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转移性乳腺癌对护理人员工作效率和生活质量的影响:一项在美国、英国和德国开展的调查研究。

The burden of metastatic breast cancer on caregiver productivity and quality of life: A survey study in the United States, United Kingdom, and Germany.

作者信息

Comerford Erin, Chung Sukyung, Graf Marlon, Land Natalie, Nguyen Anh-Thy, Sasane Medha, Zheng Ying, May Suepattra G

机构信息

Sanofi Genzyme, 55 Corporate Drive, Bridgewater, NJ 08807, USA.

Precision AQ, 60 E 42nd Street, Suite 1325 New York, NY 10165, USA.

出版信息

J Cancer Policy. 2025 Mar;43:100526. doi: 10.1016/j.jcpo.2024.100526. Epub 2024 Dec 2.

Abstract

BACKGROUND

Caring for a patient with metastatic breast cancer (mBC) can impose a substantial burden and can lead to significant productivity losses. However, the extent to which productivity loss impacts caregiver well-being has not been well-elucidated. This study examined the relationship between productivity and other characteristics with quality of life (QoL) to illuminate the multifaceted challenges faced by caregivers in the context of mBC.

METHODS

We conducted a one-time, cross-sectional survey of 345 informal caregivers of people living with mBC in the United States, United Kingdom, and Germany in December 2021. Caregivers were asked about their QoL using the Caregiver Quality of Life Index-Cancer (CQOLC) and pre-/post-caregiving productivity impacts. Heterogeneity in reported burden was assessed across a variety of caregiver characteristics.

RESULTS

One in three caregivers changed work status after onset of caregiving, either reducing working hours (12 %), stopping work altogether (13 %), or increasing working hours (8 %). Caregivers who reduced hours or stopped working reported better QoL overall with total CQOLC scores of 71.8 and 65.3, compared to those who maintained or increased work hours (CQOLC scores of 61.3 and 54.4, respectively, [p < 0.001]). While there were no differences in caregiver QoL by patients' disease status (p = 0.48), longer time spent caregiving was associated with lower burden (p = 0.002).

CONCLUSIONS

Caregiver productivity and QoL scores indicate leaving the workforce may ease the challenges associated with caregiving, suggesting a need for workplace flexibility to better support caregivers. Our study emphasizes the importance of supporting caregivers alongside patients, acknowledging caregiver well-being can significantly influence patient outcomes.

POLICY SUMMARY

Although the burden associated with cancer caregiving has been well-documented, policies supporting caregivers, such as flexible employment leave and mental health support resources, are urgently needed to improve QoL and health outcomes for both patients and their informal caregivers.

摘要

背景

照顾转移性乳腺癌(mBC)患者会带来巨大负担,并可能导致显著的生产力损失。然而,生产力损失对照顾者幸福感的影响程度尚未得到充分阐明。本研究探讨了生产力及其他特征与生活质量(QoL)之间的关系,以揭示mBC背景下照顾者面临的多方面挑战。

方法

2021年12月,我们对美国、英国和德国的345名mBC患者的非正式照顾者进行了一次性横断面调查。使用照顾者生活质量指数-癌症(CQOLC)询问照顾者的生活质量以及照顾前后对生产力的影响。通过各种照顾者特征评估报告负担的异质性。

结果

三分之一的照顾者在开始照顾后改变了工作状态,要么减少工作时间(12%),要么完全停止工作(13%),要么增加工作时间(8%)。与维持或增加工作时间的照顾者相比(CQOLC分数分别为61.3和54.4,[p<0.001]),减少工作时间或停止工作的照顾者总体生活质量更好,CQOLC总分为71.8和65.3。虽然患者的疾病状态对照顾者的生活质量没有差异(p=0.48),但照顾时间越长,负担越低(p=0.002)。

结论

照顾者的生产力和生活质量得分表明,离开劳动力市场可能会减轻与照顾相关的挑战,这表明需要工作场所的灵活性来更好地支持照顾者。我们的研究强调了在照顾患者的同时支持照顾者的重要性,认识到照顾者的幸福感会显著影响患者预后。

政策总结

尽管与癌症护理相关的负担已有充分记录,但迫切需要支持照顾者的政策,如灵活的就业休假和心理健康支持资源,以改善患者及其非正式照顾者的生活质量和健康结局。

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