Litzelman Kristin, Choi Hyojin, Maher Molly, Harnish Autumn
Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin, USA.
University of Wisconsin-Carbone Cancer Center, Madison, Wisconsin, USA.
Psychooncology. 2021 Nov;30(11):1973-1981. doi: 10.1002/pon.5773. Epub 2021 Jul 28.
To better understand how cancer caregivers engage with mental healthcare, this exploratory study sought to assess the distribution and correlates of visit characteristics for mental health-related medical care among spouses of cancer survivors.
Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based, outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other), and the health condition(s) associated with the visit. Logistic and multinomial regressions assessed the predisposing, enabling, need, and survivor characteristics associated with the visit characteristics.
A plurality of spouses of cancer survivors accessed mental healthcare through an office-based visit (90%) with a primary care provider (47%). One third accessed treatment as part of a regular check-up (32%). Several factors were associated with visit characteristics, notably the cancer survivor's health status and healthcare utilization.
The findings provide an important reminder of the often-invisible mental health burden experienced by cancer caregivers and confirm the importance of routine primary care as a doorway to mental healthcare. Assessing how the care recipient's care needs and caregiving itself may act as barriers to specialty care will be a critical future research trajectory.
为了更好地了解癌症患者家属如何获得心理医疗服务，这项探索性研究旨在评估癌症幸存者配偶接受心理健康相关医疗服务的就诊特征的分布情况及其相关因素。
利用医疗支出小组调查的全国代表性数据，我们评估了在不同医疗机构（门诊、医院门诊、急诊室或住院）、不同医疗服务提供者类型（精神科、初级保健、其他专科或其他）以及不同就诊目的（定期检查、诊断与治疗、随访、心理治疗、其他）下接受心理健康相关处方或心理治疗的照顾者比例，以及与就诊相关的健康状况。逻辑回归和多项回归分析了与就诊特征相关的前置因素、促成因素、需求因素和幸存者特征。
大多数癌症幸存者配偶通过在门诊接受初级保健提供者的诊疗来获得心理医疗服务（90%），其中47%是初级保健提供者。三分之一的人将就诊作为定期检查的一部分（32%）。有几个因素与就诊特征相关，尤其是癌症幸存者的健康状况和医疗服务利用情况。
这些发现有力地提醒了人们注意癌症患者家属常常被忽视的心理健康负担，并证实了常规初级保健作为心理医疗服务途径的重要性。评估受照顾者的护理需求以及护理本身如何可能成为获得专科护理的障碍，将是未来一个关键的研究方向。
