Washington University in St. Louis, Brown School of Social Work, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA.
Soc Sci Med. 2021 Oct;287:114357. doi: 10.1016/j.socscimed.2021.114357. Epub 2021 Aug 30.
It is widely acknowledged that cancer affects not only patients but also their friends and family members who provide informal, and typically unpaid, care. Given the dual impact that cancer often has on patients and their informal caregivers (i.e., family members, partners, or friends), an expanded dyadic framework that encompasses a range of health and psychosocial outcomes and includes primary caregivers with a range of relationships to the patients is critically needed. Moreover, an emphasis on the role of social and contextual factors may help the framework resonate with a broader range of patient-caregiver relationships and allow for the development of more effective dyadic interventions. This article describes the development of the Dyadic Cancer Outcomes Framework, which was created to guide future research and intervention development. Using an iterative process, we conducted a conceptual review of currently used dyadic and/or caregiving models and frameworks and developed our own novel dyadic framework. Our novel Dyadic Cancer Outcomes Framework highlights individual- and dyad-level predictors and outcomes, as well as incorporating the disease trajectory and the social context. This framework can be used in conjunction with statistical approaches including the Actor Partner Interdependence Model to evaluate outcomes for different kinds of partner-caregiver dyads. This flexible framework can be used to guide intervention development and evaluation for cancer patients and their primary caregivers, with the ultimate goal of improving health, psychosocial, and relationship outcomes for both patients and caregivers. Future research will provide valuable information about the framework's effectiveness for this purpose.
人们普遍认识到，癌症不仅影响患者，还影响为患者提供非正式、通常是无偿护理的朋友和家庭成员。鉴于癌症通常对患者及其非正式照顾者（即家庭成员、伴侣或朋友）都有双重影响，因此迫切需要一个扩展的对偶框架，该框架涵盖一系列健康和心理社会结果，并包括与患者有各种关系的主要照顾者。此外，强调社会和环境因素的作用可能有助于该框架与更广泛的患者-照顾者关系产生共鸣，并为更有效的对偶干预措施的发展提供依据。本文描述了对偶癌症结果框架的制定，该框架旨在指导未来的研究和干预措施的发展。我们使用迭代过程，对当前使用的对偶和/或照顾模型和框架进行了概念性审查，并制定了我们自己的新对偶框架。我们新的对偶癌症结果框架强调个体和对偶层面的预测因素和结果，并纳入疾病轨迹和社会环境。该框架可以与包括演员-伙伴相互依存模型在内的统计方法结合使用，以评估不同类型的伙伴-照顾者对偶的结果。这个灵活的框架可用于指导癌症患者及其主要照顾者的干预措施的制定和评估，最终目标是改善患者和照顾者的健康、心理社会和关系结果。未来的研究将为该框架在这方面的有效性提供有价值的信息。
