Psychological and Social Profile of Family Caregivers on Commencement of Palliative Care
Psychological and Social Profile of Family Caregivers on Commencement of Palliative Care
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DOI：
10.1016/j.jpainsymman.2010.05.006
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发表时间：
2011-03-01
影响因子：
4.7
通讯作者：
Clarke, David
中科院分区：
文献类型：
--
作者：
Hudson, Peter L.;Thomas, Kristina;Clarke, David
上下文姑息治疗服务需要支持患有晚期、危及生命、不可治愈疾病的患者及其家庭护理人员。预计还将为失去亲人的家庭成员提供全面的心理和社会支助。然而，最近的系统性审查表明，这种支持的循证方法存在重大差距。此外，需要全面了解对家庭照顾者角色的心理和社会反应，以优化支持。我们试图研究的心理和社会概况的家庭照顾者开始接受姑息治疗服务。在澳大利亚墨尔本的三个姑息治疗服务中心，在入院后两周内向患者的主要家庭照顾者进行自我报告问卷调查。该问卷包括六种工具，测量11个家庭成员相关的心理社会因素;四种工具，测量照顾者的心理困扰因素; 14个心理健康的终身风险因素;和社会人口统计学。302名家庭照顾者参加了会议。近一半（44%）的照顾者有可能的焦虑和/或抑郁障碍，40%的得分超过可能的焦虑的临界值，20%的得分超过可能的抑郁的临界值。此外，大约15%的照顾者符合损失前悲伤的标准，大约10%的人报告了中度到重度的士气低落。可能患有焦虑和/或抑郁症的照顾者也报告了更高水平的损失前悲伤。这项研究提供了进一步的证据表明，在这一人群中普遍存在不良的心理社会福祉。结果加强了需要制定适当的战略，为家庭照顾者的心理和社会支持。J Pain Symptom Manage 2011; 41：522-534. (C)2011年美国癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. Palliative care services are required to support patients who have advanced, life-threatening, noncurable disease, and their family caregivers. Comprehensive psychological and social support for bereaved family members also is expected. However, recent systematic reviews have demonstrated significant gaps in evidence-based approaches for such support. Furthermore, a comprehensive understanding of the psychological and social response to the family caregiver role is required for support to be optimized.Objectives. We sought to examine the psychological and social profile of family caregivers on commencement of receiving palliative care services.Methods. A self-report questionnaire was administered to primary family caregivers of patients within two weeks of admission to three palliative care services in Melbourne, Australia. The questionnaire incorporated six instruments that measured 11 family caregiver-related psychosocial factors; four instruments that measured caregiver psychological distress factors; 14 mental health lifetime risk factors; and a sociodemographic questionnaire.Results. Three hundred and two family caregivers participated. Nearly half (44%) of the caregivers had a probable anxiety and/or depressive disorder, with 40% scoring more than the cutoff score for probable anxiety and 20% scoring more than the cutoff score for probable depression. Additionally, approximately 15% of caregivers met the criteria for pre-loss grief, and around 10% reported moderate to severe levels of demoralization. Caregivers who had a probable anxiety and/or depressive disorder also reported higher levels of pre-loss grief.Conclusion. This study provides further evidence of the prevalence of poor psychosocial well-being in this population. The results reinforce the need to develop suitable strategies for psychological and social support for family caregivers. J Pain Symptom Manage 2011; 41: 522-534. (C) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.