配偶-照顾者慢性健康状况和个人癌症史对晚期癌症患者及其照顾者的幸福感的心理社会影响。
The Psychosocial Impact of Spouse-Caregiver Chronic Health Conditions and Personal History of Cancer on Well-being in Patients With Advanced Cancer and Their Caregivers.
机构信息
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA.
Miller School of Medicine, University of Miami, Miami, Florida, USA.
出版信息
J Pain Symptom Manage. 2021 Aug;62(2):303-311. doi: 10.1016/j.jpainsymman.2020.12.008. Epub 2020 Dec 19.
CONTEXT
Caregiving during advanced cancer presents many physical and psychological challenges, especially for caregivers who are coping with their own history of cancer or their own chronic health conditions. There is growing recognition that caregiver health and patient health are interdependent.
OBJECTIVES
The objective of this study was to use quantitative and interview data to examine and explore the impact of a caregiver's personal cancer history and chronic health conditions on the psychosocial well-being of both the caregiver and patient.
METHODS
This was a secondary analysis of data from 88 patients with advanced lung/gastrointestinal cancer and their spouse-caregivers. Participants self-reported subjective health, chronic health conditions (including cancer), anxiety and depression symptoms, and social support and social stress. Caregivers self-reported caregiving burden and preparedness for caregiving. Caregivers also completed semistructured interviews.
RESULTS
Participants were mostly white, non-Hispanic, and in their mid-60s. Caregivers reported 1.40 (SD = 1.14) chronic conditions on average; 11 reported a personal history of cancer ("survivor-caregivers"). The number of caregiver chronic health conditions was positively associated with patient depression symptoms. Patients of survivor-caregivers also reported more depression symptoms than patients of caregivers without cancer (t(85) = -2.35, P = 0.021). Survivor-caregivers reported higher preparedness for caregiving than caregivers without cancer (t(85) = -2.48, P = 0.015). Interview data enriched quantitative findings and identified factors that may drive patient depression, including emotions such as resentment or guilt. Experiencing cancer personally may provide caregivers unique insight into the patient experience.
CONCLUSION
Providers should be aware of caregiver chronic conditions and cancer history, given the potential negative effects on patient psychosocial well-being.
背景
晚期癌症患者的护理会带来许多身体和心理上的挑战，尤其是对于那些自身有癌症病史或患有慢性健康问题的护理人员而言。人们越来越认识到护理人员的健康和患者的健康是相互依存的。
目的
本研究旨在利用定量和访谈数据，考察和探讨护理人员自身的癌症病史和慢性健康状况对护理人员和患者的心理社会健康的影响。
方法
这是对 88 例晚期肺癌/胃肠道癌患者及其配偶护理人员的数据分析的二次分析。参与者自我报告主观健康状况、慢性健康状况（包括癌症）、焦虑和抑郁症状、社会支持和社会压力。护理人员自我报告照顾负担和照顾准备情况。护理人员还完成了半结构化访谈。
结果
参与者主要为白人、非西班牙裔，年龄在 60 多岁。护理人员平均报告有 1.40（标准差=1.14）种慢性疾病；11 名护理人员报告有自身癌症病史（“幸存者护理人员”）。护理人员的慢性健康状况数量与患者的抑郁症状呈正相关。幸存者护理人员的患者报告的抑郁症状也多于无癌症的护理人员的患者（t(85)=-2.35，P=0.021）。幸存者护理人员比无癌症的护理人员更有照顾的准备（t(85)=-2.48，P=0.015）。访谈数据丰富了定量研究结果，并确定了可能导致患者抑郁的因素，包括怨恨或内疚等情绪。个人经历过癌症可能会使护理人员对患者的体验有独特的了解。
结论
鉴于护理人员的慢性疾病和癌症病史可能对患者的心理社会健康产生负面影响，医护人员应予以关注。
Zotero 插件