School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250017, China.
Eur J Oncol Nurs. 2021 Jun;52:101963. doi: 10.1016/j.ejon.2021.101963. Epub 2021 Apr 24.
Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads.
This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model.
This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience.
Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.
肺癌作为一种应激事件，会对整个家庭产生深远的影响，尤其是对患者及其家庭照顾者。本研究采用对偶分析方法，探讨家庭功能对生活质量（QoL）的对偶影响，以及在晚期肺癌患者-照顾者对偶中，韧性是否起中介作用。
这是一项横断面研究，共纳入了 287 对晚期肺癌患者及其照顾者。家庭功能、韧性和 QoL 分别通过家庭评估工具（FAD）的一般功能子量表、Connor-Davidson 韧性量表的 10 项和简短形式 8 项健康调查（SF-8）进行评估。采用演员-伙伴相互依存中介模型进行数据分析。
本研究发现，对于患者和照顾者来说，韧性中介了家庭功能对 QoL 的演员效应。也就是说，家庭功能与他们的韧性呈正相关，从而提高了 QoL。另一个重要发现是，照顾者的家庭功能通过他们的韧性对患者的 QoL 产生显著的间接影响。
患者和照顾者感知到的积极家庭功能可以通过培养自身的韧性来提高他们的 QoL。此外，照顾者感知到的家庭功能也可以通过他们的韧性来提高患者的 QoL。医护人员应识别出家庭功能和韧性较差的脆弱患者和照顾者，并进行有针对性的干预，以改善肺癌患者及其家庭照顾者的 QoL。
