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癌症照顾者的孤独感:叙事性综述。

Loneliness among cancer caregivers: A narrative review.

机构信息

Postdoctoral Research Fellow, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA02215.

Assistant Professor, Johns Hopkins School of Nursing, Baltimore, MD21205.

出版信息

Palliat Support Care. 2020 Jun;18(3):359-367. doi: 10.1017/S1478951519000804.

Abstract

OBJECTIVE

Providing care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers' psychosocial challenges have been well studied, loneliness - a determinant of health - has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population.

METHOD

We used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer.

RESULTS

Eighteen studies met inclusion criteria and were included in the analysis. Caregivers' experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions.

SIGNIFICANCE OF RESULTS

Limited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.

摘要

目的

照顾癌症患者会给照顾者带来各种需求,改变他们的日常生活习惯,破坏他们的社会关系,从而导致孤独感。尽管照顾者的社会心理挑战已经得到了充分研究,但孤独感——健康的一个决定因素——在这一人群中并没有得到很好的研究。本叙述性综述旨在描述癌症患者照顾者孤独感的现有证据。我们旨在:(1)定义孤独感,(2)描述其流行率,(3)描述孤独感与健康结果之间的关系,(4)描述癌症照顾者孤独感的风险和后果,(5)确定评估孤独感的方法,以及(6)为这一独特人群减轻孤独感提出建议。

方法

我们使用了来自 PubMed、PsycINFO 和 Cumulative Index to Nursing and Allied Health Literature(CINAHL)数据库、书籍章节和报告中的文章证据。这些文章符合以下纳入标准:(1)以英文发表,(2)癌症患者的照顾者,(3)孤独感作为研究变量,(4)同行评议,且没有对出版时间的限制。照顾者被定义为为癌症患者提供大部分照顾和支持的亲属、朋友或伴侣。

结果

有 18 项研究符合纳入标准并纳入分析。照顾者的孤独感体验可能会对他们的社交、情感和身体健康产生负面影响。社会支持干预可能不足以解决这个问题。减轻孤独感的现有建议包括认知和心理重新构建、一对一和小组治疗、交友、弹性训练和基于技术的干预。

结果的意义

对癌症照顾者孤独感的关注不足,对患者和照顾者的结果都构成了双重问题。鉴于照顾者在提供护理和影响癌症患者健康结果方面的关键作用,迫切需要干预措施来解决孤独感作为照顾者健康的决定因素。

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