Understanding psychological distress among pediatric cancer caregivers.
Understanding psychological distress among pediatric cancer caregivers.
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DOI：
10.1007/s00520-016-3136-z
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Fluchel M
中科院分区：
文献类型：
--
作者：
Nam GE;Warner EL;Morreall DK;Kirchhoff AC;Kinney AY;Fluchel M
很少有研究探讨儿童癌症患者的照顾者的痛苦。我们评估了社会经济学、人口统计学和患者临床因素对照顾者自我报告的与癌症儿童相关的心理困扰的相关性。2010年7月至2012年7月，N=366名儿科癌症护理人员完成了自填式问卷。事件影响量表（IES），沿着两个分量表“侵入”和“回避”测量照顾者癌症特异性痛苦，分数越高表示更大的痛苦。使用多变量线性回归模型计算社会经济学、人口统计学和临床因素的IES系数（β）和95%置信区间（95% CI）。平均护理人员IES评分为31.2（标准差（SD）=16.9，范围0-75）。平均侵入评分为18.1（SD 9.8，范围0-35），回避评分为12.8（SD 9.0，范围0-40）。家庭收入<40，000美元的照顾者比收入在40，000 - 79，999美元之间的照顾者报告了更高的平均痛苦评分（β=4.45，95% CI 0.04-8.87，p=0.05）。很少或从不参加宗教活动、儿童年龄较小和AML诊断与较高的侵入性相关（所有p<0.05）。与未接受治疗的儿童相比（β = 3.13，95% CI 0.93-5.33，p<0.01），目前正在接受治疗的儿童的护理人员报告了更高的总体IES（β=5.9，95% CI 2.15-9.7，p <0.01）和侵入（β=4.1，95% CI 1.9-6.3，p<0.001）评分。我们的研究结果确定社会经济和临床因素，影响儿童肿瘤患者的照顾者的心理困扰。这些发现强调了制定和测试干预措施的重要性，这些干预措施旨在评估和解决高风险护理人员以及患者的心理需求。
Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic and patient clinical factors on caregivers’ self-reported psychological distress associated with having a child with cancer. N=366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010-July 2012. The Impact of Event Scale (IES), along with two subscales “intrusion” and “avoidance” measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95% Confidence Intervals (95% CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (Standard Deviation (SD)=16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes <$40,000 reported higher mean distress scores than those with incomes ranging from $40,000-$79,999 (β=4.45, 95% CI 0.04-8.87, p=0.05). Infrequently or never attending religious services, younger child age, and a diagnosis of AML were associated with higher intrusion (all p<0.05). Caregivers with a child currently receiving therapy reported higher overall IES (β=5.9, 95% CI 2.15-9.7, p<0.01) and intrusion (β=4.1, 95% CI 1.9-6.3, p<0.001) scores compared to those off therapy (β=3.13, 95% CI 0.93-5.33, p<0.01). Our findings identify socioeconomic and clinical factors that influence psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating, and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.
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