Nuwamanya Simpson, Nkola Rahel, Najjuka Sarah Maria, Nabulo Harriet, Al-Mamun Firoj, Mamun Mohammed A, Kaggwa Mark Mohan
Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
African Centre for Suicide Prevention and Research, Mbarara, Uganda.
Psychooncology. 2023 Jan;32(1):113-124. doi: 10.1002/pon.6057. Epub 2022 Oct 31.
Palliative care services involve the psychological care of the caregivers of cancer patients. Psychological conditions, especially depression among caregivers, distort caregiving roles; thus, it can increase a patient's psychological suffering.
To determine the prevalence of depression and associated coping strategies among caregivers of cancer patients at a rural cancer care facility.
This cross-sectional study was among 366 caregivers of cancer patients. The data was collected using a pretested questionnaire, where the symptoms of depression were assessed using the Patient Health Questionnaire-9 at a cutoff of 10 out of 27. The coping strategies were assessed based on the Brief-coping orientation to problems experienced Inventory. Logistic regression was used to determine the factors associated with depression.
The mean age of the participants was 39.01 (±11.50) years; most were females (60.38%). The prevalence of depression was 8.2%. The identified factors associated with increased likelihood of depression were coping strategies: active coping (aOR = 1.55, 95% Confidence Interval (CI) = 1.05-2.28, p = 0.026), denial (aOR = 1.62, 95% CI = 1.20-2.19, p = 0.001), and humor (aOR = 1.43, 95% CI = 1.11-1.84, p = 0.005). However, coping with positive reframing reduced the likelihood of depression (aOR = 0.70, 95% CI = 0.52-0.94, p = 0.019). There was no significant association between depression and social support.
The lower prevalence of depression reported in this study than in the prior Ugandan studies reflects that depression severity among caregivers in rural settings is less prevalent because of the fewer care-associated burdens they experience. Therefore, establishing palliative care near the patients can be a protective factor for caregivers' depression. In addition, the role of social support and coping strategies in depression might be helpful in mental health strategies.
姑息治疗服务涉及癌症患者照料者的心理关怀。心理状况,尤其是照料者中的抑郁,会扭曲照料角色;因此,它会增加患者的心理痛苦。
确定农村癌症护理机构中癌症患者照料者的抑郁患病率及相关应对策略。
这项横断面研究涉及366名癌症患者的照料者。数据通过预先测试的问卷收集,其中使用患者健康问卷-9评估抑郁症状,截断值为27分中的10分。应对策略基于经历问题的简要应对取向量表进行评估。采用逻辑回归确定与抑郁相关的因素。
参与者的平均年龄为39.01(±11.50)岁;大多数为女性(60.38%)。抑郁患病率为8.2%。与抑郁可能性增加相关的已确定因素是应对策略:积极应对(调整后比值比[aOR]=1.55,95%置信区间[CI]=1.05-2.28,p=0.026)、否认(aOR=1.62,95%CI=1.20-2.19,p=0.001)和幽默(aOR=1.43,95%CI=1.11-1.84,p=0.005)。然而,采用积极重新构建应对方式可降低抑郁可能性(aOR=0.70,95%CI=0.52-0.94,p=0.019)。抑郁与社会支持之间无显著关联。
本研究报告的抑郁患病率低于乌干达先前的研究,这反映出农村地区照料者的抑郁严重程度较低,因为他们经历的照料相关负担较少。因此,在患者附近建立姑息治疗可能是照料者抑郁的一个保护因素。此外,社会支持和应对策略在抑郁中的作用可能有助于心理健康策略。