Ouru Phoebe Abonyo, Zheng Hong, Lin Zhi, Yang Minghua
Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Hunan Clinical Research Center of Pediatric Cancer, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
PLoS One. 2025 Jun 6;20(6):e0324589. doi: 10.1371/journal.pone.0324589. eCollection 2025.
Caring for pediatric acute leukemia (PAL) patients poses significant psychological challenges for family caregivers, impacting their well-being and caregiving capacity. This multicenter study aimed to assess caregivers' perception of their caregiving role using the revised Caregiving Appraisal Scale (rCAS) and identify factors associated with negative and positive caregiving appraisals among caregivers of children with PAL.
A cross-sectional survey was conducted across three hospitals affiliated with Central South University. The 4-domain rCAS assessed both positive (satisfaction, mastery) and negative (burden, environmental impact) caregiving appraisals. Patient clinical data as well as demographics of both patients and caregivers were used to perform univariate, correlation, and multivariate regression analyses, identifying predictors of caregiver psychological distress.
Out of 111 recruited caregivers, 101 valid responses were analyzed. Univariate subgroup analysis showed that several caregiver- and patient-related factors were significantly associated with increased caregiver burden and environmental impact. For mastery and satisfaction, some factors were associated with higher appraisal scores while others were related to significantly lower scores. Correlation analysis showed that patient discomfort and difficulties significantly correlated with both negative and positive appraisals. The regression models revealed that the independent influencing factors contributed to about 23.9% of caregiver-perceived negative impact (P = 0.024) and 30.3% of caregiver-perceived positive impact (P < 0.001). Patient worry (P = 0.024), communication difficulties (P = 0.011), relationship to the patient (P = 0.017), and medical insurance type (P = 0.035) predicted negative appraisals while pain (P = 0.008), anxiety about surgical procedures (P = 0.022), relationship to the patient (P = 0.031), and caregiver educational level (P = 0.023) predicted positive appraisals.
Caregivers of pediatric acute leukemia experience considerable psychological strain. Despite these challenges, some caregivers report significantly higher positive appraisals. Targeted interventions are needed to reduce caregiver burden and enhance positive caregiving outcomes.
照顾小儿急性白血病（PAL）患者给家庭照顾者带来了巨大的心理挑战，影响他们的幸福感和照顾能力。这项多中心研究旨在使用修订后的照顾评估量表（rCAS）评估照顾者对其照顾角色的认知，并确定与PAL患儿照顾者负面和正面照顾评估相关的因素。
在中南大学附属的三家医院进行了横断面调查。4个维度的rCAS评估了正面（满意度、掌控感）和负面（负担、环境影响）照顾评估。患者临床数据以及患者和照顾者的人口统计学信息用于进行单因素、相关性和多因素回归分析，以确定照顾者心理困扰的预测因素。
在111名招募的照顾者中，分析了101份有效回复。单因素亚组分析表明，几个与照顾者和患者相关的因素与照顾者负担增加和环境影响显著相关。对于掌控感和满意度，一些因素与较高的评估得分相关，而其他因素则与显著较低的得分相关。相关性分析表明，患者的不适和困难与负面和正面评估均显著相关。回归模型显示，独立影响因素对照顾者感知到的负面影响贡献约23.9%（P = 0.024），对照顾者感知到的正面影响贡献30.3%（P < 0.001）。患者的担忧（P = 0.024）、沟通困难（P = 0.011）、与患者的关系（P = 0.017）和医疗保险类型（P = 0.035）预测负面评估，而疼痛（P = 0.008）、对手术程序的焦虑（P = 0.022）、与患者的关系（P = 0.031）和照顾者教育水平（P = 0.023）预测正面评估。
小儿急性白血病患者的照顾者经历了相当大的心理压力。尽管存在这些挑战，但一些照顾者报告的正面评估明显更高。需要有针对性的干预措施来减轻照顾者负担并提高正面照顾结果。
