Center for Behavioral Health and Technology, University of Virginia, PO Box 801075, Charlottesville, VA, 22908, USA.
Emily Couric Comprehensive Cancer Center, University of Virginia, Charlottesville, VA, USA.
Support Care Cancer. 2023 Aug 30;31(9):542. doi: 10.1007/s00520-023-08006-9.
This study used ecological momentary assessment (EMA) to test the association between activity, location, and social company contexts with cancer caregivers' in-the-moment affect to identify precisely when and where to deliver psychological interventions for caregivers.
Current cancer caregivers (N = 25) received 8 EMA prompts per day for 7 consecutive days. At each prompt, caregivers reported their current positive affect and negative affect, as well as what they were doing, where they were located, and who they were with. Multilevel logistic regressions tested the associations between caregivers' contexts with their own person-mean-centered state (concurrent momentary level) and trait (overall weekly average) positive or negative affect.
Caregivers reported lower state negative affect, as well as higher state positive affect, when socializing (ps < .001), when at a public location (ps < .03), and when around their friends, family, spouse/partner, or care recipient (i.e., person with cancer, ps < .02), relative to when not endorsing the context. Caregivers also reported lower state negative affect when eating/drinking or engaging in leisure (ps < .01; but no parallel effects for state positive affect). Caregivers reported higher state negative affect while working, when at their workplace, or when around work colleagues (ps < .001) and lower state positive affect when at home or alone (ps < .03).
Results suggest the pertinence of a behavioral activation framework to mitigate the emotional strain of caregiving. Interventions that facilitate caregivers' ability to socialize with a range of friends and family, including their loved one with cancer, outside of the home may have the strongest positive emotional impact.
本研究使用生态瞬时评估（EMA）来检验活动、地点和社交环境与癌症护理者即时情绪的关联，以准确确定何时何地为护理者提供心理干预。
当前癌症护理者（N=25）每天接受 8 次 EMA 提示，持续 7 天。在每次提示中，护理者报告他们当前的积极情绪和消极情绪，以及他们正在做什么、在哪里以及与谁在一起。多层次逻辑回归检验了护理者的环境与其自身的个体均值中心状态（同期瞬时水平）和特质（整体每周平均水平）积极或消极情绪之间的关联。
与不报告环境时相比，护理者报告社交时（p<.001）、在公共场所时（p<.03）和与朋友、家人、配偶/伴侣或照顾对象（即癌症患者，p<.02）在一起时，状态消极情绪较低，状态积极情绪较高。护理者在饮食/饮水或从事休闲活动时（p<.01；但状态积极情绪没有类似的影响）也报告状态消极情绪较低。当工作时、在工作场所或与同事在一起时，护理者报告状态消极情绪较高（p<.001），当在家或独处时，报告状态积极情绪较低（p<.03）。
结果表明，行为激活框架对减轻护理者的情绪压力具有相关性。促进护理者在家外与各种朋友和家人（包括他们所爱的癌症患者）社交的干预措施可能会产生最积极的情绪影响。
