Passages of cancer caregivers' unmet needs across 8 years.
Passages of cancer caregivers' unmet needs across 8 years.
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DOI：
10.1002/cncr.33053
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发表时间：
2020-10-15
期刊：
影响因子：
6.2
通讯作者：
Cannady RS
中科院分区：
文献类型：
--
作者：
Kim Y;Carver CS;Ting A;Cannady RS
有人建议，查明和解决照顾者未得到满足的需求，是减轻他们的痛苦和提高生活质量的一种手段。然而，家庭癌症护理人员的需求很复杂，特别是在长期生存期，因为需求可能会有所不同，本研究调查的患者生存轨迹也是如此。家庭癌症照顾者在诊断后2年，5年和8年完成了前瞻性纵向调查（n=633）。在2年时测量早期发育特征和人口统计学。在三次评估中测量了照顾者状态（前缓解期，当前照顾者和丧失亲人的照顾者）和未满足的需求。照顾者在8岁时未满足的需求可归因于他们的患者的疾病轨迹偏离最初的护理接受者，从而使他们的疾病状态发生变化。具体而言，在长期生存期内，无论是延长的死亡时间还是从死亡中中断，然后是丧亲，都与8年时未满足的需求的各个领域有关（t> 2.35，p<0.02）。早期感知的工作压力也可以预测8岁时未满足需求的所有领域（t> 2.50，p<0.02）。在三个评估时间点中，8年时未满足的需求最高（F> 37.51，p<.001）。8年以上的照顾状况轨迹是家庭照顾者8年未满足需求的重要预测因素。研究结果为制定以证据为基础的计划和以患者/患者为中心的护理政策提供了指导，以减少亲属诊断后多年家庭护理人员未满足的需求，反映了癌症的不同轨迹。照顾者的需求未得到满足是由于他们的病人的疾病轨迹偏离了作为一个照顾者的8年以上的照顾状态。研究结果为制定以证据为基础的计划和以患者/患者为中心的护理政策提供了指导，以减少亲属诊断后多年家庭护理人员未满足的需求，反映了癌症的不同轨迹。
Identifying and addressing the caregivers’ unmet needs have been suggested as a mean of reducing their distress and improving quality of life. However, needs of family cancer caregivers are complex in the period of long-term survivorship in particular, as the needs may diverge as does the patients’ survivorship trajectory, which this study investigated. Family cancer caregivers completed a prospective longitudinal surveys at 2, 5, and 8 years post-diagnosis (n=633). Early caregiving characteristics and demographics were measured at 2 years. Caregiver status (former caregivers-remission, current caregivers, and bereaved caregivers) and unmet needs were measured at three assessments. Caregivers’ unmet needs at 8 years were attributable to the passages of the caregiving status as their patients’ illness trajectory diverges from being initially a care recipient. Specifically, either prolonged caregiving or having a break from caregiving followed by bereavement during the long-term survivorship was related to various domains of unmet needs at 8 years (t> 2.35, p<.02). Early perceived caregiving stress also predicted all domains of unmet needs at 8 years (t> 2.50, p<.02). Unmet needs at 8 years were the highest across the three assessment timepoints (F> 37.51, p<.001). Caregiving status trajectory over 8 years was a substantial predictor of family caregivers’ unmet needs at the 8 year mark. Findings provide guidance for development of evidence-based programs and patient/caregiver-centered care policies to reduce the unmet needs of family caregivers many years after their relatives’ diagnosis reflecting the diverse trajectories of cancer caregivership. Caregivers’ unmet needs are attributable to the caregiving status over 8 years as their patients’ illness trajectory diverges from being a care recipient. Findings provide guidance for development of evidence-based programs and patient/caregiver-centered care policies to reduce the unmet needs of family caregivers many years after their relatives’ diagnosis reflecting the diverse trajectories of cancer caregivership.
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6.2
作者：
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