School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia.
Centre for Quality and Patient Safety - Monash Health Partnership, Deakin University, Burwood, Victoria, Australia.
Psychooncology. 2023 Aug;32(8):1257-1267. doi: 10.1002/pon.6177. Epub 2023 Jul 10.
Caregivers play an important role supporting people diagnosed with cancer, yet report significant unmet information and support needs that impact on their psychological wellbeing. Health literacy and social connectedness are key factors that influence wellbeing, yet few studies have examined their relative role in psychological wellbeing of carers. This study investigated relationships between caregiver and care recipient health literacy, social support, and social connectedness on psychological morbidity in a cancer setting.
This cross-sectional study included 125 caregiver-cancer care recipient dyads. Participants completed the Health Literacy Survey-EU-Q16, Social Connectedness Scale-Revised, the Medical Outcomes Study-Social Support Survey, and the Depression, Anxiety and Stress Scale-21 (DASS21). Relationships between factors were examined using hierarchical multiple regression with care recipient factors entered at Step 1 and caregiver factors at Step 2.
Most caregivers provided care for their spouse (69.6%); caregivers mean total DASS21 score was 24.38 (SD = 22.48). Mean DASS21 subscale scores for depression, anxiety, stress in caregivers were 4.02 (SD = 4.07), 2.7 (SD = 3.64), and 5.48 (SD = 4.24) respectively, suggesting normal range of depression and stress, and mild anxiety. Care recipients had a diagnosis of breast (46.4%), gastrointestinal (32.8%), lung (13.6%), or genitourinary (7.2%) cancer, and a mean DASS21 score of 31.95 (SD = 20.99). Mean DASS21 subscale scores for depression, anxiety, stress in care recipients were 5.10 (SD = 4.18), 4.26 (SD = 3.65), and 6.62 (SD = 3.99) respectively, suggesting mild depression and anxiety, and normal stress scores. Regression analyses showed that only caregiver factors (age, illness/disability, health literacy and social connectedness) were independent predictors of caregiver psychological morbidity (F [10,114] = 18.07, p < 0.001).
CONCLUSION(S): Only caregiver, and not care recipient, factors were found to influence caregiver psychological morbidity. While both health literacy and social connectedness influenced caregiver psychological morbidity, perceived social connectedness had the strongest influence. Interventions that ensure caregivers have adequate health literacy skills, as well as understand the value of social connection when providing care, and are supported to develop skills to seek support, have the potential to promote optimal psychological wellbeing in cancer caregivers.
护理人员在支持被诊断患有癌症的人群方面发挥着重要作用，但他们报告了大量未满足的信息和支持需求，这对他们的心理健康产生了影响。健康素养和社会联系是影响幸福感的关键因素，但很少有研究探讨它们在护理人员心理健康中的相对作用。本研究调查了癌症环境中护理人员和护理接受者的健康素养、社会支持和社会联系与心理发病率之间的关系。
这是一项横断面研究，纳入了 125 对护理人员-癌症护理接受者二人组。参与者完成了《健康素养调查-EU-Q16》《社会联系量表修订版》《医疗结果研究-社会支持调查》和《抑郁、焦虑和压力量表-21 版》（DASS21）。使用分层多元回归分析检验各因素之间的关系，在步骤 1 中纳入护理接受者因素，在步骤 2 中纳入护理人员因素。
大多数护理人员照顾的是他们的配偶（69.6%）；护理人员的平均 DASS21 总分为 24.38（SD=22.48）。护理人员 DASS21 子量表的抑郁、焦虑、压力评分分别为 4.02（SD=4.07）、2.7（SD=3.64）和 5.48（SD=4.24），提示抑郁和压力处于正常范围，焦虑为轻度。护理接受者的诊断为乳腺癌（46.4%）、胃肠道癌（32.8%）、肺癌（13.6%）或泌尿生殖系统癌（7.2%），平均 DASS21 评分为 31.95（SD=20.99）。护理接受者 DASS21 子量表的抑郁、焦虑、压力评分分别为 5.10（SD=4.18）、4.26（SD=3.65）和 6.62（SD=3.99），提示轻度抑郁和焦虑，压力评分正常。回归分析表明，只有护理人员因素（年龄、疾病/残疾、健康素养和社会联系）是护理人员心理发病率的独立预测因素（F[10,114]=18.07，p<0.001）。
只有护理人员因素，而不是护理接受者因素，影响护理人员的心理发病率。虽然健康素养和社会联系都影响护理人员的心理发病率，但感知到的社会联系影响最大。确保护理人员具备足够的健康素养技能，了解在提供护理时社会联系的价值，并支持他们发展寻求支持的技能，有潜力促进癌症护理人员的最佳心理健康。
