Özönder Ünal Ipek, Ordu Cetin
Department of Psychiatry, Tuzla State Hospital, Içmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, Istanbul 34947, Turkey.
Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Cemil Aslan Güder Sk. No: 8, Beşiktaş, Istanbul 34349, Turkey.
Healthcare (Basel). 2023 Oct 9;11(19):2700. doi: 10.3390/healthcare11192700.
This study aimed to elucidate the role of psychological factors in caregiver burden among caregivers of stage 4 cancer patients. Data were collected from 328 caregivers of cancer patients, employing the Zarit Care Burden Scale, Depression-Anxiety-Stress Scale (DASS-42), Dysfunctional Attitudes Scale (DAS-A), Ruminative Thought Style Questionnaire (RTSQ), and Coping Orientation to Problems Experienced Inventory (Brief COPE). Males, spouses, and caregivers of patients with a PEG or tracheostomy, or those diagnosed with pancreatic biliary cancer were found to have a significantly higher risk of caregiver burden. Age, sex, caregiver-patient relationship, caregiving duration, patient's catheter status, cancer types, depression and stress severity, rumination, dysfunctional attitudes, and dysfunctional coping strategies explained 69.7% of the variance in Zarit Care Burden Scale scores (F(14,313) = 51.457, < 0.001), illustrating their significant predictive relationship with caregiver burden. Moderation analysis revealed significant interactions of emotional coping with depression (b = -0.0524, = 0.0076) and dysfunctional coping with stress on caregiver burden (b = 0.014, = 0.006). Furthermore, rumination mediated the relationships between caregiver burden, stress, and depression ( < 0.01). Overall, the results highlight the intricate relationships among caregiver burden, mental health, and coping strategies, suggesting tailored interventions to support caregiver health and quality of care.
本研究旨在阐明心理因素在晚期癌症患者照料者照料负担中所起的作用。研究收集了328名癌症患者照料者的数据，采用了扎里特照料负担量表、抑郁-焦虑-压力量表（DASS-42）、功能失调性态度量表（DAS-A）、反刍思维方式问卷（RTSQ）以及应对问题取向量表（简易应对方式问卷）。研究发现，男性、配偶、患有经皮内镜下胃造口术（PEG）或气管造口术的患者的照料者，以及被诊断为胰胆管癌患者的照料者，其照料负担风险显著更高。年龄、性别、照料者与患者的关系、照料时长、患者的导管状况、癌症类型、抑郁和压力严重程度、反刍思维、功能失调性态度以及功能失调性应对策略，解释了扎里特照料负担量表得分中69.7%的方差变异（F(14,313) = 51.457，< 0.001），表明它们与照料负担存在显著的预测关系。调节分析显示，情绪应对与抑郁之间存在显著交互作用（b = -0.0524， = 0.0076），功能失调性应对与压力对照料负担存在显著交互作用（b = 0.014， = 0.006）。此外，反刍思维在照料负担、压力和抑郁之间的关系中起中介作用（< 0.01）。总体而言，研究结果凸显了照料负担、心理健康和应对策略之间的复杂关系，表明需要采取针对性干预措施来支持照料者的健康和护理质量。
