Head Nurse, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Attending Physician, Division of Thoracic Oncology, Department of Thoracic Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Professor, Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Semin Oncol Nurs. 2023 Oct;39(5):151497. doi: 10.1016/j.soncn.2023.151497. Epub 2023 Aug 17.
(1) To assess the levels of fear of cancer recurrence (FCR), social support, coping styles, and posttraumatic growth; (2) to identify factors associated with posttraumatic growth; and (3) to compare patient and primary caregiver characteristics by level of posttraumatic growth (no-to-little posttraumatic growth vs. moderate-to-high posttraumatic growth) in the primary caregivers of patients with an oncologic emergency.
A cross-sectional study design was adopted. Data were collected by convenience sampling of cancer patient-caregiver dyads who experienced an oncologic emergency within the last 6 months at a medical center in northern Taiwan. The patients, who had completed cancer treatment, were in an intensive care unit. They were assessed for disease severity, physical performance, and demographic and clinical characteristics. Primary caregivers were assessed for FCR, social support, coping styles, and posttraumatic growth using a set of questionnaires. We found that 80.8% of primary caregivers reported moderate-to-high posttraumatic growth and 19.2% reported no-to-little posttraumatic growth.
Greater posttraumatic growth in primary caregivers was associated with experiencing more patient oncologic emergencies, younger caregiver age, a higher caregiver FCR score, and caregivers' use of active coping behaviors. Caregivers were less likely to report posttraumatic growth if they experienced fewer patient oncologic emergencies, were older, reported lower FCR, and used active coping strategies less frequently.
Developing scenario-based simulations to facilitate caregiving for an oncologic emergency and providing psychological counseling to encourage active coping can help primary caregivers recover emotionally from an oncologic emergency and facilitate growth.
（1）评估癌症复发恐惧（FCR）、社会支持、应对方式和创伤后成长水平；（2）确定与创伤后成长相关的因素；（3）通过对经历肿瘤急症的患者的主要照顾者的创伤后成长水平（无到低创伤后成长与中到高创伤后成长）进行比较，来确定患者和主要照顾者的特征。
采用横断面研究设计。数据是通过方便抽样收集的，研究对象为过去 6 个月内在台湾北部一家医疗中心经历肿瘤急症的癌症患者-照顾者二人组。这些患者已完成癌症治疗，正在重症监护病房。对他们的疾病严重程度、身体机能以及人口统计学和临床特征进行了评估。主要照顾者使用一套问卷评估了 FCR、社会支持、应对方式和创伤后成长。我们发现，80.8%的主要照顾者报告中到高创伤后成长，19.2%报告无到低创伤后成长。
主要照顾者的创伤后成长程度较高与经历更多的患者肿瘤急症、照顾者年龄较小、照顾者 FCR 评分较高以及照顾者使用积极的应对行为有关。如果照顾者经历较少的患者肿瘤急症、年龄较大、报告的 FCR 较低且较少使用积极的应对策略，他们不太可能报告创伤后成长。
开展基于情景的模拟，以促进对肿瘤急症的护理，并提供心理咨询，以鼓励积极的应对方式，可以帮助主要照顾者从肿瘤急症中恢复情绪，并促进成长。
