Depressive symptoms predict cancer caregivers' physical health decline.
Depressive symptoms predict cancer caregivers' physical health decline.
复制标题
抑郁症状预示癌症护理人员的身体健康状况下降。
DOI：
10.1002/cncr.30835
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发表时间：
2017
期刊：
影响因子：
6.2
通讯作者：
Cannady,RachelS
中科院分区：
文献类型：
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作者：
Shaffer,KellyM;Kim,Youngmee;Carver,CharlesS;Cannady,RachelS
背景癌症护理与护理人员自身健康状况恶化有关，但其长期健康状况下降的人口和社会心理预测因素却鲜为人知。本研究检查了家庭成员癌症诊断后 2 至 8 年护理人员身体健康的变化以及该变化的前瞻性预测因素。 方法护理人员（n = 664；平均年龄，53.2 岁）在其家庭成员癌症诊断后 2 (T1)、5 (T2) 和 8 (T3) 年参加了一项全国性研究。身体健康（12 项医疗结果研究简表健康调查身体成分量表）通过 T1 到 T3 进行评估作为结果。在 T1 时自我报告预测因素，包括护理人员人口统计数据（年龄、性别、教育、收入、与患者的关系和就业状况）、患者癌症严重程度（来自医疗记录）和护理人员社会心理因素（护理压力、护理自尊、社会支持和抑郁症状）。潜在生长模型测试了护理人员初始身体健康状况及其随时间变化的预测因素。 结果在 T1 时，护理人员报告的身体健康状况略好于美国人口 (M= 51.22，P= .002)，但在接下来的 6 年中有所下降 (Mslope= -0.27，P< .001)。所有人口统计因素、患者癌症严重程度和 T1 护理压力均与护理人员的初始身体健康状况相关 (P≤ .03)。较高的抑郁症状与护理人员最初的身体健康状况无关，但却是护理人员身体健康状况更快下降的唯一显着预测因素 (B= -0.02，P= .004)。结论 研究结果强调了护理人员的抑郁症状对其身体健康状况下降的独特贡献。在癌症生存轨迹的早期评估和解决护理人员的抑郁症状可能有助于防止这一重要但脆弱人群的健康状况过早下降。Cancer2017；123：4277–4285。©2017 美国癌症协会。
BACKGROUNDCancer caregiving has been associated with worsening health among caregivers themselves, yet demographic and psychosocial predictors of their long‐term health decline are less known. This study examines changes in caregivers' physical health 2 to 8 years after their family members' cancer diagnosis and prospective predictors of that change.METHODSCaregivers (n = 664; mean age, 53.2 years) participated in a nationwide study at 2 (T1), 5 (T2), and 8 (T3) years after their family members' cancer diagnosis. Physical health (12‐item Medical Outcomes Study Short Form Health Survey Physical Component Scale) was assessed T1 through T3 as outcome. Predictors were self‐reported at T1, including caregiver demographics (age, sex, education, income, relationship to patient, and employment status), patient cancer severity (from medical records), and caregiver psychosocial factors (caregiving stress, caregiving esteem, social support, and depressive symptoms). Latent growth modeling tested predictors of caregivers' initial physical health and their physical health change across time.RESULTSAt T1, caregivers reported slightly better physical health than the US population (M= 51.22,P= .002), which declined over the following 6 years (Mslope= −0.27,P< .001). All demographic factors, patient cancer severity, and T1 caregiving stress were related to caregivers' initial physical health (P≤ .03). Higher depressive symptoms were unrelated to caregivers' initial physical health, but were the only significant predictor of caregivers' more rapid physical health decline (B= −0.02,P= .004).CONCLUSIONFindings highlight the unique contribution of caregivers' depressive symptoms to their physical health decline. Assessing and addressing depressive symptoms among caregivers early in the cancer survivorship trajectory may help to prevent premature health decline among this important yet vulnerable population.Cancer2017;123:4277–4285.©2017 American Cancer Society.