Qian Yiqing, Kent Erin E
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Health Policy and Management, 1102-B McGavran-Greenberg Hall, CB # 7411, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7411, USA.
Support Care Cancer. 2022 Jun;30(6):5469-5480. doi: 10.1007/s00520-022-06966-y. Epub 2022 Mar 19.
Cancer caregiving can be distressing, and many caregivers have support service needs. Given the role gender has played in shaping norms around caring, gender may influence caregiving experiences. Using Behavioral Risk Factor Surveillance System data, 2015-2018, we aimed to examine gender as an effect modifier of the unmet support service needs and mental health association among cancer caregivers.
Our n = 5814 sample represented approximately 4.8 million caregivers. Mental health was operationalized as number of mentally unhealthy days over the past 30 (MUDs) and Frequent Mental Distress (FMD, MUDs ± 14 days). Unmet supportive care needs included endorsement of needing but not receiving caregiving classes, help accessing services, support groups, counseling, and respite care. We conducted zero-inflated negative binomial (ZINB) and logistic regression analyses to examine the associations between unmet needs with MUDs and FMD and then tested gender as an effect modifier.
Cancer caregivers reported an average of 6 MUDs. Approximately 20% of caregivers reported FMD, and 17% reported having any unmet needs. Gender moderated the unmet needs and FMD association. Among female caregivers, those with unmet needs were more likely to report FMD (aOR: 2.167; 95%CI: 1.447, 3.243); among male caregivers, no association was found (aOR: 0.970; 95%CI: 0.471, 2.001). In the ZINB model of MUDs, no significant moderation effect of gender was found.
Though distress does not appear to vary by gender, having unmet support needs may negatively affect mental health in female cancer caregivers. Studies on gendered experiences can inform strategies to meet caregiver needs.
癌症护理工作可能令人痛苦，许多护理人员有支持服务需求。鉴于性别在塑造护理规范方面所起的作用，性别可能会影响护理体验。利用2015 - 2018年行为风险因素监测系统的数据，我们旨在研究性别作为癌症护理人员未满足的支持服务需求与心理健康关联的效应修饰因素。
我们的n = 5814样本代表了约480万护理人员。心理健康通过过去30天内精神不健康天数（MUDs）和频繁精神困扰（FMD，MUDs ± 14天）来衡量。未满足的支持性护理需求包括认可需要但未接受护理课程、获得服务帮助、支持小组、咨询和喘息护理。我们进行了零膨胀负二项式（ZINB）和逻辑回归分析，以研究未满足需求与MUDs和FMD之间的关联，然后将性别作为效应修饰因素进行检验。
癌症护理人员报告的平均MUDs为6天。约20%的护理人员报告有FMD，17%报告有任何未满足的需求。性别调节了未满足需求与FMD之间的关联。在女性护理人员中，有未满足需求的人更有可能报告有FMD（调整后比值比：2.167；95%置信区间：1.447，3.243）；在男性护理人员中，未发现关联（调整后比值比：0.970；95%置信区间：0.471，2.001）。在MUDs的ZINB模型中，未发现性别有显著的调节作用。
尽管痛苦似乎不因性别而异，但未满足支持需求可能会对女性癌症护理人员的心理健康产生负面影响。关于性别化体验的研究可为满足护理人员需求的策略提供信息。
