Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 95 Qingchun Street, Hangzhou, Zhejiang Province, 310003, China.
Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan Province, 250021, China.
Qual Life Res. 2024 Nov;33(11):3131-3140. doi: 10.1007/s11136-024-03759-0. Epub 2024 Aug 20.
The co-occurrence of health impairments in patients and their informal caregivers may be particularly common in intimate care settings in China. Patients with Chronic Refractory Wounds (CRWs) and their informal caregivers constitute a dyad and exhibit dyadic effects during the caring process. Unfortunately, no study has yet explored the dyadic effects of stigma on the QoL of patients with CRWs and their caregivers.
We used a convenience sampling method and recruited CRWs patient-caregiver dyads (N = 207) in China between April 2022 and October 2023.
We found that: (i) dyadic members experience varying degrees of stigma; (ii) the actor-partner effect of CRWs patients' stigma on their own and their informal caregivers' QoL was significant (Path A: β = - 1.27, Path A: β = - 0.37, Path P: β = - 0.08, Path P: β = - 0.18); (iii) informal caregivers' stigma adversely affects both their own and their patients' psychological QoL((Path A: β = - 0.65, Path P: β = - 0.52)). Informal caregivers' stigma can negatively impact patients' physical QoL (Path P: β = - 0.17), whereas it does not significantly affect their own physical QoL.
There is a notable actor-partner effect of the CRWs patients' stigma on their own and their informal caregivers' QoL. CRWs patients' stigma should become a priority for the government to improve CRWs patients' and informal caregivers' QoL. Besides, health professionals should be addressing several assessments and interventions to decrease informal caregivers' affiliate stigma symptoms and improve CRWs patients' and informal caregivers' QoL.
在亲密护理环境中，患者及其非专业照护者的健康受损可能同时发生，这种情况在中国尤其常见。患有慢性难治性伤口（CRWs）的患者及其非专业照护者构成了一个对偶体，并在照护过程中表现出对偶体效应。遗憾的是，目前尚无研究探讨耻辱感对 CRWs 患者及其照护者生活质量的对偶体效应。
我们采用便利抽样法，于 2022 年 4 月至 2023 年 10 月期间在中国招募了 CRWs 患者-照护者对偶体（N=207）。
我们发现：（i）对偶体成员经历着不同程度的耻辱感；（ii）CRWs 患者的耻辱感对自身和非专业照护者生活质量的演员-伙伴效应显著（路径 A：β=-1.27，路径 A：β=-0.37，路径 P：β=-0.08，路径 P：β=-0.18）；（iii）非专业照护者的耻辱感对其自身和患者的心理生活质量均产生负面影响（路径 A：β=-0.65，路径 P：β=-0.52）。非专业照护者的耻辱感会对患者的生理生活质量产生负面影响（路径 P：β=-0.17），但对其自身的生理生活质量没有显著影响。
CRWs 患者的耻辱感对自身和非专业照护者的生活质量存在显著的演员-伙伴效应。政府应将 CRWs 患者的耻辱感作为优先事项，以提高 CRWs 患者和非专业照护者的生活质量。此外，卫生专业人员应进行多项评估和干预，以减轻非专业照护者的关联耻辱感症状，提高 CRWs 患者和非专业照护者的生活质量。
