School of Social Work, University of Michigan, Ann Arbor, Michigan, USA.
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Psychooncology. 2021 Aug;30(8):1356-1365. doi: 10.1002/pon.5691. Epub 2021 Apr 16.
Black Americans are disproportionately affected by cancer and chronic diseases. Black patients with cancer and their family caregivers may concurrently experience symptoms that influence their wellbeing. This study investigates the influence of mental and physical symptom distress on quality of life (QOL) among Black Americans with cancer and their family caregivers from a dyadic perspective.
One hundred and fifty-one dyads comprised of a Black American with breast, colorectal, lung or prostate cancer and a Black family caregiver were included in this secondary analysis of pooled baseline data from three studies. Self-reports of problems managing 13 symptoms were used to measure mental and physical symptom distress. Descriptive statistics and the actor-partner interdependence model were used to examine symptom prevalence and the influence of each person's symptom distress on their own and each other's QOL.
Fatigue, sleep problems, pain and mental distress were prevalent. Patients and caregivers reported similar levels of mental distress; however, patients reported higher physical distress. Increased patient mental distress was associated with decreased patient QOL (overall, emotional, social, functional). Increased patient physical distress was associated with decreased patient QOL (overall, physical, emotional, functional) and decreased caregiver emotional wellbeing. Increased caregiver mental distress was associated with decreased caregiver QOL (overall, emotional, social, functional) and decreased patient overall QOL. Increased caregiver physical distress was associated with decreased caregiver QOL (overall, physical, functional), decreased patient emotional wellbeing, and better patient social wellbeing.
Supporting symptom management in Black patient/caregiver dyads may improve their QOL.
非裔美国人受到癌症和慢性病的影响不成比例。患有癌症的非裔美国患者及其家庭照顾者可能同时经历影响其健康的症状。本研究从二元视角调查了癌症和非裔美国家庭照顾者的精神和身体症状困扰对生活质量（QOL）的影响。
本二次分析来自三项研究的综合基线数据，共纳入 151 对由患有乳腺癌、结直肠癌、肺癌或前列腺癌的非裔美国患者和非裔美国家庭照顾者组成的二元组。使用 13 种症状管理问题的自我报告来衡量精神和身体症状困扰。采用描述性统计和主体间伙伴关系模型来检查症状的流行情况以及每个人的症状困扰对自身和对方 QOL 的影响。
疲劳、睡眠问题、疼痛和精神困扰很常见。患者和照顾者报告的精神困扰程度相似；然而，患者报告的身体困扰程度更高。患者精神困扰的增加与患者 QOL（整体、情绪、社会、功能）的降低有关。患者身体困扰的增加与患者 QOL（整体、身体、情绪、功能）的降低和照顾者的情绪健康状况的降低有关。照顾者精神困扰的增加与照顾者 QOL（整体、情绪、社会、功能）的降低和患者整体 QOL 的降低有关。照顾者身体困扰的增加与照顾者 QOL（整体、身体、功能）的降低、患者情绪健康状况的降低和患者社会健康状况的改善有关。
支持非裔美国家庭患者/照顾者二元组的症状管理可能会提高他们的 QOL。
