Xiang Ellen, Guzman Patricia, Mims Martha, Badr Hoda
Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA.
McGovern Medical School, Health Science Center, The University of Texas, Houston, TX 77225, USA.
Cancers (Basel). 2022 Aug 27;14(17):4146. doi: 10.3390/cancers14174146.
Individuals with cancer commonly rely on their informal caregivers (e.g., spouse/partner, family member, close friend) to help them manage the demands of the disease and its treatment. Caregiving, including helping with patient care, performing household chores, and providing emotional and practical support, can be particularly demanding for employed caregivers, who must juggle their work responsibilities while providing care. Although a burgeoning literature describes the toll that balancing these oft-competing demands can exact, few resources exist to support employed cancer caregivers. To address this gap, we conducted a narrative review of the impacts of cancer on employed caregivers. We found that employed caregivers experience significant financial impacts in terms of lost time and income. They also experience a variety of work-related (e.g., reduced productivity, absenteeism) and mental health (e.g., stress, burden) impacts. Going forward, prospective studies are needed to characterize changes in caregiver support needs and preferences at different time points along the cancer care continuum (e.g., at diagnosis, during treatment, end-of-life) so that appropriate workplace accommodations can be provided. More population-based studies are also needed to develop models for identifying caregivers who are at increased risk for poor employment or mental health outcomes so that more targeted support programs can be developed. Ultimately, a multipronged effort on behalf of employers, healthcare, and community-based organizations may be needed to support and empower this vulnerable subgroup.
癌症患者通常依靠他们的非正式照料者(如配偶/伴侣、家庭成员、密友)来帮助他们应对疾病及其治疗带来的各种需求。照料工作,包括协助患者护理、做家务以及提供情感和实际支持,对于有工作的照料者来说可能格外艰巨,因为他们必须在履行工作职责的同时还要提供照料。尽管有大量文献描述了平衡这些常常相互冲突的需求所带来的代价,但支持有工作的癌症照料者的资源却很少。为了填补这一空白,我们对癌症对有工作的照料者的影响进行了一项叙述性综述。我们发现,有工作的照料者在时间和收入损失方面遭受了重大的经济影响。他们还经历了各种与工作相关的影响(如生产力下降、旷工)和心理健康影响(如压力、负担)。展望未来,需要进行前瞻性研究,以描述在癌症护理连续过程中不同时间点(如诊断时、治疗期间、临终时)照料者支持需求和偏好的变化,以便能够提供适当的工作场所便利。还需要更多基于人群的研究来开发模型,以识别就业或心理健康结果较差风险增加的照料者,从而能够制定更有针对性的支持项目。最终,雇主、医疗保健机构和社区组织可能需要共同做出多方面的努力,以支持和赋能这一弱势群体。