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在临终姑息治疗环境中,特质焦虑水平高对家庭照顾者的生物心理社会影响。

Biopsychosocial impact of high levels of trait anxiety on family caregivers in the end-of-life palliative care setting.

作者信息

Grumeth Anastasia Maria, Rothenhäusler Hans-Bernd, Mörkl Sabrina, Wagner-Skacel Jolana, Sciri Elisabeth, Baranyi Andreas

机构信息

Department of Psychiatry, Psychosomatics and Psychotherapeutic Medicine, Division of Psychiatry and Psychotherapeutic Medicine, Graz, Austria.

Department of Psychiatry, Psychosomatics and Psychotherapeutic Medicine, Division of Medical Psychology, Psychosomatics and Psychotherapeutic Medicine, Graz, Austria.

出版信息

PLoS One. 2025 Mar 18;20(3):e0307349. doi: 10.1371/journal.pone.0307349. eCollection 2025.

Abstract

INTRODUCTION

Caring for a family member with a palliative diagnosis at home is physically and mentally stressful. This prospective study explores the emotional and physical burdens experienced by family caregivers in end-of-life palliative care settings, particularly focusing on those caregivers with high levels of pre-existing trait anxiety. The following hypotheses were examined: 1.) Family caregivers with high levels of trait anxiety suffer from high levels of anxiety, stress, burnout symptoms, insomnia, daytime sleepiness, physical complaints, health-related anxiety and resentments. 2.) Caregivers with a high level of trait anxiety are less resilient and receive less social support. They are more likely to use inappropriate strategies in the context of emotional regulation and work-related behavior. 3.) The support provided by the mobile palliative care team reduces stress and improves the quality of sleep of the caregiving relatives.

METHODS

Forty-seven caregivers participated, with assessments conducted at two time points: before the mobile palliative care team's intervention and six weeks later. Data collection included measures such as the State-Trait Anxiety Inventory (STAI), Whiteley Index (WI), Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Giessen Complaints Questionnaire, Berner Bitterness Inventory (BVI), Brief Resilience Coping Scale, FEEL-E for emotional regulation, AVEM, and the MOS Social Support Survey.

RESULTS

High levels of trait anxiety among caregivers were significantly associated with increased anxiety, stress, emotional exhaustion, depersonalization, insomnia, and feelings of resentment. Notably, maladaptive emotional regulation strategies were also prevalent. Intervention by the mobile palliative care team significantly reduced stress and insomnia, showing benefits across all levels of trait anxiety.

CONCLUSION

Family caregivers with high trait anxiety face significant challenges in end-of-life palliative care settings, indicating a crucial need for early identification and comprehensive biopsychosocial support to mitigate adverse emotional and physical health outcomes.

摘要

引言

在家照顾患有姑息性诊断的家庭成员会带来身心压力。这项前瞻性研究探讨了临终姑息治疗环境中家庭照顾者所经历的情感和身体负担,尤其关注那些特质焦虑水平较高的照顾者。检验了以下假设:1. 特质焦虑水平高的家庭照顾者会遭受高水平的焦虑、压力、倦怠症状、失眠、日间嗜睡、身体不适、健康相关焦虑和怨恨情绪。2. 特质焦虑水平高的照顾者复原力较低,获得的社会支持较少。他们在情绪调节和工作相关行为方面更有可能采用不适当的策略。3. 移动姑息治疗团队提供的支持可减轻压力并改善照顾亲属的睡眠质量。

方法

47名照顾者参与研究,在两个时间点进行评估:移动姑息治疗团队干预前和六周后。数据收集包括状态-特质焦虑量表(STAI)、怀特利指数(WI)、感知压力量表(PSS-10)、马氏倦怠量表(MBI-HSS)、失眠严重程度指数(ISI)、爱泼华嗜睡量表(ESS)、吉森症状问卷、伯尔尼怨恨量表(BVI)、简短复原力应对量表、情绪调节FEEL-E量表、AVEM量表以及医学结局研究社会支持调查等测量工具。

结果

照顾者的高特质焦虑水平与焦虑、压力、情绪耗竭、去个性化、失眠和怨恨情绪的增加显著相关。值得注意的是,适应不良的情绪调节策略也很普遍。移动姑息治疗团队的干预显著减轻了压力和失眠,对所有特质焦虑水平的照顾者均有益处。

结论

特质焦虑水平高的家庭照顾者在临终姑息治疗环境中面临重大挑战,这表明迫切需要早期识别和全面的生物心理社会支持,以减轻不良的情绪和身体健康后果。

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