Borelli Eleonora, Bigi Sarah, Potenza Leonardo, Gilioli Fabio, Efficace Fabio, Porro Carlo Adolfo, Luppi Mario, Bandieri Elena
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Department of Linguistic Sciences and Foreign Literatures, Catholic University of the Sacred Heart, Milan, Italy.
Front Oncol. 2023 Sep 14;13:1213906. doi: 10.3389/fonc.2023.1213906. eCollection 2023.
Early palliative care (EPC) improves the quality of life (QoL) of advanced cancer patients and their caregivers. The increasingly widespread use of this care model requires the development of measures supporting its interventions. Although the construct of patient's QoL has been extensively investigated and several QoL measures have been further validated, there is a paucity of data concerning the QoL of the caregiver. In 2018, McDonald and colleagues addressed this issue by interviewing 23 primary caregivers of advanced cancer patients who participated in an EPC randomized clinical trial to understand their perspective on the QoL construct. The Authors identified six major dimensions associated with the construct of caregiver's QoL. The present retrospective study aimed to validate these dimensions on a larger sample and in a real-life EPC setting.
Previously collected reports from 137 primary caregivers of advanced cancer patients on EPC answering questions about their experience with this care model were qualitatively analyzed through a deductive, thematic approach to identify and confirm the six dimensions constituting the construct of interest based on McDonald's and colleagues' results.
The six dimensions ("living in the patient's world", "burden of illness and caregiving", "assuming the caregiver role", "renegotiating relationships", "confronting mortality", and "maintaining resilience") were consistently found in the reports from primary caregivers in a real-life EPC setting, confirming to be significant themes associated to their QoL.
A definite and recurrent construct of primary caregiver's QoL as described by McDonald and colleagues was also found in a larger sample and in a real-life EPC setting. Thus it may lay the groundwork for the development of a dedicated questionnaire.
早期姑息治疗(EPC)可提高晚期癌症患者及其照护者的生活质量(QoL)。这种照护模式的日益广泛应用需要制定支持其干预措施的方法。尽管患者生活质量的构成已得到广泛研究,且多项生活质量测量方法得到了进一步验证,但关于照护者生活质量的数据却很匮乏。2018年,麦克唐纳及其同事通过采访23名参与EPC随机临床试验的晚期癌症患者的主要照护者,以了解他们对生活质量构成的看法,从而解决了这一问题。作者确定了与照护者生活质量构成相关的六个主要维度。本回顾性研究旨在在更大样本和现实生活中的EPC环境中验证这些维度。
通过演绎性主题分析法,对之前收集的137名晚期癌症患者的主要照护者关于EPC的报告进行定性分析,这些报告回答了他们对这种照护模式的体验,以根据麦克唐纳及其同事的结果识别并确认构成感兴趣结构的六个维度。
在现实生活中的EPC环境下,主要照护者的报告中始终发现了这六个维度(“生活在患者的世界”、“疾病和照护负担”、“承担照护者角色”、“重新协商关系”、“面对死亡”和“保持恢复力”),证实它们是与其生活质量相关的重要主题。
在更大样本和现实生活中的EPC环境中,也发现了麦克唐纳及其同事所描述的主要照护者生活质量的明确且反复出现的结构。因此,它可能为开发一份专门的问卷奠定基础。