent death of a family member and to prevent postdeath unadjusted responses.
癌症患者终末期及其个体临近死亡的相关问题,代表了影响所有家庭成员的重大家庭危机。本研究旨在评估终末期癌症患者家属的心理发病率,从心理困扰、抑郁、焦虑、躯体化和复杂的预期悲痛方面进行评估,并确定哪些因素可能影响这些反应。
112 名终末期癌症患者的家属完成了评估方案,包括简明症状量表(抑郁、焦虑、躯体化和总困扰计算评分)、马维特-迈泽尔照顾者悲痛量表-短式(预期悲痛)、家庭需求清单(需求的重要性和满足感)和系统临床结局常规评估-15(家庭功能)。通过描述性和频率统计确定心理发病率。通过结构方程模型方法确定心理发病率的预测因素。
关于家庭照顾者心理发病率的流行率,66.1%报告有高水平的困扰,68.8%显示有高风险的抑郁,72.3%显示有高风险的焦虑,50.9%报告有高水平的躯体化,25.9%显示有高风险的复杂预期悲痛。发现年龄、性别、与终末期癌症患者的关系、所扮演的照顾角色(主要与非主要)、卫生保健专业人员满足需求的情况以及家庭功能等预测因素,对个体发展心理发病率的风险起着重要作用。
本研究揭示了终末期癌症患者家属存在令人震惊的心理发病率,因此,从以患者为中心的方法转向以家庭为中心的方法至关重要,这有助于降低面对家庭成员临近死亡时家庭失调的风险,并防止死亡后未调整的反应。