Nationwide survey on family caregiver-perceived experiences of patients with cancer of unknown primary site.
Nationwide survey on family caregiver-perceived experiences of patients with cancer of unknown primary site.
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全国范围内对原发部位不明的癌症患者的家庭护理人员感知经历的调查。
DOI：
10.1007/s00520-022-07070-x
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发表时间：
2022
影响因子：
3.1
通讯作者：
Ando S
中科院分区：
文献类型：
--
作者：
Ishida K;Sato K;Komatsu H;Morita T;Akechi T;Uchida M;Masukawa K;Igarashi N;Kizawa Y;Tsuneto S;Shima Y;Miyashita M;Ando S
目的原发部位不明癌（CUP）是一种侵袭性疾病，预后差。由于缺乏对CUP患者及其家庭经历的研究，本研究旨在比较CUP与常见癌症（肺癌，结肠癌和胃癌）的家庭负担。之间的关联，家庭成员感知的负担和CUP患者的生活质量（QOL）在生命的尽头和家庭抑郁症，分别，也explored.MethodsThis是一个预先计划的全国性的横断面调查数据的二次分析，从丧亲的家庭照顾者的癌症患者谁死在286个机构。主要测量指标为8项家庭照顾者感知负担量表（包括专家访问、不确定性和延长诊断）、良好死亡量表和患者健康问卷9。结果在27,591份调查问卷中，我们分别分析了97份和717份来自CUP和普通癌症患者家庭照顾者的回复。CUP患者家属在三个负担分量表上的得分均显著高于普通癌症患者（效应量：专家访问分量表，0.3;不确定性分量表，0.66;延长诊断分量表，0.69;校正后P < 0.01）。较大的家庭负担与较低的患者生活质量和较高的家庭抑郁症显着相关。负担是显着相关的是一个配偶，第二意见咨询，诊断周期> 1 month.ConclusionThe CUP患者的家庭照顾者的经验差的专家访问，更大的不确定性，和长期的诊断。他们应该从一开始就得到照顾，以获得专家的帮助，获得早期诊断，并减少不确定性。
PurposeCancer of unknown primary site (CUP) is an aggressive disease with poor prognosis. As research on the experiences of CUP patients and their families is scarce, this study aimed to compare the family caregiver-perceived burden of CUP with that of common cancers (lung, colon, and stomach cancers). The association between family caregiver-perceived burden and CUP patients’ quality of life (QOL) at end-of-life and family depression, respectively, was also explored.MethodsThis was a pre-planned secondary analysis of nationwide cross-sectional survey data from the bereaved family caregivers of patients with cancer who died at 286 institutions. The major measurements were the eight-item family caregiver-perceived Burden scale (comprising specialist access, uncertainty, and prolonged diagnosis), Good Death Inventory, and Patient Health Questionnaire 9.ResultsOf 27,591 survey responses, we analyzed 97 and 717 responses from family caregivers of patients with CUP and common cancer, respectively. The families of CUP patients scored significantly higher on all three burden subscales than those of common cancer patients (effect sizes: specialist access subscale, 0.3; uncertainty subscale, 0.66; and prolonged diagnosis subscale, 0.69; adjustedP< 0.01). Greater family burden was significantly associated with lower patient QOL and higher family depression. Burden was significantly associated with being a spouse, second opinion consultation, and diagnosis period of > 1 month.ConclusionThe family caregivers of CUP patients experience poor specialist access, greater uncertainty, and a prolonged diagnosis. They should be cared for from the initial stages to establish access to specialists, obtain an early diagnosis, and reduce uncertainty.