Pitzer Kyle, Washington Karla T, Hudson Darrell L, Makinde Keisha White, Becker Todd D, Oliver Debra Parker, Benson Jacquelyn J, Demiris George
School of Medicine, Washington University in St. Louis, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
Department of Health Education and Health Equity, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
Support Care Cancer. 2025 Jun 23;33(7):614. doi: 10.1007/s00520-025-09676-3.
Caregivers of patients diagnosed with cancer experience a variety of stressors related to their roles and responsibilities. Due to these stressors, mental health issues are much more prevalent among these caregivers than the general population. Individual and contextual factors may exacerbate these mental health issues, including where a caregiver lives. This study examined the association between area deprivation and mental health among caregivers of patients with cancer as well as differential associations based on household income.
As part of a larger clinical trial for caregivers of patients with cancer receiving outpatient palliative care, caregivers completed demographic and baseline surveys from which the data were derived. To determine area deprivation, caregiver addresses were geocoded. Linear models were then estimated to assess the association between area deprivation and anxiety and depression and interactions between area deprivation and household income. Exploratory subgroup analyses based on hours of care provided per week were also performed.
While there was no significant association between area deprivation and depression regardless of household income, the models did indicate a cross-over association between area deprivation and anxiety by household income. Specifically, caregivers with annual household incomes less than $70,000 had greater anxiety as area deprivation increased while caregivers with household incomes greater than $70,000 had lesser anxiety as area deprivation increased, on average.
The findings highlight the importance of considering both the financial situation and the living environment of caregivers when developing practices and clinical infrastructure to support those caring for cancer patients.
被诊断患有癌症的患者的照料者会经历与他们的角色和责任相关的各种压力源。由于这些压力源，心理健康问题在这些照料者中比在普通人群中更为普遍。个体和环境因素可能会加剧这些心理健康问题，包括照料者居住的地方。本研究调查了癌症患者照料者的地区贫困与心理健康之间的关联，以及基于家庭收入的差异关联。
作为一项针对接受门诊姑息治疗的癌症患者照料者的大型临床试验的一部分，照料者完成了人口统计学和基线调查，数据由此得出。为了确定地区贫困程度，对照料者的住址进行了地理编码。然后估计线性模型，以评估地区贫困与焦虑和抑郁之间的关联，以及地区贫困与家庭收入之间的相互作用。还基于每周提供的照料时长进行了探索性亚组分析。
无论家庭收入如何，地区贫困与抑郁之间均无显著关联，但模型确实表明地区贫困与焦虑之间存在因家庭收入而异的关联。具体而言，家庭年收入低于7万美元的照料者，随着地区贫困程度的增加，焦虑程度更高；而家庭收入高于7万美元的照料者，随着地区贫困程度的增加，平均焦虑程度更低。
研究结果凸显了在制定支持癌症患者照料者的实践和临床基础设施时，考虑照料者财务状况和生活环境的重要性。
