Nardella Nicole, Xia Brent Taiting, Allenson Kelvin, Oraiqat Adrianna, Fan Wenyi, Mo Qianxing, Permuth Jennifer, Kim Dae Won, Hodul Pamela
Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.
Division of Surgical Oncology, St. Elizabeth Healthcare, Edgewood, KY 41017, USA.
Healthcare (Basel). 2025 Jan 9;13(2):114. doi: 10.3390/healthcare13020114.
Through survey and analysis of pancreas cancer patient-caregiver dyads, we aimed to identify patient and caregiver characteristics that influence and determine the impact of caregiver coping strategies, self-esteem, and resilience on caregiver distress. This was a cross-sectional, observational study including pancreatic cancer patients and their caregivers. Demographics of patients and caregivers were collected. Caregivers completed validated instruments (National Comprehensive Cancer Network (NCCN) Distress Thermometer, Caregiver Reaction Assessment (CRA), Perceived Stress Scale 4 (PSS-4), Patient Reported Outcomes Measurement Information System-Anxiety/Depression Short Form (PROMIS-Anxiety/Depression), Brief Resilience Scale (BRS), Zarit Caregiver Burden Interview (CBI-12), and Brief Coping Orientation to Problems Experienced (COPE)) investigating anxiety, depression, perceived stress, caregiver burden, use of approach and avoidant coping, resilience, and self-esteem. Descriptive statistics, univariate, and multiple linear regression models were used to analyze the data. One hundred and fourteen patient-caregiver dyads were included in this study. The majority of patients were male (55%), 65% of caregivers were female, and 64% of patients were receiving palliative intent treatment. Younger caregiver age, more personal care tasks, higher patient distress, and caregiving for a parent were characteristics related to caregiver avoidant coping. Fewer caregiving activities and early clinical stage were associated with caregiver approach coping. High caregivers' self-esteem was significantly associated with fewer personal care tasks to perform and with caregivers of patients with higher levels of education. Avoidant coping and low resilience were both significantly correlated to distress, anxiety, depression, caregiver burden, and perceived stress. Additionally, low self-esteem was associated with a high perceived caregiver burden. Overall, caregiver factors such as age, relationship with the patient, and number of care tasks and activities influence caregivers coping and self-esteem. Additionally, patient education and clinical stage impacted caregiver coping and self-esteem. Developing interventions to address caregiver coping, self-esteem, and resilience will prove beneficial in improving caregiver distress, anxiety, depression, burden, and perceived stress.
通过对胰腺癌患者-照顾者二元组的调查和分析，我们旨在确定影响并决定照顾者应对策略、自尊和心理韧性对照顾者痛苦影响的患者和照顾者特征。这是一项横断面观察性研究，纳入了胰腺癌患者及其照顾者。收集了患者和照顾者的人口统计学信息。照顾者完成了经过验证的量表（美国国立综合癌症网络（NCCN）痛苦温度计、照顾者反应评估（CRA）、感知压力量表4（PSS-4）、患者报告结局测量信息系统-焦虑/抑郁简表（PROMIS-焦虑/抑郁）、简易心理韧性量表（BRS）、扎里特照顾者负担访谈（CBI-12）以及经历问题的简易应对取向（COPE）），以调查焦虑、抑郁、感知压力、照顾者负担、积极应对和消极应对的使用情况、心理韧性和自尊。使用描述性统计、单变量和多元线性回归模型对数据进行分析。本研究纳入了114对患者-照顾者二元组。大多数患者为男性（55%），65%的照顾者为女性，64%的患者接受姑息性治疗。照顾者年龄较小、个人护理任务较多、患者痛苦程度较高以及照顾父母是与照顾者消极应对相关的特征。较少的照顾活动和早期临床阶段与照顾者积极应对相关。照顾者的高自尊与较少的个人护理任务以及照顾受教育程度较高患者的照顾者显著相关。消极应对和低心理韧性均与痛苦、焦虑、抑郁、照顾者负担和感知压力显著相关。此外，低自尊与高照顾者负担感相关。总体而言，照顾者的年龄、与患者的关系以及护理任务和活动的数量等因素会影响照顾者的应对方式和自尊。此外，患者的教育程度和临床阶段会影响照顾者的应对方式和自尊。制定旨在解决照顾者应对方式、自尊和心理韧性的干预措施将有助于改善照顾者的痛苦、焦虑、抑郁、负担和感知压力。
