Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Department of Anaesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden.
Acta Oncol. 2022 Oct;61(10):1186-1191. doi: 10.1080/0284186X.2022.2119098. Epub 2022 Sep 12.
Oesophageal cancer surgery is extensive with high risk of long-term health-related quality of life (HRQL) reductions. After hospital discharge, the family members often carry great responsibility for the rehabilitation of the patient, which may negatively influence their wellbeing. The purpose was to clarify whether a higher caregiver burden was associated with psychological problems and reduced HRQL for family caregivers of oesophageal cancer survivors.
This was a nationwide prospective cohort study enrolling family members of all patients who underwent surgical resection for oesophageal cancer in Sweden between 2013 and 2020. The family caregivers reported caregiver burden, symptoms of anxiety, depression, post-traumatic stress, and HRQL 1 year after the patient's surgery. Associations were analysed with multivariable logistic regression and presented as odds ratios (OR) with 95% confidence intervals (CI). Differences between groups were presented as mean score differences (MSD).
Among 319 family caregivers, 101 (32%) reported a high to moderate caregiver burden. Younger family caregivers were more likely to experience a higher caregiver burden. High-moderate caregiver burden was associated with an increased risk of symptoms of anxiety (OR 5.53, 95%CI: 3.18-9.62), depression (OR 8.56, 95%CI: 3.80-19.29), and/or posttraumatic stress (OR 5.39, 95%CI: 3.17-9.17). A high-moderate caregiver burden was also associated with reduced HRQL, especially for social function (MSD 23.0, 95% CI: 18.5 to 27.6) and role emotional (MSD 27.8, 95%CI: 19.9 to 35.7).
The study indicates that a high caregiver burden is associated with worse health effects for the family caregiver of oesophageal cancer survivors.
食管癌手术范围广泛，长期生活质量相关健康问题（HRQL）风险高。患者出院后，家庭成员通常对患者的康复承担很大的责任，这可能会对他们的幸福感产生负面影响。本研究旨在阐明较高的照料者负担是否与食管癌幸存者的照料者的心理问题和生活质量下降有关。
这是一项全国性的前瞻性队列研究，纳入了 2013 年至 2020 年期间在瑞典接受手术切除食管癌的所有患者的家庭成员。患者手术后 1 年，家庭成员报告了照料者负担、焦虑、抑郁、创伤后应激症状和 HRQL。采用多变量逻辑回归分析关联，并以 95%置信区间（CI）表示比值比（OR）。组间差异以平均得分差异（MSD）表示。
在 319 名家庭成员中，101 名（32%）报告存在中高度照料者负担。年轻的照料者更有可能经历较高的照料者负担。中高度照料者负担与焦虑症状（OR 5.53，95%CI：3.18-9.62）、抑郁（OR 8.56，95%CI：3.80-19.29）和/或创伤后应激（OR 5.39，95%CI：3.17-9.17）的风险增加相关。中高度照料者负担也与 HRQL 下降相关，尤其是社会功能（MSD 23.0，95%CI：18.5-27.6）和角色情感（MSD 27.8，95%CI：19.9-35.7）。
该研究表明，较高的照料者负担与食管癌幸存者的照料者的健康影响更差有关。
