结构方程模型在癌症患者家属生活质量评价中的应用

目的：评价癌症患者家属的护理负担和生活质量,并对其影响因素进行研究。方法：采用中文版Zarit护理负担量表、癌症患者家属生活质量调查表和患者日常生活能力量表进行问卷调查。结果：结构方程模型拟合参数GFI=0．936,AGFI=0．860,CFI=0．959,模型拟合较好。护理负担显著影响护理者生活质量（P〈0．01）,患者日常生活能力和护理者特征可通过影响护理负担,对护理者生活质量产生间接影响。结论：未来的干预措施应围绕改善患者日常生活能力和加强协助照顾来帮助护理者减轻负担,最终达到提高护理者生活质量的目的。     

结构方程模型在癌症患者家属生活质量评价中的应用

目的:评价癌症患者家属的护理负担和生活质量,并对其影响因素进行研究.方法:采用中文版Zarit护理负担量表、癌症患者家属生活质量调查表和患者日常生活能力量表进行问卷调查.结果:结构方程模型拟合参数GFI=0.936,AGFI=0.860,CFI=0.959,模型拟合较好.护理负担显著影响护理者生活质量(P＜0.01),患者日常生活能力和护理者特征可通过影响护理负担,对护理者生活质量产生间接影响.结论:未来的干预措施应围绕改善患者日常生活能力和加强协助照顾来帮助护理者减轻负担,最终达到提高护理者生活质量的目的.     

常见脑肿瘤住院患者主要照顾者负担的影响因素

目的：探讨分析影响常见脑肿瘤住院患者主要照顾者的负担影响因素,以期在一定程度上能够针对性的帮助主要照顾者减轻其负担。方法：采用调查问卷的形式开展调查,问卷的内容包括一般资料调查、照顾者负担量表以及症状自评量表（SCL -90）。结果：用负担量表评价脑肿瘤住院患者主要照顾者的负担情况,其中负担最重的是时间依赖,接下来依次为身体负担和情感负担。脑肿瘤患者的主要照顾者在躯体化、抑郁、焦虑、恐怖、偏执、焦虑等六个方面对比常模组有显著性差异。而人际关系敏感度、敌对和精神病性等三个方面对比则没有统计学差异。影响脑肿瘤住院患者主要照顾者负担的影响有患者因素、是否有共同照顾者、照顾持续时间、患者医疗费用支付方法及照顾者的心理状态。结论：肿瘤患者的身心状况是影响肿瘤患者照顾者生活质量的主要因素。     

心理支持护理对肺癌术后化疗患者自我感受负担和生活质量的影响

目的探讨心理支持护理对肺癌患者自我感受负担和生活质量的影响。方法选取2014年1月至2015年10月间陕西省宝鸡市中心医院收治的100例肺癌术后化疗患者,采用随机数字表法分为观察组与对照组,每组50例。观察组患者在对照组基础上采用心理支持护理干预,对照组患者采用常规护理方法,12周后,对比两组患者心理状态、生活质量和自我感受负担。结果干预后,观察组患者的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分明显低于对照组,两组比较,差异均有统计学意义(均P<0.05)。观察组患者的自我感受负担(SPB)总分及各项目情感性负担、身体性负担、社交性负担、发展受限负担和时间依赖负担得分均明显低于对照组,两组比较,差异均有统计学意义(均P<0.05)。观察组患者和对照组患者生活质量(KPS)评分各项目均高于对照组,两组比较,差异有统计学意义(P<0.05)。结论心理支持护理使肺癌患者减少了焦虑和抑郁情绪的产生,改善了患者自我感受负担,提高了生活质量。     

食管癌术后病人睡眠影响因素分析及对策

目的：了解食管癌术后病人睡眠状况及其影响因素，以便采取针对性的护理措施。方法：采用自行设计的调查表对52例食管癌术后病人进行问卷调查。结果：80．8％的食管癌术后病人每天睡眠时间不足6小时，睡眠满意度6分以下者占78．8％。睡眠问题主要为睡眠不稳，入睡困难、早醒、恶梦夜惊。疼痛、安置多种管道、咳痰、心理因素是导致食管癌术后病人睡眠差的主要因素。结论：食管癌术后病人睡眠影响因素具有其特殊性，应引起医护人员的高度重视，护理应针对这些因素做好疼痛护理、健康教育及心理护理，使睡眠影响因素降低到最低点，促进病人早日康复。     

