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晚期癌症患者及其家庭照顾者的疾病不确定性与生活质量:演员-伙伴相互依赖模型分析。

Illness uncertainty and quality of life in patients with advanced cancer and their family caregivers: An actor-partner interdependence model analysis.

机构信息

Syracuse University, School of Social Work, Syracuse, New York, USA.

University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, North Carolina, USA.

出版信息

Psychooncology. 2023 Nov;32(11):1744-1751. doi: 10.1002/pon.6228. Epub 2023 Oct 4.

Abstract

OBJECTIVE

The relationship between illness uncertainty and quality of life (QOL) has been examined for either the patient or caregiver, but not among the patient-caregiver dyads. This study examined relationships between illness uncertainty and QOL among patients with advanced cancer and family caregivers.

METHODS

We conducted a secondary analysis of data from a randomized clinical trial that examined the effects of a dyadic-based intervention on psychological outcomes for patients with advanced cancer and family caregivers (N = 484 dyads). Illness uncertainty and QOL were measured using the shorten version of the Mishel Uncertainty in Illness Scale for Adult and the Functional Assessment of Cancer Therapy, respectively. The actor-partner interdependence model was used to examine whether an individual's uncertainty (either a patient's or caregiver's) was associated with their own QOL (i.e., an actor effect) and/or their partner's QOL (i.e., a partner effect).

RESULTS

Significant actor effects included a negative association between patients' uncertainty and their own QOL (b = -0.422; p < 0.001) and a negative association between caregivers' uncertainty and their own QOL (b = -0.408; p < 0.001). In terms of partner effects, patients' uncertainty was negatively associated with caregivers' QOL (b = -0.095; p < 0.01). No partner effect was found for caregivers, suggesting that caregivers' uncertainty was not related to patients' QOL.

CONCLUSIONS

Study findings support targeted interventions offered to both patients and their family caregivers to manage their illness uncertainty and improve their QOL.

摘要

目的

疾病不确定性与生活质量(QOL)之间的关系已经在患者或护理人员中进行了研究,但在患者-护理人员二人组中尚未进行研究。本研究调查了晚期癌症患者及其家庭护理人员之间疾病不确定性与 QOL 之间的关系。

方法

我们对一项随机临床试验的数据进行了二次分析,该试验检查了基于二人组的干预对晚期癌症患者及其家庭护理人员的心理结果的影响(N=484 对)。使用成人米舍尔疾病不确定感量表的缩短版和癌症治疗功能评估量表分别测量疾病不确定性和 QOL。使用演员-伙伴相互依存模型来检查个体的不确定性(患者或护理人员的)是否与他们自己的 QOL(即演员效应)和/或他们的伴侣的 QOL(即伙伴效应)相关。

结果

显著的演员效应包括患者不确定性与自身 QOL 之间的负相关(b=-0.422;p<0.001)以及护理人员不确定性与自身 QOL 之间的负相关(b=-0.408;p<0.001)。就伙伴效应而言,患者的不确定性与护理人员的 QOL 呈负相关(b=-0.095;p<0.01)。没有发现护理人员的伙伴效应,这表明护理人员的不确定性与患者的 QOL 无关。

结论

研究结果支持针对患者及其家庭护理人员提供有针对性的干预措施,以管理其疾病不确定性并提高其 QOL。

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