Caregiving Demands and Well-being in Parents of Children Treated With Outpatient or Inpatient Methotrexate Infusion: A Report From the Children's Oncology Group
Caregiving Demands and Well-being in Parents of Children Treated With Outpatient or Inpatient Methotrexate Infusion: A Report From the Children's Oncology Group
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DOI：
10.1097/mph.0b013e31828b0947
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发表时间：
2014-08-01
影响因子：
1.2
通讯作者：
Hinds, Pamela S.
中科院分区：
文献类型：
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作者：
Kelly, Katherine P.;Wells, Diane K.;Hinds, Pamela S.
父母的幸福感受到孩子的肿瘤治疗方案和相关的治疗需求的影响。对来自47个研究中心的161名父母的父母的养育需求和幸福感进行了评估，他们的孩子在急性淋巴细胞白血病巩固治疗期间随机接受4小时（门诊）或24小时（住院）甲氨蝶呤输注。随机分配至4小时输注组的大多数患者（66.3%）作为住院患者接受输注。最常报告的原因是缺乏足够的门诊设施（53.6%）和医生偏好（25.0%）。随机或实际输液地点的儿童健康需求和健康总分之间没有差异，但有一个例外：接受门诊输液的儿童的父母的健康量表疲劳评分显著更高（P = 0.001）。与健康对照人群相比，24小时组（mu = 42.6; SD 16.2）和4小时组（mu = 40.6; SD 14.1）的平均总体健康评分均升高。需要更多的研究来描述治疗环境对父母在儿童急性淋巴细胞白血病治疗期间的需求和幸福感的影响。在随机临床试验中，研究治疗地点影响的研究者需要控制门诊护理提供资源的机构变异性。
Parent well-being is affected by their child's oncology treatment regimen and associated caregiving demand. Parental caregiving demands and well-being were evaluated in 161 parents from 47 sites whose child was randomized to receive either a 4-hour (outpatient) or 24-hour (inpatient) methotrexate infusion during consolidation treatment for acute lymphoblastic leukemia. A majority of patients randomized to the 4-hour infusion (66.3%) received the infusion as an inpatient. The most frequently reported reasons for this were lack of an adequate outpatient facility (53.6%) and physician preference (25.0%). There were no differences between caregiving demand and well-being total scores by either randomized or actual infusion location with one exception: well-being scale fatigue scores were significantly greater (P = 0.001) for parents whose child received the outpatient infusion. Mean total well-being scores for both the 24-hour arm (mu = 42.6; SD 16.2) and the 4-hour arm (mu = 40.6; SD 14.1) were elevated compared to healthy control populations. Additional research is needed to characterize impact of treatment setting on parental caregiving demand and well-being during their child's treatment for acute lymphoblastic leukemia. Investigators examining impact of treatment location in randomized clinical trials need to control for institutional variability in outpatient care delivery resources.