Predictors of Healthcare Utilization in Family Caregivers of Persons With a Primary Malignant Brain Tumor.
Predictors of Healthcare Utilization in Family Caregivers of Persons With a Primary Malignant Brain Tumor.
复制标题
原发性恶性脑肿瘤患者家庭护理人员医疗保健利用的预测因素。
DOI：
10.1097/jnn.0000000000000732
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Loughan,Ashlee
中科院分区：
文献类型：
--
作者：
Goldberg,Isabella;Sherwood,Paula;Sereika,SusanM;Donovan,HeidiS;Weimer,Jason;Drappatz,Jan;Boele,Florien;Shi,Xiaojun;Loughan,Ashlee
背景：负向身体健康是由照顾患有原发恶性脑瘤的家庭成员所产生的情感压力造成的；然而，对照顾者的医疗保健利用(HCU)的下游影响尚不清楚。这项分析考察了患者确诊后6个月内照顾者的情绪健康与HCU标记物之间的关系。方法对116名神经肿瘤照顾者进行了一项纵向研究，分析了照顾者的自我报告HCU数据。医疗保健利用被操作为处方药的数量，报告到初级保健提供者(PCP)的就诊次数，PCP就诊的性质，共病情况的数量，以及共病情况的变化。潜在的预测因素是照顾者的抑郁症状(流行病学研究中心-抑郁量表)、每天提供护理的时间、掌握情况(皮尔林和斯库勒)和负担(照顾者反应评估)。采用Logistic混合效应模型。结果：给予者抑郁症状水平较高(P<；01)、焦虑(P=.02)，与时间表相关的负担(P=.02)和遗弃(P<；01)更有可能报告并存状况恶化。掌握程度较高者(P=.02)不太可能报告并存状况恶化。曾去过初级保健中心的照顾者自尊感较高(P=.03)更有可能报告与疾病相关的探视。结论研究结果表明神经肿瘤照顾者的情绪健康与他们的HCU之间存在关系。数据突出了护理者的初级保健医生识别有健康恶化和HCU增加风险的护理者的重要性，并进行干预以确保护理者的自我护理。
BACKGROUNDNegative physical health results from the emotional stress of providing care to a family member with a primary malignant brain tumor; however, the downstream effects on caregivers' healthcare utilization (HCU) are unknown. This analysis examined associations between caregivers' emotional health and markers of HCU during the 6 months after patients' diagnoses.METHODSCaregivers' self-report HCU data from a longitudinal study with 116 neuro-oncology caregivers were analyzed. Healthcare utilization was operationalized as number of prescription medications, reporting visits to primary care providers (PCPs), nature of PCP visit, number of comorbid conditions, and change in comorbid conditions. Potential predictors were caregivers' depressive symptoms (Center for Epidemiologic Studies-Depression Scale), hours providing care per day, mastery (Pearlin and Schooler), and burden (Caregiver Reaction Assessment). Logistic mixed effects modeling were used.RESULTSCaregivers with higher levels of depressive symptoms (P<. 01), anxiety (P=. 02), burden related to schedule (P=. 02), and abandonment (P<. 01) were more likely to report worsening comorbid conditions. Those with higher mastery (P=. 02) were less likely to report worsening comorbid conditions. Caregivers who had a PCP visit and reported higher burden related to feelings of self-esteem (P=. 03) were more likely to report an illness-related visit.CONCLUSIONFindings suggest a relationship between neuro-oncology caregivers' emotional health and their HCU. Data highlight the importance of caregivers' PCPs identifying caregivers at risk for deteriorating health and increased HCU and intervene to ensure caregivers' self-care.