Effects of caregiving status and changes in depressive symptoms on development of physical morbidity among long-term cancer caregivers.
Effects of caregiving status and changes in depressive symptoms on development of physical morbidity among long-term cancer caregivers.
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DOI：
10.1037/hea0000528
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Cannady RS
中科院分区：
文献类型：
--
作者：
Shaffer KM;Kim Y;Carver CS;Cannady RS
众所周知，癌症照护负担在患者的生存轨迹中各不相同，并且与照护者随后的健康损害有关。然而，对于长期生存期间的风险因素如何与该时期照护者健康的脆弱性相关，人们知之甚少。本研究考察了在诊断后五年内，照护状况和抑郁症状对身体发病情况发展的影响。
家庭照护者（N = 491；平均年龄M = 55.78）在其照护对象被诊断出癌症后的两年（T1）和五年（T2）完成了调查。在T1评估了已知会影响照护者健康的人口统计学和照护背景变量。在T1和T2评估了自我报告的抑郁症状以及一系列身体疾病状况。在T2评估了照护状况（曾经照护、正在照护或丧亲）。
分层负二项回归显示，在控制其他变量的情况下，与曾经照护者相比，T2时正在照护的照护者（p = 0.02），而不是T2时丧亲的照护者（p = 0.32），在T1和T2之间出现了更多的身体疾病状况。独立地，在T2报告新出现或长期抑郁症状加重的照护者（p值<0.03），而不是那些在T2症状缓解的照护者（p = 0.61），比在T1和T2都报告极少抑郁症状的照护者表现出更严重的身体发病情况。
研究结果强调了长期照护需求和抑郁症状在癌症照护者过早身体健康下降中的作用。对于患有复发性或长期疾病的患者的照护者，应强调在长期生存轨迹中的临床关注，并解决照护者抑郁症状加重的问题。
Cancer caregiving burden is known to vary across the survivorship trajectory and has been linked with caregivers’ subsequent health impairment. Little is known, however, regarding how risk factors during long-term survivorship relates to vulnerability to caregivers’ health during that period. This study examined effects of caregiving status and depressive symptoms on development of physical morbidity by five years post-diagnosis. Family caregivers (N=491; age M=55.78) completed surveys at two (T1) and five years (T2) after their care recipients’ cancer diagnosis. Demographic and caregiving context variables known to affect caregivers’ health were assessed at T1. Self-reported depressive symptoms and a list of physical morbid conditions were assessed at T1 and T2. Caregiving status (former, current, or bereaved) was assessed at T2. Hierarchical negative binomial regression revealed that current caregivers at T2 (p=.02), but not those bereaved by T2 (p=.32), developed more physical morbid conditions between T1 and T2 compared with former caregivers, controlling for other variables. Independently, caregivers reporting either newly emerging or chronically elevated depressive symptoms at T2 (ps<.03), but not those whose symptoms remitted at T2 (p=.61), showed greater development of physical morbidity than those reporting minimal depressive symptoms at both T1 and T2. Results highlight the roles of long-term caregiving demands and depressive symptoms in cancer caregivers’ premature physical health decline. Clinical attention through the long-term survivorship trajectory should be emphasized for caregivers of patients with recurrent or prolonged illness and to address caregivers’ elevated depressive symptoms.
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DOI：
10.1073/pnas.1531903100
发表时间：
2003-07-22
影响因子：
11.1
作者：
Kiecolt-Glaser, JK;Preacher, KJ;Glaser, R
通讯作者：
Glaser, R
影响因子：
14
作者：
通讯作者：
--
影响因子：
2
作者：
GIVEN, CW;GIVEN, B;FRANKLIN, S
通讯作者：
FRANKLIN, S
影响因子：
2.6
作者：
Cora, Alice;Partinico, Manuela;Palomba, Daniela
通讯作者：
Palomba, Daniela
影响因子：
14.6
作者：
Grunfeld, E;Coyle, D;Glossop, R
通讯作者：
Glossop, R