Complicated grief symptoms in caregivers of persons with lung cancer: the role of family conflict, intrapsychic strains, and hospice utilization.
Complicated grief symptoms in caregivers of persons with lung cancer: the role of family conflict, intrapsychic strains, and hospice utilization.
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肺癌患者护理人员的悲伤症状复杂：家庭冲突，心理菌株和临终关怀的作用。
DOI：
10.2190/om.62.3.a
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Yonker JA
中科院分区：
文献类型：
--
作者：
Kramer BJ;Kavanaugh M;Trentham-Dietz A;Walsh M;Yonker JA
本研究以压力过程概念模型为导向，探讨复杂哀伤症状的社会与心理决定因素，重点是家庭冲突、心理压力，以及照护品质与安宁疗护利用的潜在调节作用。根据来自威斯康星州癌症护理和满意度评估（ACCESS）辅助研究的152名配偶和成年子女肺癌护理者调查受访者的数据，采用分层多元回归分析来检查复杂悲伤的决定因素。在控制了环境因素和死亡后的时间后，复杂的悲伤症状在受教育程度较低的照顾者、之前冲突较少但在生命结束时冲突较多的家庭、有家庭成员难以接受疾病的家庭、以及照顾更害怕死亡的病人的家庭中更高。此外，安宁疗护的使用也能缓和死亡恐惧对复杂哀伤的影响。研究结果显示，家庭冲突、心理压力和安宁疗护的使用可能有助于解释丧亲照护者复杂哀伤症状的差异。对加强复杂的悲伤评估工具和预防干预的意义在整个癌症护理的连续性被强调。
Guided by a stress process conceptual model, this study examines social and psychological determinants of complicated grief symptoms focusing on family conflict, intrapsychic strains, and the potential moderating effect of care quality and hospice utilization. Relying on data from 152 spouse and adult child lung cancer caregiver survey respondents, drawn from an ancillary study of the Assessment of Cancer CarE and SatiSfaction (ACCESS) in Wisconsin, hierarchical multiple regression analysis was used to examine determinants of complicated grief. After controlling for contextual factors and time since death, complicated grief symptoms were higher among care-givers with less education, among families with lower prior conflict but higher conflict at the end-of-life, who had family members who had difficulty accepting the illness, and who were caring for patients with greater fear of death. Additionally, hospice utilization moderated the effect of fear of death on complicated grief. Findings suggest that family conflict, intrapsychic strains, and hospice utilization may help to explain the variability found in complicated grief symptoms among bereaved caregivers. Implications for enhancing complicated grief assessment tools and preventative interventions across the continuum of cancer care are highlighted.
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