Zürich University of Applied Sciences (ZHAW), Institute of Nursing, Winterthur - CHPresent Address: Nelson Marlborough Health, Nelson Hospital PO Box Nelson, 7048, New Zealand.
School of Health Sciences, University of Surrey, Guilford, UK.
Eur J Oncol Nurs. 2021 Feb;50:101877. doi: 10.1016/j.ejon.2020.101877. Epub 2020 Nov 17.
Due to delivery of chemotherapy being mostly in ambulatory care settings, support of people with cancer relies heavily on caregivers (e.g. relatives). Whilst cancer caregiver research has been flourishing, there has been little focus on the specific experiences of caregivers of older people (>70yrs) with cancer, and little considerations of cultural influences on their experiences. This study explored caregiver experiences and outcomes in the geriatric oncology context in Switzerland.
Sequential mixed-methods design, comprising a) cross-sectional survey (n = 86/RR52%; age range 37-85) and b) interviews (n = 19) to explore experiences of caregivers of older people (mean age in yrs 74.6 (sd 4.3) with cancer, and factors related to caregivers' psychological morbidity and health related quality of life (HrQoL).
Caregivers reported a median of three moderate/high unmet needs (range 0-41) and 44% reported clinically significant psychological morbidity. Demographics (caregiver age, gender, and marital status), caregiving tasks (physical, psycho-emotional, social and/or treatment related care), unmet needs and caregiver burden collectively explained between 20 and 57% of variance in caregiver psychological morbidity and HRQoL. Two main themes emerged from interviews: "Being a caregiver and doing caregiving" and "Living through the situation." These indicated that caregiver roles are multiple and fluid, and identified responsibilities not previously reported outside of palliative care settings, such as thinking about and planning for death and dying.
Caregiving for an older person with cancer can have detrimental impacts on caregivers' wellbeing and quality of life. Consideration needs to be given to the particular needs of caregivers in geriatric oncology settings. Their support needs appear different to those of their counterparts caring for younger people with cancer, notably related to spiritual needs; this may in part relate to possible differences arising from caregivers themselves being older.
由于化疗的实施大多在门诊环境中，癌症患者的支持主要依赖于照顾者（例如亲属）。虽然癌症照顾者的研究蓬勃发展，但很少关注癌症老年患者（>70 岁）照顾者的特定经历，也很少考虑文化对其经历的影响。本研究探讨了瑞士老年肿瘤学背景下照顾者的经历和结果。
采用序贯混合方法设计，包括 a）横断面调查（n=86/RR52%；年龄范围 37-85 岁）和 b）访谈（n=19），以探讨老年癌症患者照顾者的经历（照顾者平均年龄为 74.6（标准差 4.3）岁）以及与照顾者心理困扰和健康相关生活质量（HrQoL）相关的因素。
照顾者报告了中位数为 3 项中度/高度未满足的需求（范围 0-41），44%的照顾者报告了临床显著的心理困扰。人口统计学因素（照顾者年龄、性别和婚姻状况）、照顾任务（身体、心理情感、社会和/或治疗相关护理）、未满足的需求和照顾者负担共同解释了照顾者心理困扰和 HRQoL 差异的 20%至 57%。访谈中出现了两个主要主题：“作为照顾者和提供照顾”和“经历情况”。这些主题表明，照顾者的角色是多样和灵活的，并确定了在姑息治疗环境之外未报告过的责任，例如思考和计划死亡。
照顾老年癌症患者可能会对照顾者的幸福感和生活质量产生不利影响。需要考虑老年肿瘤学环境中照顾者的特殊需求。他们的支持需求似乎与照顾年轻癌症患者的照顾者不同，特别是与精神需求有关；这可能部分与照顾者本身年龄较大有关。
