The self-care practices of family caregivers of persons with poor prognosis cancer: differences by varying levels of caregiver well-being and preparedness.
The self-care practices of family caregivers of persons with poor prognosis cancer: differences by varying levels of caregiver well-being and preparedness.
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DOI：
10.1007/s00520-017-3650-7
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发表时间：
2017-08
期刊：
影响因子：
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通讯作者：
Bakitas MA
中科院分区：
文献类型：
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作者：
Dionne-Odom JN;Demark-Wahnefried W;Taylor RA;Rocque GB;Azuero A;Acemgil A;Martin MY;Astin M;Ejem D;Kvale E;Heaton K;Pisu M;Partridge EE;Bakitas MA
对于患有预后不良癌症的成年人的家庭照顾对照顾者自己的个人自我护理实践的影响知之甚少。我们探讨了照顾者的离散自我护理实践与不同水平的照顾者的福祉，准备和决策自我效能感的差异。美国东南部八个社区癌症中心的横断面调查。医疗保险受益人的家庭照顾者年龄≥65岁，患有胰腺癌、肺癌、脑癌、卵巢癌、头颈癌、血液癌或IV期癌症，完成了个人自我护理实践的测量（健康责任，身体活动，营养，精神成长，人际关系，压力管理和睡眠），幸福（焦虑、抑郁和健康相关生活质量[HRQoL]）、准备和决策自我效能。护理人员（n=294）平均年龄66岁，主要为女性（72.8%）、白色（91.2%）、新教徒（76.2%）、退休人员（54.4%）和患者配偶/伴侣（60.2%）。大约一半（46.9%）是收入低于50 000美元（53.8%）的农村居民。大多数人每周提供6-7天（71%）的支助，时间超过1年（68%）。近四分之一（23%）的人报告高度抑郁，34%报告边缘或高度焦虑。在所有自我护理实践中的低参与度与更差的照顾者焦虑，抑郁和精神HRQoL相关（所有p值<0.05）。健康责任感、心灵成长、人际关系、压力管理得分较低的照顾者，其准备与决策自我效能感较低。一个显着比例的照顾者同时报告低参与各种形式的自我护理的做法，高抑郁和焦虑，低HRQoL心理健康评分。照顾者的福祉，准备和决策的自我效能可能会优化，通过针对性的干预措施，以提高健康责任，压力管理，人际关系，和精神成长自我保健的做法。
Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers’ own individual self-care practices. We explored differences in caregivers’ discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy. Cross-sectional survey within eight community-based southeastern U.S. cancer centers. Family caregivers of Medicare beneficiaries ≥65 years with pancreatic, lung, brain, ovarian, head & neck, hematologic, or stage IV cancer completed measures of individual self-care practices (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep), well-being (anxiety, depression, and health-related quality of life [HRQoL]), preparedness, and decision-making self-efficacy. Caregivers (n=294) averaged 66 years, were mostly female (72.8%), white (91.2%), Protestant (76.2%), retired (54.4%) and patients’ spouse/partner (60.2%). Approximately half were rural-dwellers (46.9%) with incomes <$50,000 (53.8%). Most provided support 6–7 days/week (71%) for >1 year (68%). Nearly a quarter (23%) reported high depression and 34% reported borderline or high anxiety. Low engagement in all self-care practices was associated with worse caregiver anxiety, depression, and mental HRQoL (all p-values<.05). Caregivers with lower health responsibility, spiritual growth, interpersonal relation, and stress management scores had lower preparedness and decision-making self-efficacy. A significant proportion of caregivers simultaneously report low engagement in all forms of self-care practices, high depression and anxiety, and low HRQoL mental health scores. Caregiver well-being, preparedness, and decision-making self-efficacy might be optimized through interventions targeted at enhancing health responsibility, stress management, interpersonal relationships, and spiritual growth self-care practices.