肿瘤患者住院睡眠质量调查分析及护理对策

目的：调查肿瘤患者在住院期间的睡眠质量,探讨及分析护理干预对肿瘤患者住院睡眠质量的影响。方法采用问卷调查法对200例肿瘤内科住院患者睡眠质量的影响因素进行调查;通过PSQI（匹兹堡睡眠质量指数）评价睡眠质量,分析睡眠不良（PSQI≥7）和睡眠良好（PSQI＜7）的情况;对PSQI≥7的患者进行干预性护理,并观察对睡眠质量的影响。结果睡眠不良者141人,占70．5％,PSOI评分为11．62±2．17,睡眠良好者59人,占29．5％,PSOI评分为3．54±1．16,两组的PSOI评分差异有统计学意义（P＜0．05）。对睡眠不良者采用干预性护理后,患者睡眠均有不同程度改善,PSOI评分为9．41±2．03,与未干预前相比,差异有统计学意义（P＜0．05）。结论焦虑及噪音是影响肿瘤患者住院睡眠质量的主要因素,通过有针对性的护理干预可以改善住院患者睡眠情况,有利于疾病的恢复。     

心理干预对老年肺癌根治术患者心理状态的影响

目的探讨心理干预对老年肺癌患者肺癌根治术围手术期精神焦虑和抑郁的作用。方法选取2015年8月至2018年2月间上海市同济大学附属肺科医院收治的81例老年肺癌根治术患者进行回顾性分析,将采用常规护理与心理干预的41例患者纳入心理组,仅采用常规护理的40例患者纳入常规组。比较两组患者术后精神焦虑和抑郁情况、睡眠质量以及护理满意度。结果护理后,心理组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)和匹兹堡睡眠质量自评量表(PSQI)评分均低于常规组,差异均有统计学意义(均P <0. 05)。心理组患者的护理满意度为97. 6%,高于常规组的85. 0%,差异有统计学意义(P <0. 05)。结论心理干预可改善老年肺癌根治术患者围手术期的精神焦虑和抑郁,提高睡眠质量和护理满意度。     

护理干预对肺癌化疗患者生活质量及满意度的影响

目的探讨护理干预对肺癌化疗患者生活质量及满意度的影响。方法回顾性分析2014年5月至2015年5月间收治的90例肺癌化疗患者的临床资料,按照就诊时间顺序分为常规护理组和护理干预组,每组各45例。护理干预组患者给予护理干预和基础护理,常规护理组给予基础护理。对比两组患者的生活质量、睡眠质量及护理满意度。结果常规护理组与护理干预组患者功能量表中的角色功能、躯体功能、认知功能和社会功能,症状量表中的疼痛、恶心呕吐和疲倦,单一症状量表中的腹泻、便秘、失眠和纳差评分的差异均有统计学意义(均P<0.05)。常规护理组与护理干预组患者的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、安眠药物和白天功能评分相比,差异均有统计学意义(均P<0.05)。常规护理组患者的满意度为75.6%,护理干预组的满意度为91.1%,差异有统计学意义(P<0.05)。结论对肺癌化疗患者实施护理干预可有效改善患者的生活质量及睡眠质量,提高护理满意度,值得推广。     

护士为主导的团体心理辅导对晚期肺癌患者心理困扰及自我感受负担的影响

目的探讨以护士为主导的团体心理辅导对晚期肺癌患者心理困扰及自我感受负担的影响。方法选取2017年1月至2018年1月间荆州市胸科医院收治的100例晚期肺癌患者,采用随机数表法分为观察组和对照组,每组50例。观察组患者在日常护理基础上采用以护士为主导的心理辅导,对照组患者采用日常护理,比较两组患者护理前后心理困扰及自我感受负担评分。结果干预后,观察组患者负性情绪和总评分均低于对照组患者,活力值高于对照组患者,且观察组患者第四周、第六周自我感受负担评分均低于对照组患者,差异均有统计学意义(均P <0. 05)。结论对晚期肺癌患者采用团体心理辅导,可帮助患者缓解负性情绪,并减轻患者自我感受负担。     

肺癌患者睡眠与生活质量影响因素的回归分析

目的:了解肺癌患者的睡眠质量和生活质量的现状,探讨睡眠质量与生活质量及相关因素的关系.方法:以Karnofsky功能状态量表(KPS)、匹兹堡睡眠质量指数(PSQI)、欧洲癌症研究与治疗组织生活质量核心量表和肺癌特异性量表(EORTC QLQ-C30和LC13)评估我院98例肺癌患者的躯体功能状态、睡眠质量和生活质量,并选择其中的初诊患者,在治疗结束后1个月进行再评估.结果:78.6％的患者能维持正常生活或工作,45.9％的患者存在睡眠障碍.多元逐步回归分析结果显示,婚姻状况和KPS评分是肺癌患者睡眠质量的主要影响因素(P＜0.05),KPS评分和睡眠质量是肺癌患者生活质量的主要影响因素,P＜0.05.结论:肺癌患者存在不同程度的睡眠障碍.躯体功能仍是影响肺癌患者生活质量的主要因素.     

