King Jennifer J, Segrin Chris, Badger Terry A, Thomson Cynthia A
Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave., Drachman Hall, A260, PO Box: 245209, Tucson, AZ, 85719, USA.
College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, USA.
Support Care Cancer. 2022 Jun;30(6):4781-4788. doi: 10.1007/s00520-022-06800-5. Epub 2022 Feb 10.
Caregivers of cancer patients find it challenging to perform their roles and to meet the demands of caregiving. Spirituality has been investigated as a potential coping strategy employed by caregivers, yet spirituality and related practices vary among cultural groups. In this study, we investigated the relationship between spirituality and health-related quality of life (HRQOL) and evaluated mediation effects of loneliness on this relationship. The sample was 234 lower socioeconomic status (SES) Hispanic caregivers of breast cancer survivors using existing data from the Support for Latinas with Breast Cancer and Their Intimate and Family Partners study, funded by the American Cancer Society (Badger, PI). A cross-sectional analysis was conducted at baseline, using self-reported spirituality, loneliness, and HRQOL data collected from 2012 to 2017. The exposures and outcomes were assessed using the Spiritual Well-Being Scale, the Social Isolation-Short Form 8a PROMIS Item Bank v2.0 scale, and the Global Health Scale PROMIS v.1.0/1.1 scale. Descriptive and mediation analyses using the Preacher and Hayes' approach were conducted to estimate the direct effect of spirituality on HRQOL and the indirect effect of spirituality through mediation of loneliness in relation to HRQOL. A positive association between spirituality and HRQOL was found, whereas loneliness was inversely associated with HRQOL (b = - .18, SE = .03, p < .0001). Age did not function as a moderator of the spirituality-HRQOL association in any of the models tested, but in the model testing mediation, loneliness was shown to mediate the association between spirituality and HRQOL (b = - .17, p < .0001). These results suggest that spirituality may be beneficial to HRQOL in caregivers of Hispanic breast cancer survivors, due in part to reduced loneliness among more spiritual caregivers.
癌症患者的照料者发现履行其角色并满足照料需求具有挑战性。灵性已被作为照料者采用的一种潜在应对策略进行研究，但不同文化群体的灵性及相关实践存在差异。在本研究中，我们调查了灵性与健康相关生活质量（HRQOL）之间的关系，并评估了孤独感对这种关系的中介作用。样本为234名社会经济地位较低（SES）的西班牙裔乳腺癌幸存者照料者，使用的是由美国癌症协会资助的“支持患有乳腺癌的拉丁裔女性及其亲密伴侣和家庭成员”研究（主要研究者为Badger）的现有数据。在基线时进行了横断面分析，使用了2012年至2017年收集的自我报告的灵性、孤独感和HRQOL数据。使用灵性幸福感量表、社会隔离 - 简短形式8a PROMIS项目库v2.0量表和全球健康量表PROMIS v.1.0/1.1量表评估暴露因素和结果。采用Preacher和Hayes的方法进行描述性和中介分析，以估计灵性对HRQOL的直接影响以及灵性通过孤独感中介对HRQOL的间接影响。发现灵性与HRQOL呈正相关，而孤独感与HRQOL呈负相关（b = -0.18，SE = 0.03，p < 0.0001）。在任何测试模型中，年龄都未作为灵性与HRQOL关联的调节因素，但在测试中介作用的模型中，孤独感被证明介导了灵性与HRQOL之间的关联（b = -0.17，p < 0.0001）。这些结果表明，灵性可能有益于西班牙裔乳腺癌幸存者照料者的HRQOL，部分原因是灵性较高的照料者孤独感降低。
