College of Nursing Science, Kyung Hee University, Seoul, South Korea; University of Maryland School of Nursing, Baltimore, MD, USA.
University of Maryland School of Nursing, Baltimore, MD, USA.
Eur J Oncol Nurs. 2021 Jun;52:101962. doi: 10.1016/j.ejon.2021.101962. Epub 2021 Apr 17.
Caregiver burden is frequently studied cross-sectionally, but longitudinal studies on family caregiver burden during active cancer treatment are lacking. The goals of this study were to characterize trajectories of caregivers' burden during a 6-month active treatment period, and to examine which predictors are associated with their burden.
This study was a secondary analysis of data from a prospective study. A sample of 112 family caregivers of patients receiving cancer treatment were assessed at three time points (the initiation of new treatment regimen, 3-, and 6-month follow-up). Caregivers completed measures: Caregiver Reaction Assessment and Mutuality Scale of the Family Care Inventory. Data were analyzed using latent growth curve modeling.
The two highest burdens were subdomains related to disrupted schedule and financial problems. Models showed a decline in schedule burden over time, yet total burden and other subscales (financial problems, health problems, and lack of family support and self-esteem) remained relatively stable. In multivariate analysis, mutuality, the relationship quality between patients and caregivers was inversely related to burden at baseline. Being a spouse, a sole caregiver and lower income were related to higher burden over time.
Our findings confirmed significant determinants of caregiver burden over the course of active treatment. It is important for health care providers to be attentive to vulnerable caregivers who are at higher risk of elevated burden over time. Considering the multidimensional nature of caregiver burden, early assessment and tailored support programs may be effective by focusing on patient-caregiver relationships, caregiving roles, and income.
caregiver 负担经常进行横断面研究，但缺乏关于癌症治疗活跃期家庭 caregiver负担的纵向研究。本研究的目的是描述癌症治疗活跃期 6 个月内 caregiver负担的轨迹，并探讨哪些预测因素与其负担相关。
这是一项前瞻性研究数据的二次分析。在三个时间点（新治疗方案开始时、3 个月和 6 个月随访时）评估了 112 名接受癌症治疗的患者的家属照顾者样本。照顾者完成了以下评估：照顾者反应评估和家庭关怀清单的相互性量表。使用潜在增长曲线模型对数据进行分析。
负担最高的两个亚组与日程紊乱和经济问题有关。模型显示，随着时间的推移，日程紊乱负担呈下降趋势，但总负担和其他亚组（经济问题、健康问题以及缺乏家庭支持和自尊）相对稳定。在多变量分析中，相互性（患者和照顾者之间的关系质量）与基线时的负担呈负相关。配偶、单一照顾者和较低的收入与随着时间的推移负担增加有关。
我们的研究结果证实了在癌症治疗活跃期照顾者负担的显著决定因素。医疗保健提供者应该关注那些在整个治疗过程中负担不断增加的脆弱照顾者。考虑到照顾者负担的多维性质，通过关注患者-照顾者关系、照顾角色和收入，早期评估和量身定制的支持计划可能会有效。
