Psychological Distress in Bereaved Caregivers of Patients With Advanced Cancer.
Psychological Distress in Bereaved Caregivers of Patients With Advanced Cancer.
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晚期癌症病人家属之心理困扰。
DOI：
10.1016/j.jpainsymman.2020.08.028
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发表时间：
2021-03
影响因子：
4.7
通讯作者：
Temel JS
中科院分区：
文献类型：
--
作者：
El-Jawahri A;Greer JA;Park ER;Jackson VA;Kamdar M;Rinaldi SP;Gallagher ER;Jagielo AD;Topping CEW;Elyze M;Jones B;Temel JS
照顾晚期癌症患者的个人（“护理者”）在患者的病程中经历心理困扰。然而，关于丧亲照护者心理困扰的患病率及其与患者EOL照护质量的关系的数据有限。我们对168名护理人员进行了二次分析，这些护理人员参加了一项针对无法治愈的肺癌和胃肠道癌症患者及其护理人员的支持性护理试验。我们使用医院焦虑和抑郁量表（HADS）评估护理人员在患者死亡后三个月的抑郁和焦虑症状。护理人员还在患者死后三个月对患者生命最后一周的身体和心理困扰进行了10分制的评分。我们采用线性回归调整照顾者的年龄、性别、随机化和癌症类型，以探讨丧亲照顾者的抑郁和焦虑症状与他们在EOL患者的生理和心理困扰评分之间的关系。在168名失去亲人的照顾者中，30.4% （n=51）和43.4% （n=73）分别报告了临床显著的抑郁和焦虑症状。照顾者对患者生理（B=0.32， P=0.009）和心理（B=0.50， P<0.001）痛苦的评分与丧失亲人的照顾者的抑郁症状加重相关。只有患者在EOL时所经历的更严重的心理困扰的照顾者评分（B=0.42， P<0.001）与丧失亲人的照顾者的更严重的焦虑症状相关。许多失去亲人的晚期癌症患者的照顾者都有抑郁和焦虑的症状，这与他们在EOL中感受到亲人的痛苦有关。许多晚期癌症患者的家属在亲人去世后的3到6个月里会出现明显的临床抑郁和焦虑症状。EOL患者的生理和心理困扰与失去亲人的照顾者的抑郁和焦虑症状有关。
Individuals caring for patients with advanced cancer (“caregivers”) experience psychological distress during the patient’s illness course. However, data on the prevalence of bereaved caregivers’ psychological distress and its relationship with the quality of patient’s EOL care are limited. We conducted a secondary analysis of 168 caregivers enrolled in a supportive care trial for patients with incurable lung and gastrointestinal cancers and their caregivers. We used the Hospital Anxiety and Depression Scale (HADS) to assess caregivers’ depression and anxiety symptoms at three months after the patient’s death. Caregivers also rated the patient’s physical and psychological distress in the last week of life on a 10-point scale three-months afterthepatientdeath. We used linear regression adjusting for caregiver age, sex, randomization, and cancer type to explore the relationship between bereaved caregivers’ depression and anxiety symptoms and their ratings of physical and psychological distress in patients at the EOL. Of the 168 bereaved caregivers, 30.4% (n=51) and 43.4% (n=73) reported clinically significant depression and anxiety symptoms, respectively. Caregiver ratings of worse physical (B=0.32, P=0.009)and psychological (B=0.50, P<0.001) distress experienced by the patient at the EOL were associated with worse depression symptoms in bereaved caregivers. Only caregiver rating of worse psychological distress experienced by the patient at the EOL (B=0.42, P<0.001) was associated with worse bereaved caregivers’ anxiety symptoms. Many bereaved caregivers of patients with advanced cancer experience symptoms of depression and anxiety, which are associated with their perceptions of distress in their loved ones at the EOL. Many bereaved caregivers of patients with advanced cancer endure clinically significant depression and anxiety symptoms at three to six months after the death of their loved ones. Physical and psychological distress in patients at the EOL is associated with bereaved caregivers’ depression and anxiety symptoms.
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影响因子：
1.6
作者：
Jho HJ;Choi JY;Kwak KS;Chang YJ;Ahn EM;Park EJ;Paek SJ;Kim KM;Kim SH
通讯作者：
Kim SH
影响因子：
1.7
作者：
Fenix, J. B.;Cherlin, Emily J.;Bradley, Elizabeth H.
通讯作者：
Bradley, Elizabeth H.
影响因子：
5.4
作者：
Hodges, LJ;Humphris, GM;Macfarlane, G
通讯作者：
Macfarlane, G
影响因子：
4.7
作者：
Milberg, Anna;Olsson, Eva-Carin;Friedrichsen, Maria
通讯作者：
Friedrichsen, Maria
影响因子：
4.7
作者：
Abbott, Caroline H.;Prigerson, Holly G.;Maciejewski, Paul K.
通讯作者：
Maciejewski, Paul K.