Only the Lonely: Expression of Proinflammatory Genes Through Family Cancer Caregiving Experiences.
Only the Lonely: Expression of Proinflammatory Genes Through Family Cancer Caregiving Experiences.
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只有寂寞：通过家庭癌症护理经验表达促炎基因的表达。
DOI：
10.1097/psy.0000000000000897
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发表时间：
2021-02-01
影响因子：
3.3
通讯作者：
Penedo FJ
中科院分区：
文献类型：
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作者：
Kim Y;Cole SW;Carver CS;Antoni MH;Penedo FJ
癌症的经历不仅会引发家庭的动荡，也会增强家庭的韧性，这与家庭照顾者的心理调适和身体健康有关。然而，将家族癌症发病与健康联系起来的生物学途径仍然知之甚少。本研究探讨了在结直肠癌患者诊断后的第一年期间，心理风险和弹性因素与护理人员中促炎基因表达谱（逆境保守转录反应：CTRA）相关的程度。共有41名护理人员（平均年龄=54岁，74%为女性，40%为西班牙裔）在诊断后4个月和12个月左右提供了心理数据和外周血样本。使用控制人口统计学和生物特征因素的混合回归模型来测试照顾者CTRA基因表达与工作压力，孤独和缺乏社会支持（风险因素）以及利益发现和意义（弹性因素）的关联。当单独测试时，除了获益发现之外，所有获益发现与CTRA显著相关（R2≥.112，p<.045）。当调整风险组或韧性组的其他因素后，孤独感、社会支持和意义影响仍然显着（R2≥.120，p<.041）。当所有的研究因素同时调整（R2= 0.139），只有孤独仍然显着（p= 0.034）。研究结果表明，当照顾者经历低社会支持和孤独，以及他们的照顾没有意义或目的时，与照顾相关的转录效应似乎最明显。这些研究结果表明，优先减少照顾者孤独感的新干预策略的发展可能会对与照顾者健康相关的生物学机制产生有利影响。
The experience of cancer not only elicits turmoil but also resilience in the family, which has been related to psychological adjustment and physical health of family caregivers. The biological pathways linking family cancer caregiving to health, however, remain poorly understood. This study examined the extent to which psychological risk and resilience factors related to a proinflammatory gene expression profile (Conserved Transcriptional Response to Adversity: CTRA) among caregivers during the first year post-diagnosis of a colorectal cancer patient. A total of 41 caregivers (mean age=54 years old, 74% female, 40% Hispanic) provided psychological data and peripheral blood samples around 4 months and 12 months post-diagnosis. Mixed regression models controlling for demographic and biometric factors were used to test the associations of caregiver CTRA gene expression with caregiving stress, loneliness, and lack of social support (risk factors), as well as benefit finding and meaning (resilience factors). When individually tested, all but benefit finding were significantly related to CTRA (R2≥.112, p<.045). When adjusted for other factors in either the risk or resilience group, loneliness, social support, and meaning effects remained significant (R2≥.120, p<.041). When all study factors were simultaneously adjusted (R2=.139), only loneliness remained significant (p=.034). Findings suggest that caregiving-related transcriptional effects appear to be most pronounced when caregivers experience low social support and loneliness, as well as little meaning or purpose in their caregiving. These findings suggest that the development of new intervention strategies that prioritize reductions in caregiver loneliness may favorably impact biological mechanisms related to caregiver health.