Burden and depression among caregivers of patients with cancer at the end of life
Burden and depression among caregivers of patients with cancer at the end of life
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DOI：
10.1188/04.onf.1105-1117
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发表时间：
2004-11-01
影响因子：
1.9
通讯作者：
Rahbar, M
中科院分区：
文献类型：
--
作者：
Given, B;Wyatt, G;Rahbar, M
目的/目标：检查患者和家庭护理人员变量，这些变量可预测癌症患者临终时家庭护理人员的护理负担和抑郁症。设计：对癌症诊断和治疗后的患者及其家庭护理人员的初始队列进行了一项前瞻性纵向研究。背景：美国中西部的社区肿瘤中心。样本：152 名在研究过程中死亡的癌症患者的家庭护理人员。方法：在诊断后第 64 周：12-16、24-30 和 52 周对患者进行了电话采访。此外，还审查了患者病历和州死亡证明。主要研究变量、看护者年龄、性别、教育程度、与患者的关系、就业、状况、患者症状报告、患者癌症类型、癌症分期、患者诊断到死亡的时间、看护者负担和抑郁的影响。结果：45-54岁的看护者报告的抑郁症状最高，35-44岁的看护者报告被遗弃感最强。癌症患者的照顾者、成年子女和受雇者报告了高水平的抑郁症状。在女性、非配偶和成年子女看护者中，被遗弃感（看护者负担的一部分）更为普遍，早期癌症患者和患有多种症状的患者的成年子女看护者报告称，由于提供护理，他们的日程安排被打乱。其患者在诊断后早期死亡的护理人员报告了最高的抑郁症状、负担和对日程的影响。结论：护理人员报告的抑郁水平处于临床抑郁症筛查的阈值。患者症状的数量与护理人员抑郁症状的水平有关。一个协会。也发现了抑郁症和就业状况之间的关系！护理人员的痛苦并不取决于护理需求。对护理的影响：很少有研究前瞻性地分析家庭护理人员在为家庭成员提供临终癌症护理时的负担和抑郁经历。旨在减少看护者抑郁症状的干预措施应针对中年、成年儿童和就业的看护者。旨在减轻在提供护理时感到被遗弃和日程安排被打乱相关的负担的干预措施应针对女性、非配偶和成年子女的护理人员，以及早期癌症和多种症状患者的护理人员。
Purpose/Objectives: To examine the patient and family caregiver variables that predicted caregiver burden and depression for family caregivers of patients with cancer at the end of life.Design: A prospective, longitudinal study was implemented with an., inception cohort of patients and their family caregivers who were followed after the diagnosis and treatment of cancer.Setting: Community oncology sites in the midwestern United States.Sample: 152 family caregivers of patients With cancer who died during the course of the study.Methods: Telephone interviews were conducted with patients at 64: 12-16, 24-30, and 52 weeks following diagnoses. In addition patient medical records and state death certificates were reviewed.Main Research Variables, Effect of caregiver age, gender, education,relationship to the patient, employment,status, reports of patient symptoms, patient cancer type, stage of cancer, time from the patient's diagnosis to death, caregiver burden, and depression.Findings: Caregivers aged 45-54 reported the highest levels of depressive symptoms, and caregivers aged 35-44 reported the strongest sense of abandonment. Caregivers who were,the adult children of patients with cancer and those who were employed reported high levels of depressive symptoms. Feeling abandoned (a portion of caregiver burden) was more prevalent in female, nonspouse, and adult children caregivers, and adult children caregivers of patients with early-stage cancer and patients with Multiple symptoms reported a high,perception of disruption in their schedule because of providing care. Carlegivers whose patients, died early following diagnosis reported the highest depressive symptoms, burden, and impact on schedule.Conclusions: Caregivers reported levels of depression at thresholds for screening of clinical depression. The number of patient symptoms was related to levels of caregiver depressive symptoms. An association. also was found between depression and employment status.! Caregiver distress was not dependent on demands of care.Implications for Nursing: Very little research exists that prospectively analyzes family caregiyer experiences of-burden and depression when providing end-of-life cancer care for a family member. Interventions aimed at decreasing caregiver depressive symptoms should be targeted to caregivers who are middle-aged, adult children, and employed. Interventions aimed at decreasing the burden associated with feeling abandoned and having schedules disrupted while providing care should be targeted to caregivers who are female, nonspouse, and adult children, and caregivers of patients with early-stage cancer and multiple symptoms.