Quality of life discordance between terminal cancer patients and family caregivers: a multicenter study
Quality of life discordance between terminal cancer patients and family caregivers: a multicenter study
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DOI：
10.1007/s00520-016-3108-3
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发表时间：
2016-07-01
影响因子：
3.1
通讯作者：
Kim, So Jin
中科院分区：
文献类型：
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作者：
Lee, Yong Joo;Kim, Jung Eun;Kim, So Jin
背景：关于癌症患者和家庭照顾者之间生活质量（QOL）不一致的研究有限，结果不一致。本研究的目的是探讨患者和家庭照顾者之间的生活质量不一致的临终关怀设置，并确定与discordance.Methods相关的因素，我们招募了178名患者，家庭照顾者对从6个三级医院临终关怀姑息治疗单位在韩国在这个横断面研究。为了根据患者和家庭护理者的生活质量水平进行分组，我们分别使用欧洲癌症研究与治疗组织的姑息治疗生活质量问卷核心15和护理者生活质量指数-癌症来测量患者和家庭护理者对的生活质量。配对被分为以下三组：两个良好的QOL对，只有穷人的病人QOL，只有穷人的家庭照顾者QOL。与只有差的患者或只有差的家庭照顾者的生活质量相关的因素进行了比较，两个良好的生活质量对。结果家庭照顾者的生活质量与晚期癌症患者的生活质量无显著相关性（P=0.227）。同样，患者的情绪功能差是与唯一的患者QOL差组相关的唯一显著因素[校正比值比（aOR），4.1; 95%置信区间（CI），1.5-11.5]。然而，情绪困扰的家庭照顾者（aOR，10.2; 95%CI，2.8-37.5），家庭成员中有宗教信仰者（aOR，4.1; 95%CI，1.5-11.3），以及社会支持低的家庭照顾者（aOR，3.9; 95%可信区间，1.5-10.6）是唯一的家庭照顾者生活质量差组的独立预测因素。结论评估患者和家庭照顾者各自的情绪状态是在临终关怀中需要减少两组之间生活质量的差距。此外，还应更多地关注家庭照顾者缺乏社会支持的问题。
Background Research studies on quality of life (QOL) discordance between cancer patients and family caregivers are limited, and the results are inconsistent. The objective of this study was to examine QOL discordance between patients and family caregivers in a hospice setting and to identify factors associated with the discordance.Methods We enrolled 178 patient-family caregiver pairs from six tertiary hospital hospice palliative care units in South Korea in this cross-sectional study. To establish groupings based on patient and family caregiver QOL levels, we measured the QOL of patient and family caregiver pairs using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care and the Caregiver QOL Index-Cancer, respectively. Pairs were categorized into the following three groups: both good QOL pairs, only poor patient QOL, and only poor family caregiver QOL. Factors associated with only poor patient or only poor family caregiver QOL were compared to both good QOL pairs. A stepwise multivariate regression model was used to identify relevant factors.Results The QOL of family caregivers did not correlate significantly (P=0.227) with QOL in terminally ill cancer patients. As well, poor emotional function in patients was the only significant factor associated with the only poor patient QOL group [adjusted odds ratio (aOR), 4.1; 95 % confidence interval (CI), 1.5-11.5]. However, emotionally distressed family caregivers (aOR, 10.2; 95 % CI, 2.8-37.5), family caregiverswho professed a religion (aOR, 4.1; 95% CI, 1.5-11.3), and family caregivers with low social support (aOR, 3.9; 95% CI, 1.5-10.6) were independent predictors for the only poor family caregiver QOL group.Conclusions Assessing the respective emotional status of both the patient and family caregiver is needed in hospice care to reduce the gap in QOL between the two groups. Further, more attention should be paid to the lack of social support for family caregivers.