Cheng Hui-Lin, Leung Doris Yin Ping, Ko Po Shan, Lam Wai Man, Lam Po Tin, Luk Andrew Leung, Chung Ming Wai, Lam Simon Ching
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
Nursing Services Division, United Christian Hospital, Kowloon, Hong Kong.
Psychooncology. 2023 Mar;32(3):457-464. doi: 10.1002/pon.6099. Epub 2023 Feb 3.
Although unmet support needs are associated with health-related quality of life (HRQOL) in cancer caregivers, little is known about the mechanism underlying the relationship between two variables. The self-efficacy (SE) theory and literature suggest that caregiving SE is important in the perception of and reaction to caregiving demands, which in turn affects HRQOL. The aim of this study was to examine whether caregiving SE mediates the relationship between unmet support needs and HRQOL in family caregivers of palliative cancer patients.
This secondary analysis used the data from 125 family caregivers of palliative cancer patients who were recruited from two public hospitals in Hong Kong. The caregivers completed a survey questionnaire that covered socio-demographic characteristics, unmet support needs, caregiving SE, and HRQOL. Parallel mediation analyses were conducted via SPSS PROCESS macro (Model 4) to test the hypothesized models.
The direct effect of unmet support needs on mental HRQOL was significant (effect = -0.49, 95% CI = -0.06 to -0.92). For the indirect effect, only caregiving SE in the domain of 'care for the care recipient' mediated the relationship between unmet support needs and mental HRQOL (effect = -0.32, 95% CI = -0.08 to -0.59).
The findings suggest that caregiving SE may function as a mechanism through which unmet support needs influence mental HRQOL in family caregivers of palliative cancer patients. Healthcare providers should consider developing supportive care interventions to improve caregivers' HRQOL by incorporating effective strategies to enhance SE and reduce unmet needs for this population.
尽管癌症照护者未满足的支持需求与健康相关生活质量（HRQOL）相关，但对于这两个变量之间关系的潜在机制知之甚少。自我效能（SE）理论及相关文献表明，照护自我效能在对照护需求的认知和反应中很重要，进而影响健康相关生活质量。本研究的目的是检验在姑息治疗癌症患者的家庭照护者中，照护自我效能是否介导了未满足的支持需求与健康相关生活质量之间的关系。
这项二次分析使用了从香港两家公立医院招募的125名姑息治疗癌症患者家庭照护者的数据。照护者完成了一份调查问卷，内容涵盖社会人口学特征、未满足的支持需求、照护自我效能和健康相关生活质量。通过SPSS PROCESS宏程序（模型4）进行平行中介分析，以检验假设模型。
未满足的支持需求对心理维度的健康相关生活质量的直接效应显著（效应=-0.49，95%置信区间=-0.06至-0.92）。对于间接效应，只有“对受照护者的照护”领域的照护自我效能介导了未满足的支持需求与心理维度的健康相关生活质量之间的关系（效应=-0.32，95%置信区间=-0.08至-0.59）。
研究结果表明，照护自我效能可能是一种机制，通过该机制，未满足的支持需求影响姑息治疗癌症患者家庭照护者的心理维度健康相关生活质量。医疗服务提供者应考虑制定支持性护理干预措施，通过纳入有效策略来提高自我效能并减少该人群未满足的需求，从而改善照护者的健康相关生活质量。
