Kurtz M E, Kurtz J C, Given C W, Given B
Department of Family Medicine, Michigan State University, East Lansing, USA.
Soc Sci Med. 1995 Mar;40(6):837-46. doi: 10.1016/0277-9536(94)00249-s.
This research examined, in a sample of N = 150 cancer patients and caregivers, the relationships among patient's physical functioning, depression and symptomatology, impact on caregivers' schedule and health, and caregiver depression, as well as the changes in these variables over time. A measure of caregivers' optimism was also included in the analyses. The disposition of caregiver optimism was a strong predictor of caregiver reactions to the burdens of caring, and seemed to play the role of a personality characteristic which was for the most part independent of patient variables. Levels of patient symptoms and their change over time were both strongly linked to change in patient immobility over time. Patient symptoms, and to a lesser degree patient immobility, were strong predictors of patient depression which in turn predicted caregiver depression. In general, as patients' needs subsided, caregivers perceived fewer reactions to the burdens of caring. Caregivers' reactions were clearly distinct, and were influenced differently by different patient variables. However, all three types of caregivers' reactions were influenced by caregivers' optimism. Oncologists, nurses and other health care professionals involved in the care of patients with cancer should consider this potentially important personal characteristic in the assessment of need for and the development of interventions designed to assist patients with cancer and their family caregivers.
本研究以150名癌症患者及其照料者为样本，考察了患者身体功能、抑郁及症状、对照料者日程安排和健康状况的影响、照料者抑郁之间的关系，以及这些变量随时间的变化。分析中还纳入了一项对照料者乐观程度的测量。照料者乐观的倾向是其对照料负担反应的有力预测指标，似乎起到了一种人格特征的作用，在很大程度上独立于患者变量。患者症状水平及其随时间的变化均与患者身体活动能力随时间的变化密切相关。患者症状，以及程度稍轻的患者身体活动能力，是患者抑郁的有力预测指标，而患者抑郁又进而预测照料者抑郁。总体而言，随着患者需求的减少，照料者感受到的照料负担反应也减少。照料者的反应明显不同，且受不同患者变量的影响也不同。然而，照料者的这三种反应均受照料者乐观程度的影响。参与癌症患者护理的肿瘤学家、护士和其他医护专业人员在评估帮助癌症患者及其家庭照料者的干预措施的需求和制定时，应考虑这一潜在的重要个人特征。
