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原发性脑肿瘤诊断对照顾者的影响:来自患者视角的见解。

The impact of a primary brain tumor diagnosis on caregivers: Insights from the patients' perspective.

机构信息

Department of Psychiatry, Center for Psychiatric Oncology, Massachusetts General Hospital, Boston, MA, USA.

Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.

出版信息

Support Care Cancer. 2024 Aug 19;32(9):595. doi: 10.1007/s00520-024-08783-x.

Abstract

PURPOSE

The diagnosis of a primary brain tumor (PBT) causes significant distress for the caregiver-patient dyad, warranting increased supportive care intervention. Although researchers have previously assessed caregivers' perceptions of their own supportive care needs, no study to date has identified how patients perceive the caregiving experience and/or patients' recommendations for integrating supportive care of caregivers in neuro-oncology. This qualitative study examined caregiver distress as well as caregiver supportive care needs from the patients' perspective to inform future intervention development.

METHODS

Adults with PBT (N = 15; M = 45; 53% female; 93% White) were divided into four, 90-min focus groups moderated by a clinical neuropsychologist. Patients responded to semi-structured interview questions regarding various supportive care needs throughout the course of disease. Each discussion was transcribed and coded using thematic content analysis and NVivo software. Inter-rater reliability was excellent (M = 0.92, range = 0.85-0.93).

RESULTS

Seven distinct codes related to PBT caregivers emerged and were classified into two broader themes: Caregiver Impact (47% of coded content) and Caregiver Support (53% of coded content). Caregiver Impact refers to patients' perspective of the practical and emotional demands of caregiving. Under Caregiver Support, patients cited a strong need for increased support of caregivers, including bereavement care, individual psychotherapy, and joint caregiver-patient dyad sessions.

CONCLUSION

Patients with PBT expressed profound concerns regarding the demands of caregiving and its impact on the well-being of their loved ones. Findings emphasize the need for comprehensive dyadic support in neuro-oncology throughout the disease trajectory to enhance the overall quality-of-life for both patients and their caregivers.

摘要

目的

原发性脑肿瘤(PBT)的诊断会给照顾者-患者双方带来巨大的痛苦,因此需要增加支持性护理干预。尽管研究人员之前已经评估了照顾者对自身支持性护理需求的看法,但迄今为止,没有研究确定患者如何看待照顾体验,以及患者对将照顾者的支持性护理纳入神经肿瘤学的建议。这项定性研究从患者的角度考察了照顾者的痛苦以及照顾者的支持性护理需求,以为未来的干预措施的发展提供信息。

方法

15 名患有 PBT 的成年人(M=45 岁;53%为女性;93%为白人)被分为四组,每组 90 分钟,由一名临床神经心理学家主持焦点小组讨论。患者根据疾病过程中的各种支持性护理需求回答半结构化访谈问题。每个讨论都使用主题内容分析和 NVivo 软件进行转录和编码。评分者间信度极好(M=0.92,范围=0.85-0.93)。

结果

出现了七个与 PBT 照顾者相关的不同代码,并分为两个更广泛的主题:照顾者影响(47%的编码内容)和照顾者支持(53%的编码内容)。照顾者影响是指患者对照顾的实际和情感需求的看法。在照顾者支持下,患者强烈需要增加对照顾者的支持,包括丧亲关怀、个体心理治疗和照顾者-患者双方小组会议。

结论

患有 PBT 的患者对照顾的需求及其对亲人福祉的影响表示深切关注。研究结果强调了在神经肿瘤学中,需要在整个疾病过程中为患者及其照顾者提供全面的双方支持,以提高他们的整体生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfe/11333512/0b2c36ac03de/520_2024_8783_Fig1_HTML.jpg

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