Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
Nutrition, Health and Behavior Program, School of Public Health, University of Haifa, Haifa, Israel.
Blood Adv. 2024 Nov 26;8(22):5917-5924. doi: 10.1182/bloodadvances.2024012915.
Informal caregivers of patients with cancer are known to experience extensive burdens, whereas this issue remains unresolved in the setting of hematological malignancies. Yet, these diseases are characterized by a prolonged course, numerous relapses, and implementation of multiline therapy, administered in outpatient facilities. This study aimed to assess the factors contributing to burden and depressive symptoms in informal caregivers of patients with hematological malignancies, while concentrating on the role of medical visits. The study population comprised patients and their caregivers, recruited at the Rambam Hematology Ambulatory Unit. Participants completed validated questionnaires, including the Center for Epidemiologic Studies Depression Scale and the Zarit Caregiver Burden Interview. The cohort (n = 185) included 115 patients (average age, 62.8 ± 14.5 years; 54 males) and 70 caregivers. Among caregivers, 80% reported high psychological burden, and 50% reported significant depressive symptoms. The burden was higher if caregivers were females and if patients were less educated, less healthy, and more depressed. The caregiver burden and depressive symptoms were significantly linked, and the medical visit frequency predicted the level of both. The caregiver burden fully mediated the link between the independent variables of self-rated health and medical visits and the dependent variable of caregiver depressive symptoms. Informal caregivers of ambulatory patients with hemato-oncological malignancies experience high levels of psychological burden and depressive symptoms. This is partly attributed to the medical visit frequency. Hence, a decrease in the number and length of such visits via the implementation of advanced technology could essentially reduce burden and depressive symptoms of caregivers, without compromising patient outcomes.
癌症患者的非专业照护者承受着巨大的负担，而血液系统恶性肿瘤患者的这一问题尚未得到解决。然而，这些疾病具有病程长、多次复发和实施多线治疗的特点，通常在门诊进行。本研究旨在评估导致血液系统恶性肿瘤患者非专业照护者负担和抑郁症状的因素，同时关注医疗就诊的作用。研究人群包括在 Rambam 血液学门诊就诊的患者及其照护者。参与者完成了经过验证的问卷，包括流行病学研究中心抑郁量表和 Zarit 照护者负担访谈。该队列（n=185）包括 115 名患者（平均年龄 62.8±14.5 岁；54 名男性）和 70 名照护者。在照护者中，80%报告存在较高的心理负担，50%报告存在明显的抑郁症状。如果照护者是女性，如果患者受教育程度较低、健康状况较差且抑郁程度较高，则照护者的负担会更高。照护者的负担和抑郁症状显著相关，医疗就诊频率可以预测这两者的水平。照护者的负担完全介导了自我评估健康状况和医疗就诊这两个独立变量与照护者抑郁症状这一因变量之间的联系。血液肿瘤门诊患者的非专业照护者经历着较高水平的心理负担和抑郁症状。这部分归因于医疗就诊的频率。因此，通过实施先进技术减少此类就诊的次数和时长，可以有效地减轻照护者的负担和抑郁症状，而不会影响患者的治疗效果。