Caregiver burden among poor caregivers of patients with cancer in an urban African setting

Objectives: The nature and magnitude of the problems facing caregivers remain largely unknown in developing countries of the world. This study addresses these issues in a group of caregivers of patients with cancer in Zaria, Nigeria. Method: One hundred and three patients attending an oncology outpatient clinic at the Ahmadu Bello University Teaching Hospital were enrolled in the study with their caregivers. The caregivers were interviewed using the Socio‐demographic data sheet, General Health Questionnaire‐30 (GHQ‐30) and Zarith Burden Interview (ZBI). A score of 4 or more in GHQ and scores above the median score of the sample in ZBI were considered a clinically significant level of psychological morbidity and a high level of burden, respectively. Data obtained were analyzed using the Statistical Package for Social Sciences Version 13 for Windows. All statistical tests of significance were carried out at 5% level of probability. Results: The patients were 60 women whose mean age was 57. Of the 103 caregivers, 60 (58%) were men and 43 (42%) were women. Their mean age was 37. Their mean ZBI and GHQ‐30 scores were 29.16±12.8 (median = 25) and 3.67±3.01, respectively. A high level of burden was found in 49.5% (95% CI 39.9–59.1%) and psychological morbidity was found in 46.6% (95% CI 37.0–56.2%) of the caregivers. High levels of burden and psychological morbidity were significantly associated with absence of financial support. Conclusion: The study demonstrated a high level of caregiver burden, psychological morbidity and financial strain in family caregivers coming to the clinic with a relative who has cancer in an urban Nigerian setting. Copyright © 2010 John Wiley & Sons, Ltd.     

Impact of caregiver burden on caregiver mental health in patients with esophageal cancer: chain mediating effects of benefit finding and rumination,a cross-sectional study

BackgroundCancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined.MethodsThe study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the non-conforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model.ResultsThe study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=−0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=−0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients.ConclusionsThe findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver’s level of benefit finding and promote deliberate ruminative thinking.     

Burden,emotional distress and quality of life among informal caregivers of lung cancer patients: An exploratory study

This study was conducted to explore the interrelationships among caregiver burden, emotional status and quality of life (QoL) in caregivers of lung cancer patients, and to identify whether caregiver burden and health status are associated with patient emotional status and QoL. Forty‐three dyads of lung cancer patients and their caregivers were included for analysis. Caregiver‐reported outcomes were measured by Caregiver Burden Scale (CBS), Caregivers Quality of Life Index‐Cancer (CQOLC) and Hospital Anxiety and Depression Scale (HADS), while patient‐reported outcomes were collected by HADS and Lung Cancer Symptom Scale (LCSS). The majority of the CBS and CQOLC scores were significantly higher in anxious and depressed caregivers than non‐anxious and non‐depressed caregivers (p < .01 or .05). Caregivers of depressed patients experienced significantly greater emotional distress than those of non‐depressed patients (p < .01). Significantly positive associations were identified among most of the CBS, CQOLC and caregiver HADS scores. Patient LCSS scores were positively correlated with the CBS and caregiver HADS scores, and patient HADS scores were also positively related to caregiver HADS scores. The close interrelationships between caregiver and patient health outcomes provide evidence that lung cancer patients and their caregivers should be viewed as a unit in future supportive service models.     

Understanding burden in caregivers of colorectal cancer survivors: what role do patient and caregiver factors play?

