How Does Caregiver Well-Being Relate to Perceived Quality of Care in Patients With Cancer? Exploring Associations and Pathways
How Does Caregiver Well-Being Relate to Perceived Quality of Care in Patients With Cancer? Exploring Associations and Pathways
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DOI：
10.1200/jco.2016.67.3434
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发表时间：
2016-10-10
影响因子：
45.3
通讯作者：
Rowland, Julia H.
中科院分区：
文献类型：
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作者：
Litzelman, Kristin;Kent, Erin E.;Rowland, Julia H.
感知护理质量（QOC）是一个越来越重要的衡量护理质量的指标，并可能受到癌症患者的生活质量和医生信任等因素的影响。本研究旨在评估是否非正式的照顾者的幸福感也与癌症患者的QOC感知和评估潜在的途径，这些factors.MethodsThis研究使用的数据从癌症护理结果研究和监测（CanCORS）财团。入组CanCORS的肺癌和结直肠癌患者（N = 689）提名一名非正式护理人员参加随访调查。两组患者均自我报告了社会人口统计学、心理社会学和生活特征;癌症特征来自CanCORS核心数据集。多变量逻辑回归被用来评估照顾者的心理社会因素和随后的患者感知的QOC之间的关联，控制早期的患者感知的QOC和协变量。二次分析研究潜在的途径，这些factor.ResultsPatients的非正式照顾者有较高水平的抑郁症状显着更有可能报告公平或穷人的QOC（比值比，1.06; 95%CI，1.01至1.13）。当照顾者报告一般或较差的自评健康状况时，患者报告一般或较差的感知QOC的可能性增加了三倍以上（比值比，3.76; 95%CI，1.76至9.55）。控制患者的心理社会因素和医生的沟通和协调的医疗护理减少了这些关系的影响大小和/或统计学意义。ConclusionInformal照顾者是护理团队的重要组成部分，他们的幸福感与患者感知的QOC。将非正式癌症护理人员作为护理团队的一部分，并进行持续的风险分层筛查和干预，以优化他们的健康状况，可能会改善患者报告的结局和QOC。
PurposePerceived quality of care (QOC) is an increasingly important metric of care quality and can be affected by such factors among patients with cancer as quality of life and physician trust. This study sought to evaluate whether informal caregiver well-being was also associated with perceived QOC among patients with cancer and assessed potential pathways that link these factors.MethodsThis study used data from the Cancer Care Outcomes Research and Surveillance (CanCORS) consortium. Patients with lung and colorectal cancer enrolled in CanCORS (N = 689) nominated an informal caregiver to participate in a caregiving survey. Both groups self-reported sociodemographic, psychosocial, and caregiving characteristics; cancer characteristics were obtained from the CanCORS core data set. Multivariable logistic regression was used to assess the association between caregiver psychosocial factors and subsequent patient-perceived QOC, controlling for earlier patient-perceived QOC and covariates. Secondary analysis examined potential pathways that link these factors.ResultsPatients whose informal caregiver had higher levels of depressive symptoms were significantly more likely to report fair or poor QOC (odds ratio, 1.06; 95% CI, 1.01 to 1.13). When caregivers reported fair or poor self-rated health, patients were more than three times more likely to report fair or poor perceived QOC (odds ratio, 3.76; 95% CI, 1.76 to 9.55). Controlling for patient psychosocial factors and physician communication and coordination of medical care reduced the effect size and/or statistical significance of these relationships.ConclusionInformal caregivers are an important part of the care team and their well-being is associated with patient-perceived QOC. Engaging informal cancer caregivers as part of the care team and conducting ongoing risk stratification screening and intervention to optimize their health may improve patient-reported outcomes and QOC.