Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
College of Public Health, Social and Behavioral Sciences, Temple University, Bell Building, Suite 370, 1101 W. Montgomery Ave., Philadelphia, PA, 19122, USA.
Support Care Cancer. 2022 Feb;30(2):1597-1605. doi: 10.1007/s00520-021-06544-8. Epub 2021 Sep 21.
Informal caregivers play a fundamental role in the care of hematological cancer patients, but less is known about how secondary caregivers are involved. We assessed the presence or absence of a secondary caregiver, the types of caregiving activities performed by primary and secondary caregivers, and examined whether the presence of a secondary caregiver was associated with primary caregiver characteristics and well-being over time.
A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Multilevel models were developed to examine the associations between the presence of a secondary caregiver and the primary caregivers' well-being.
Most (64.9%) primary caregivers reported having secondary caregivers. Multilevel models showed primary caregivers without help had higher baseline mental and physical health, but experienced deteriorating physical health over time, compared to supported primary caregivers. Supported primary caregivers reported improvements in mental health over time that was associated with improvements in physical health.
Primary caregivers in good physical and mental health at the beginning of their caregiving journey but who have the least assistance from others may be at greatest risk for detrimental physical health effects long term. Attention to the arrangement of caregiving roles (i.e., who provides what care) over time is needed to ensure that caregivers remain healthy and well supported.
非专业照护者在血液病癌症患者的护理中起着至关重要的作用，但对于次级照护者的参与情况了解较少。我们评估了次级照护者的存在与否、主要照护者和次级照护者所执行的照护活动类型，并考察了次级照护者的存在是否与主要照护者的特征和随时间推移的幸福感相关。
弗吉尼亚州和宾夕法尼亚州的肿瘤诊所招募了一组血液病癌症患者-照护者配对（n=171），并对其进行了 2 年的随访。采用多水平模型来检验次级照护者的存在与主要照护者幸福感之间的关联。
大多数（64.9%）主要照护者报告有次级照护者。多水平模型显示，没有帮助的主要照护者在基线时心理健康和身体健康状况较好，但与得到支持的主要照护者相比，他们的身体健康状况随时间恶化。得到支持的主要照护者报告称，心理健康状况随时间改善，这与身体健康状况的改善相关。
在开始照护旅程时身体健康和心理健康状况较好，但从他人那里获得帮助最少的主要照护者可能会面临长期的身体不良健康影响的最大风险。需要关注照护角色的安排（即，谁提供什么照护）随时间的变化，以确保照护者保持健康并得到充分支持。
