A national profile of health-focused caregiving activities prior to a new cancer diagnosis.
A national profile of health-focused caregiving activities prior to a new cancer diagnosis.
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DOI：
10.1016/j.jgo.2021.11.010
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发表时间：
2022-05
影响因子：
3
通讯作者：
Ornstein, Katherine A.
中科院分区：
文献类型：
--
作者：
Liu, Bian;Kent, Erin E.;Dionne-Odom, J. Nicholas;Alpert, Naomi;Ornstein, Katherine A.
很少有人知道如何无偿的家庭照顾者可能已经在他们的照顾对象的癌症诊断之前从事的活动。我们研究了癌前诊断的变异模式及其与变异株的关系。我们对2011-2017年国家健康和老龄化趋势研究（NHATS）与国家护理研究（NSOC）和医疗保险索赔数据进行了基于人口的分析。潜类分析被用来检查16个以健康为中心的任务的模式（例如，跟踪药物，预约）的家庭护理人员协助成年人≥65岁之前的事件癌症诊断。高应变定义为6个应变项目的总分≥ 85百分位数（例如，经济困难，没有时间给自己）。使用多变量逻辑回归分析，调整护理接受者和护理者的特征，研究了护理模式和应变之间的关联。在2011-2017年期间，估计有420万护理人员在护理人员新诊断出癌症之前照顾老年人。他们平均参与了四项以健康为中心的活动。近五分之一（18.7%）的癌前护理人员患有高度护理压力。照顾者被分为3个以健康为中心的活动类别：低水平（41.2%），中度协调（29.3%）和高强度（29.4%）。较高的生育活动与较高的生育应变相关（校正比值比（aOR）=3.85，95%CI：2.34-6.33）。高强度类别的照顾者的工作压力最高（39.9%），包括更多的配偶（28.1%对<18%）。在美国，三分之一在癌症诊断之前帮助老年人的护理人员已经高度紧张，并从事以健康为重点的高水平护理任务。肿瘤临床医生应评估可能已经支持新诊断癌症患者的家庭照顾者的能力和压力，并将照顾者转介到其他支持性护理服务。
Little is known about how unpaid family caregivers may already be engaged in caregiving activities prior to their care recipient’s cancer diagnosis. We examined pre-cancer diagnosis caregiving patterns and their association with caregiving strain. We conducted a population-based analysis of 2011–2017 National Health and Aging Trends Study (NHATS) linked with National Study of Caregiving (NSOC) and Medicare claims data. Latent class analysis was used to examine patterns of 16 health-focused caregiving tasks (e.g., tracking medications, making appointments) of family caregivers assisting adults ≥65 years prior to an incident cancer diagnosis. High caregiving strain was defined as a total score ≥85th percentile of 6 caregiving strain items (e.g., financial difficulty, no time for self). Association between caregiving patterns and strain were examined using multivariable logistic regression, adjusting for care recipient and caregiver characteristics. An estimated 4.2 million caregivers cared for older adults prior to care recipients’ new cancer diagnoses during 2011–2017. They engaged in a median of four health-focused caregiving activities. Nearly 1-in-5 (18.7%) pre-cancer caregivers had high caregiving strain. Caregivers were classified into 3 health-focused caregiving activity classes: Low-level (41.2%), Moderate-coordination (29.3%), and High-intensity (29.4%). Higher caregiving activity was associated with higher caregiving strain (adjusted odds ratio (aOR)=3.85, 95% CI: 2.34–6.33). Caregivers in the High-intensity class had the highest caregiving strain (39.9%), and include more spouses (28.1% vs <18%). One-third of U.S. caregivers who help older adults prior to their cancer diagnoses are already highly strained and engaged in high-level health-focused caregiving tasks. Oncology clinicians should assess the capacity and strain of family caregivers who may already be supporting patients with new cancer diagnoses and refer caregivers to additional supportive care services.
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影响因子：
6.2
作者：
Kent EE;Rowland JH;Northouse L;Litzelman K;Chou WY;Shelburne N;Timura C;O'Mara A;Huss K
通讯作者：
Huss K
影响因子：
3.1
作者：
Goren, Amir;Gilloteau, Isabelle;DiBonaventura, Marco daCosta
通讯作者：
DiBonaventura, Marco daCosta
影响因子：
1.6
作者：
Geng HM;Chuang DM;Yang F;Yang Y;Liu WM;Liu LH;Tian HM
通讯作者：
Tian HM
影响因子：
4.4
作者：
Caba Y;Dharmarajan K;Gillezeau C;Ornstein KA;Mazumdar M;Alpert N;Schwartz RM;Taioli E;Liu B
通讯作者：
Liu B
影响因子：
2.8
作者：
Kim, Youngmee;Schulz, Richard
通讯作者：
Schulz, Richard