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了解癌症住院老年患者照护者的生活质量。

Understanding Caregiver Quality of Life in Caregivers of Hospitalized Older Adults With Cancer.

机构信息

Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Ontario.

Department of Hematology/Hematopoietic Cell Transplant, City of Hope Comprehensive Cancer Centre, Duarte, California.

出版信息

J Am Geriatr Soc. 2019 May;67(5):978-986. doi: 10.1111/jgs.15841. Epub 2019 Mar 22.

Abstract

BACKGROUND/OBJECTIVES: Caregivers of older adults with cancer assist both with cancer care and other health issues, which may make them vulnerable to consequences of caregiving. Hospitalization may represent a time when a caregiver's ability to provide care at home is exceeded. We sought to characterize caregivers of hospitalized older adults with cancer, determine their quality of life (QOL), and identify factors associated with caregiver QOL.

METHODS

Patients (n = 100), aged 65 years and older, with an unplanned hospitalization and their caregivers were included. Caregivers completed a questionnaire about their health, social support, caregiving relationship, QOL (Caregiver Quality of Life Index-Cancer [CQOLC] tool), and patient function. Patient medical history was obtained via chart review. The association between patient, caregiving, and caregiver factors and CQOLC was determined using multivariate linear regression.

RESULTS

Most patients (73%) had metastatic/advanced disease, and 71% received treatment for their cancer within 30 days of hospitalization. Median Karnofsky Performance Status (KPS) was 60%, and 89% required help with instrumental activities of daily living, as reported by caregivers. Median caregiver age was 65 years (range = 29-84 years). The majority (60%) had no major comorbidities and rated their health as excellent/good (79%), though 22% reported worsening health due to caregiving. Caregivers had a median Mental Health Inventory-18 score of 70 (range = 0-97), a median Medical Outcomes Study (MOS)-social activity score of 56 (range = 0-87.5), and a median MOS-Social Support Survey score of 68 (range = 0-100). Caregivers provided a median of 35 hours of care per week (range = 0-168 hours of care per week). Mean CQOLC was 84.6 ± 23.5. Lower caregiver QOL was associated with poorer caregiver mental health, less social support, and poorer patient KPS (P < .05).

CONCLUSION

Caregivers of hospitalized older adults with cancer are older but generally in good health. Those with poorer mental health, less social support, and caring for patients with poorer performance status are more likely to experience lower QOL. J Am Geriatr Soc 67:978-986, 2019.

摘要

背景/目的:照顾癌症老年患者的照护者既协助癌症护理,也协助处理其他健康问题,这可能使他们容易受到照护的影响。住院可能代表着照护者在家中提供护理能力超出的时期。我们旨在描述住院癌症老年患者的照护者,确定他们的生活质量(QOL),并确定与照护者 QOL 相关的因素。

方法

纳入了 100 名年龄在 65 岁及以上、非计划性住院且有照护者的患者。照护者完成了一份关于他们的健康、社会支持、照护关系、QOL(癌症照护者生活质量指数-CQOLC[Caregiver Quality of Life Index-Cancer]工具)和患者功能的问卷。通过病历回顾获取患者的病史。使用多元线性回归确定患者、照护和照护者因素与 CQOLC 之间的关联。

结果

大多数患者(73%)患有转移性/晚期疾病,71%的患者在住院后 30 天内接受癌症治疗。照护者报告的卡氏功能状态量表(Karnofsky Performance Status,KPS)中位数为 60%,89%的患者需要帮助完成日常生活活动。照护者的中位年龄为 65 岁(范围=29-84 岁)。大多数(60%)没有重大合并症,自我报告健康状况为优秀/良好(79%),尽管有 22%的人因照护而报告健康状况恶化。照护者的心理健康量表-18 中位数为 70(范围=0-97),医疗结局研究(MOS)-社会活动量表中位数为 56(范围=0-87.5),MOS-社会支持量表中位数为 68(范围=0-100)。照护者每周提供的护理中位数为 35 小时(范围=0-168 小时/周)。CQOLC 的平均得分是 84.6±23.5。较低的照护者 QOL 与较差的照护者心理健康、较少的社会支持以及较差的患者 KPS 相关(P<.05)。

结论

照顾癌症住院老年患者的照护者年龄较大,但总体健康状况良好。那些心理健康状况较差、社会支持较少、照顾 KPS 较差的患者更有可能经历较低的 QOL。美国老年医学会 67:978-986,2019 年。

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