采用 Actor-Partner Interdependence Model 分析原发性脑肿瘤患者及其照顾者的癌症复发恐惧。
Examining fear of cancer recurrence in primary brain tumor patients and their caregivers using the Actor-Partner Interdependence Model.
机构信息
Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA.
Massey Cancer Center, Richmond, Virginia, USA.
出版信息
Psychooncology. 2021 Jul;30(7):1120-1128. doi: 10.1002/pon.5659. Epub 2021 Mar 9.
OBJECTIVE
Fear of cancer recurrence (FCR) is related to psychological distress and poor quality of life in cancer patients and their caregivers. However, no studies have investigated FCR in neuro-oncology. Given the varied prognosis, treatment, and disease trajectory of brain cancer, FCR may affect patients and their caregivers differently.
METHODS
Eighty adult primary brain tumor (PBT) patients and 52 caregivers completed questionnaires assessing FCR and psychological distress (depressive symptoms, generalized anxiety, and death anxiety). Differences in patient and caregiver FCR by demographic and medical characteristics were examined. Using multilevel modeling, the Actor-Partner Interdependence Model (APIM) was used to investigate the interrelationship between patient and caregiver FCR with demographics and psychological distress measures.
RESULTS
Caregivers reported significantly higher FCR than patients. There were no effects of demographic or medical characteristics on patient FCR. Time since diagnosis was negatively related to caregiver FCR. All measures of psychological distress exerted a significant actor effect on FCR among both patients and caregivers. Two partner effects were found: caregiver depressive symptoms and death anxiety negatively predicted patients' FCR.
CONCLUSIONS
This is the first investigation of FCR in PBT patients and their caregivers. Most demographic and medical characteristics were not related to patient or caregiver FCR. Caregiver FCR may be higher at the time of diagnosis and decrease over time. APIMs revealed actor effects on patient and caregiver FCR for all measures of psychological distress. Results demonstrated the dyadic effects of a brain tumor diagnosis, emphasizing the need to include caregivers in psychotherapy for neuro-oncology patients.
目的
癌症复发恐惧（FCR）与癌症患者及其照顾者的心理困扰和生活质量差有关。然而，目前尚无研究调查神经肿瘤学中的 FCR。鉴于脑癌的预后、治疗和疾病进程各不相同，FCR 可能会对患者及其照顾者产生不同的影响。
方法
80 名成年原发性脑肿瘤（PBT）患者和 52 名照顾者完成了评估 FCR 和心理困扰（抑郁症状、广泛性焦虑和死亡焦虑）的问卷。通过比较患者和照顾者的人口统计学和医疗特征，研究了 FCR 的差异。采用多层次建模，使用 Actor-Partner Interdependence Model（APIM）调查了患者和照顾者 FCR 与人口统计学和心理困扰测量之间的相互关系。
结果
照顾者报告的 FCR 明显高于患者。患者的 FCR 不受人口统计学或医疗特征的影响。诊断后时间与照顾者的 FCR 呈负相关。所有心理困扰测量均对患者和照顾者的 FCR 产生了显著的自变量效应。发现了两个伙伴效应：照顾者的抑郁症状和死亡焦虑会对患者的 FCR 产生负面影响。
结论
这是对 PBT 患者及其照顾者的 FCR 的首次调查。大多数人口统计学和医疗特征与患者或照顾者的 FCR 无关。在诊断时，照顾者的 FCR 可能较高，并且随着时间的推移而降低。APIM 揭示了所有心理困扰测量对患者和照顾者 FCR 的自变量效应。结果表明脑肿瘤诊断存在双变量效应，强调需要将照顾者纳入神经肿瘤学患者的心理治疗中。
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