Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, 55 Fruit Street, Yawkey 9E, Boston, MA, 02114, USA.
Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, MA, USA.
Support Care Cancer. 2022 Jul;30(7):5811-5820. doi: 10.1007/s00520-022-06989-5. Epub 2022 Mar 30.
Caregivers of patients with malignant gliomas are at risk for psychological distress. However, factors associated with distress in this population have not been well described. We conducted a prospective study evaluating psychological distress in patients with malignant gliomas and their caregivers and exploring factors associated with caregiver distress.
We enrolled patients with newly diagnosed malignant gliomas (N = 77) and their caregivers (N = 61). At baseline and 3, 6, and 9 months after diagnosis, we administered the Hospital Anxiety and Depression Scale to assess psychological distress and the Caregiver Reaction Assessment to evaluate caregiver burden. We performed multivariable regression analyses to investigate caregiver-related, patient-related, and tumor-related factors associated with caregivers' distress.
At baseline, 48.3% (29/60) and 26.2% (16/61) of caregivers reported clinically significant anxiety and depression symptoms, respectively. Anxiety and depression symptoms persisted over time. Greater caregiver depression was associated with male gender (B = 1.48, 95% CI 0.16-2.81, p = 0.03), higher caregiver burden (B = 0.08, 95% CI 0.01-0.15, p = 0.02), caregiver anxiety (B = 0.53, 95% CI 0.38-0.68, p < 0.0001), patient depression (B = 0.34, 95% CI 0.13-0.55, p = 0.002), and caring for a younger patient (B = -0.07, 95% CI -0.15 to 0.00, p = 0.049). Factors associated with greater caregiver anxiety symptoms were caregiver depression (B = 0.91, 95% CI 0.71-1.12, p < 0.0001) and younger patient age (B = -0.15, 95% CI -0.24 to -0.05, p = 0.003).
Male gender, higher caregiver burden, greater patient depression symptoms, and younger patient age are associated with increased distress among caregivers of patients with malignant gliomas, underscoring the need for tailored supportive care interventions targeting caregivers at highest risk for psychological distress.
恶性脑胶质瘤患者的照料者面临心理困扰的风险。然而,该人群中与困扰相关的因素尚未得到很好的描述。我们进行了一项前瞻性研究,评估恶性脑胶质瘤患者及其照料者的心理困扰,并探讨与照料者困扰相关的因素。
我们纳入了 77 例新诊断为恶性脑胶质瘤的患者和 61 名照料者。在基线和诊断后 3、6 和 9 个月,我们使用医院焦虑和抑郁量表评估心理困扰,使用照料者反应评估量表评估照料者负担。我们进行多变量回归分析,以调查与照料者相关、与患者相关和与肿瘤相关的因素与照料者困扰的关系。
基线时,48.3%(29/60)和 26.2%(16/61)的照料者报告存在有临床意义的焦虑和抑郁症状。焦虑和抑郁症状随时间持续存在。照料者抑郁程度较高与男性(B=1.48,95%CI 0.16-2.81,p=0.03)、较高的照料者负担(B=0.08,95%CI 0.01-0.15,p=0.02)、照料者焦虑(B=0.53,95%CI 0.38-0.68,p<0.0001)、患者抑郁(B=0.34,95%CI 0.13-0.55,p=0.002)和照顾年轻患者(B=-0.07,95%CI-0.15 至 0.00,p=0.049)有关。与照料者焦虑症状更严重相关的因素包括照料者抑郁(B=0.91,95%CI 0.71-1.12,p<0.0001)和患者年龄较小(B=-0.15,95%CI-0.24 至-0.05,p=0.003)。
男性、较高的照料者负担、患者抑郁症状较重和患者年龄较小与恶性脑胶质瘤患者照料者的困扰增加有关,这突显了针对心理困扰风险最高的照料者进行有针对性的支持性护理干预的必要性。