Family caregivers' level of mastery predicts survival of patients with glioblastoma: A preliminary report.
Family caregivers' level of mastery predicts survival of patients with glioblastoma: A preliminary report.
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DOI：
10.1002/cncr.30428
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发表时间：
2017-03-01
期刊：
影响因子：
6.2
通讯作者：
Sherwood PR
中科院分区：
文献类型：
--
作者：
Boele FW;Given CW;Given BA;Donovan HS;Schulz R;Weimer JM;Drappatz J;Lieberman FS;Sherwood PR
多形性胶质母细胞瘤（GBM）与预后不良相关，患者严重依赖家庭护理人员提供身体和情感支持。家庭照顾者的能力和心理健康可能会影响他们提供护理的能力，并影响患者的预后。我们的目的是调查照顾者的焦虑，抑郁症状，负担和掌握是否影响新诊断为GBM患者的生存样本。基线数据来自参与NIH资助的纵向研究的患者-患者配对。进行考克斯回归分析，以确定在控制已知协变量（患者年龄、体力状态、手术类型和术后治疗）后，护理者焦虑（情绪状态-焦虑）、抑郁症状（流行病学中心-抑郁）、负担（护理者反应评估）和掌握感（掌握量表）是否可预测GBM患者的生存时间。总共纳入了88例患者-患者配对。样本的中位总生存期为14.5个月（范围0-88个月）。在控制了协变量后，照顾者的掌握程度可以预测患者的生存率。掌握程度每增加一个单位，患者死亡风险降低16.1%（95%可信区间：0.771-0.913，P<0.001）。我们的研究结果是第一批探索家庭支持对GBM患者结局的影响。如果这些结果在其他研究中得到支持，那么在临床实践中为神经肿瘤护理人员提供更结构化的支持和指导有可能改善护理人员的掌握感，从而更好地影响患者的健康。我们调查了照顾者的焦虑，抑郁症状，负担和掌握是否影响新诊断为胶质母细胞瘤患者的生存率。在控制了已知的协变量后，护理人员掌握程度可预测患者的生存率（风险比0.839; 95%CI：0.771-0.913）。
Glioblastoma multiforme (GBM) is associated with a poor prognosis and patients rely heavily on family caregivers for physical and emotional support. The capability and mental health of family caregivers may influence their ability to provide care and affect patient outcomes. We aimed to investigate whether caregivers’ anxiety, depressive symptoms, burden and mastery influenced survival in a sample of patients newly diagnosed with GBM. Baseline data from caregiver-patient dyads participating in a NIH funded longitudinal study were used. Cox regression analyses were performed to determine whether caregiver anxiety (Profile of Mood States-Anxiety), depressive symptoms (Center for Epidemiologic Studies-Depression), burden (Caregiver Reaction Assessment), and feelings of mastery (Mastery Scale) predicted GBM patient survival time after controlling for known covariates (patient age, performance status, type of surgery, and postsurgical treatment). In total, 88 caregiver-patient dyads were included. Median overall survival for the sample was 14.5 months (range 0–88 months). After controlling for covariates, caregiver mastery was predictive of patient survival. With each unit increase in mastery, there was a 16.1% risk reduction of patient death (95% confidence interval: 0.771–0.913, P<0.001). Our results are among the first to explore the impact of family caregiving for GBM patients’ outcomes. If these results are supported in other studies, providing neuro-oncology caregivers with more structured support and guidance in clinical practice have the potential to improve caregivers’ feelings of mastery, influencing patients’ wellbeing for the better. We investigated whether caregivers’ anxiety, depressive symptoms, burden and mastery influenced survival in a sample of patients newly diagnosed with glioblastoma. After controlling for known covariates, caregiver mastery was predictive of patient survival (hazard ratio 0.839; 95% CI: 0.771–0.913).