Guo Jia-Wen, Reblin Maija, Tay Djin, Ellington Lee, Beck Anna C, Cloyes Kristin G
University of Utah, College of Nursing, 10 South 2000 East, Salt Lake City, UT, USA 84112.
Moffitt Cancer Centre, Health Outcomes and Behavior, 12902 Magnolia Dr, Tampa, FL, USA 33612.
J Soc Pers Relat. 2021 Nov;38(11):3121-3141. doi: 10.1177/02654075211024743. Epub 2021 Jun 16.
Family caregivers of home hospice cancer patients often experience burden and distress, which can be mitigated by perceived social support. However, less attention has been paid to the non-family sources of support within social networks, or to how sources of support may also be sources of stress. We describe support and stress in social networks of hospice family caregivers and identify caregiving characteristics associated with classes identified in our data. We collected demographic and psychosocial self-report data from family caregivers providing in-home hospice care for advanced cancer patients (N = 90). Caregivers also reported perceived support and stress from specific family and non-family relationships. We identified three classes with unique patterns of stress and support within caregivers' support networks using a latent class analysis. Classes include: 1) high support, low stress across family and non-family network members ("supportive"; 53% of caregivers); 2) high support, high stress across family and non-family network ("ambivalent maximizers"; 26%); and 3) high support, high stress across family network only ("family-focused ambivalent"; 21%). Caregivers in the class reported more burden than caregivers in the class ( = .024). This is one of the first studies to systematically explore the role of non-family support, as well as how stress and support co-occur within relationships and across networks. As informal support networks of hospice family caregivers are complex and multifaceted, understanding the patterns of support and stress across various network members is essential to offer services to more effectively manage caregiver burden.
居家临终关怀癌症患者的家庭照护者常常承受负担和痛苦，而感知到的社会支持可以减轻这些负担和痛苦。然而，人们较少关注社交网络中非家庭来源的支持，也较少关注支持来源如何也可能成为压力来源。我们描述了临终关怀家庭照护者社交网络中的支持和压力，并确定了与我们数据中所识别类别相关的照护特征。我们从为晚期癌症患者提供居家临终关怀护理的家庭照护者那里收集了人口统计学和心理社会自我报告数据（N = 90）。照护者还报告了来自特定家庭和非家庭关系的感知支持和压力。我们使用潜在类别分析在照护者的支持网络中识别出了具有独特压力和支持模式的三个类别。类别包括：1）家庭和非家庭网络成员中支持度高、压力低（“支持型”；占照护者的53%）；2）家庭和非家庭网络中支持度高、压力高（“矛盾最大化者”；占26%）；3）仅在家庭网络中支持度高、压力高（“以家庭为中心的矛盾型”；占21%）。第三类照护者报告的负担比第一类照护者更多（p = 0.024）。这是首批系统探索非家庭支持作用以及压力和支持如何在关系中及跨网络同时出现的研究之一。由于临终关怀家庭照护者的非正式支持网络复杂且多面，了解不同网络成员间的支持和压力模式对于提供更有效管理照护者负担的服务至关重要。
