Sociology, University of Alabama Birmingham, Birmingham, AL, USA.
Institute for Research in Social Sciences (IRiSS), Stanford University, Stanford, CA, USA.
Support Care Cancer. 2019 Jan;27(1):191-198. doi: 10.1007/s00520-018-4311-1. Epub 2018 Jun 20.
This study examines caregiver quality of life (CQOL) 3-26 years after autologous hematopoietic cell transplantation (HCT) for patients with lymphoma. Using a framework that views the patient-caregiver dyad as a system of mutual influence, we argue that CQOL is associated with survivor functional health status and sense of personal control.
Ninety-nine autologous HCT survivor-caregiver dyads participated. CQOL was measured using the Caregiver Quality of Life Scale-Cancer. Survivor functional health status was assessed using the Functional Assessment of Cancer Therapy-General. Sense of control was examined using an instrument from the MIDUS II study. Clinical measures were collected from medical records.
After controlling for sociodemographic and clinical covariates, caregivers with higher sense of control had higher CQOL. Poorer survivor functional health was associated with lower CQOL but only when the survivor reported low personal control. When the survivor reported high personal control, functional health was not a factor. Lower CQOL was observed for younger and more educated caregivers. In contrast, more education among survivors was linked to higher CQOL.
These results (1) support using a mutuality framework for the study of long-term outcomes of caregivers, (2) suggest the importance of ongoing support for caregivers, and (3) help identify caregivers at risk for poorer adaptation. Poorer survivor functional health is a risk factor, but its adverse implications can be offset by higher caregiver and survivor sense of control, a psychological resource aiding caregiver adaptation. These findings can inform the development of support programs for long-term caregivers.
本研究考察了淋巴瘤患者自体造血细胞移植（HCT）后 3-26 年后照顾者的生活质量（CQOL）。通过将患者-照顾者对偶视为相互影响的系统的框架，我们认为 CQOL 与幸存者的功能健康状况和个人控制感有关。
99 例自体 HCT 幸存者-照顾者对参与了研究。使用癌症照顾者生活质量量表-照顾者版来衡量 CQOL。使用癌症治疗功能评估-一般量表来评估幸存者的功能健康状况。使用 MIDUS II 研究中的一种工具来检查控制感。临床测量结果来自病历。
在控制了社会人口统计学和临床协变量后，控制感较强的照顾者具有较高的 CQOL。幸存者功能健康状况较差与 CQOL 较低相关，但仅在幸存者报告个人控制感较低时才相关。当幸存者报告个人控制感较高时，功能健康状况不是一个因素。年龄较小和受教育程度较高的照顾者观察到 CQOL 较低。相比之下，幸存者受教育程度较高与 CQOL 较高相关。
这些结果（1）支持使用相互性框架来研究照顾者的长期结局，（2）表明持续支持照顾者的重要性，（3）有助于识别适应较差的照顾者。较差的幸存者功能健康是一个风险因素，但较高的照顾者和幸存者控制感可以抵消其不利影响，这是一种帮助照顾者适应的心理资源。这些发现可以为长期照顾者的支持计划的制定提供信息。
