The end-of-life experience: modifiable predictors of caregivers' bereavement adjustment.
The end-of-life experience: modifiable predictors of caregivers' bereavement adjustment.
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临终经历：照顾者丧亲调整的可修改预测因素。
DOI：
10.1002/cncr.28495
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发表时间：
2014-03-15
期刊：
影响因子：
6.2
通讯作者：
Prigerson, Holly G.
中科院分区：
文献类型：
--
作者：
Garrido, Melissa M.;Prigerson, Holly G.
本研究的目的是确定癌症患者丧亲照顾者的心理障碍、遗憾、健康相关生活质量和心理健康功能的最佳预测因子，从而确定有希望的干预目标，以改善丧亲适应。应对癌症是一项纵向研究，研究对象是2002-2008年入组的晚期癌症患者和非正式护理人员。我们的主要结果指标是245名照顾者的丧亲调整（例如，抑郁、焦虑、后悔）。精神障碍诊断和统计手册的结构化临床访谈确定了照顾者是否符合重度抑郁症（MDD）或焦虑症的标准。使用医学结局研究简表（SF-36）评估了从基线到丧失后的健康相关生活质量和心理健康功能的变化。超过一半的照顾者报告对癌症患者的临终关怀感到遗憾;更好的患者死亡质量（调整后的比值比[AOR]= 0.77，95%置信区间[CI]= 0.67-0.88）降低了丧亲遗憾的风险。丧亲照顾者抑郁症或焦虑的发生率为12.6%，丧亲前心理健康状况较好的照顾者抑郁症或焦虑的发生率较低（AOR=0.03，95%CI =0.004-0.25）。更好的患者死亡质量也预示着护理人员健康相关生活质量的改善（校正标准化β =0.28，p<0.001）。不复苏订单完成预测从损失前到损失后的心理健康改善（校正标准化β =0.29，p<.001）。减少照顾者的痛苦，鼓励病人提前护理计划，并提高病人的死亡质量的干预措施，以改善照顾者丧亲之痛的调整有希望的目标。
The objective of this study is to determine the best set of predictors of psychological disorders, regrets, health-related quality of life, and mental health function among bereaved caregivers of patients with cancer, thereby identifying promising targets for interventions to improve bereavement adjustment. Coping with Cancer is a longitudinal study of patients with advanced cancer and informal caregivers who were enrolled from 2002–2008. Our main outcome measure was bereavement adjustment of 245 caregivers (e.g., depression, anxiety, regrets) six months post-loss. The Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders determined if caregivers met criteria for Major Depressive Disorder (MDD) or an anxiety disorder. Changes in health-related quality of life and mental health function from baseline to post-loss were assessed with the Medical Outcomes Study Short Form (SF-36). Over half the caregivers reported regret about the cancer patient’s end-of-life care; better patient quality of death (Adjusted Odds Ratio [AOR]= 0.77, 95% Confidence Interval [CI]= 0.67–0.88) reduced the risk of bereavement regret. The incidence of MDD or anxiety among the bereaved caregivers was 12.6% and was less likely for caregivers with better mental health pre-loss (AOR=0.03, 95% CI=0.004–0.25). Better patient quality of death also predicted improved caregiver health-related quality of life (adjusted standardized beta=0.28, p<.001). Do not resuscitate order completion predicted improved mental health from pre-loss to post-loss (adjusted standardized beta=0.29, p<.001). Reducing caregiver distress, encouraging patient advance care planning, and improving patients’ quality of death appear promising targets of interventions to improve caregiver bereavement adjustment.
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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：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1080/03610927808827599
发表时间：
1978-01-01
期刊：
COMMUNICATIONS IN STATISTICS PART A-THEORY AND METHODS
影响因子：
--
作者：
SUGIURA, N
通讯作者：
SUGIURA, N
影响因子：
3
作者：
MCHORNEY, CA;WARE, JE;RACZEK, AE
通讯作者：
RACZEK, AE
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H