This study investigated how both caregiver and patient factors predict different aspects of burden in colorectal cancer caregivers. One hundred and fifty‐three caregiver–survivor dyads separately provided information on patient disease and treatment‐related factors, and perceived global health status (EORTC QLQ30), along with caregiver socio‐demographic factors, health and care‐related activities. Four multiple regression analyses were conducted to assess the influence of caregiver characteristics, patient characteristics and care‐related activities on four dimensions of burden from the Caregiver Reaction Assessment scale. Caregiver characteristics significantly predicted health and financial burden (11%–13% of explained variance) with comorbidity and younger age increasing this risk. Patient health, in particular global health status and the presence of a stoma, predicted all burden scores, explaining 14%–22% of variance. Care‐related activities was also a significant predictor of all burden scores, explaining an additional 5%–11% of variance, with time involved in caring the most consistent predictor. Results highlight that a combination of factors influence caregiver burden. These results may be used to identify those most at risk, allowing practitioners to deliver tailored effective support. In particular, efforts to alleviate the burden of caring on caregiver schedule may be merited, given that this was the domain in which the burden was greatest.     

Caregiver Burden and Perceived Social Support among Caregivers of Patients with Cancer

The purpose of this study is to describe the relationship between caregiver burden and perceived social supportamong caregivers of patients with cancer. The research was conducted in a university hospital in İzmir, Turkey.Eighty patient relatives who provided care service to patients with cancer who were admitted at hematology andoncology clinics participated in the study. The findings indicated that the care burden score was mild level. Themean of the perceived social support score was 58.4±21.0 supporting the conclusion that there is a weak andnegative-direct relation between caregiver and perceived social support and that as the perceived social supportincreased, conversely, care burden decreased.     

The Impact of Depression on Quality of Life in Caregivers of Cancer Patients: A Moderated Mediation Model of Spousal Relationship and Caring Burden

Family caregivers play an important role in managing and supporting cancer patients. Although depression in family caregivers is known to negatively affect caregiver health, the mechanism by which it affects caregivers is not clear. The purpose of this study was to explore the influence of depression on quality of life (QoL) in family caregivers of patients with cancer. Specifically, this study examined (1) whether caring burden mediates the relationship between depression and QoL, and (2) how this mediating effect varies depending on the caregiver’s relationship with the patient. This study performed a secondary analysis on cross-sectional survey data. Ninety-three family caregivers of cancer patients were included in the study. Moderated mediation analyses were conducted using PROCESS macro with the regression bootstrapping method. The moderated mediation models and the indirect effect of caregiver depression on QoL through caring burden were significantly different depending on caregivers’ relationships with patients (i.e., spousal or non-spousal). Specifically, the indirect effect of caregiver depression on QoL was greater for the patient’s spouse than for other family caregivers. Healthcare providers should focus on identifying caregivers’ depression and relationship with the patient and offer tailored support and intervention to mitigate the caring burden and improve the caregivers’ QoL.     

Relationships between supportive care needs and perceived burden in breast cancer survivor–caregiver dyads

While burden in cancer caregivers is high and associated with poor outcomes, little is known about significance of specific supportive care needs’ domains in determining survivors’ or caregivers’ perceived caregiver burden. This cross‐sectional study explored which domains of survivor‐ and caregiver‐reported supportive care needs were most associated with survivor‐ and caregiver‐reported caregiver burden, in breast cancer survivor–caregiver dyads. Cancer survivors (N = 55) and their caregivers (N = 44) completed measures of supportive care needs, anxiety, depression, functional well‐being and perceived caregiver burden. Correlation and linear regression analyses were used to determine relative significance of survivor and caregiver supportive care needs in accounting for variance in survivor and caregiver perceptions of burden. Higher survivor‐perceived caregiver burden and higher caregiver‐perceived difficulty of caregiving were associated with higher levels of survivor and caregiver supportive care needs. Survivors’ psychological needs uniquely contributed to survivors’ self‐perceived burden, and survivors’ sexual needs and caregivers’ work and social needs uniquely contributed to caregivers’ perceived difficulty of caregiving. Caregiver's perceived time spent caregiving was associated with access to services needs but not other needs. Survivor and caregiver supportive care needs and burden appear interdependent. Longitudinal research with larger samples is warranted to examine these relationships.     

Burdens,Needs and Satisfaction of Terminal Cancer Patients and their Caregivers

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and needmany types of assistance. In the present study we interviewed terminally ill cancer patients and caregiversto determine how much burden they experienced and to find out what factors are most important forsatisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced,and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitalsand 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregiverscompleted the questionnaire. Care burden was not insubstantial in both and the caregiver group felt moreburden than the patient group (P<0.001). While the patient group needed financial support most (39.0%),the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwisemultiple logistic regression analyses showed that in the patient group, patient’s health status (OR, 2.03;95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care,while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI,1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our studyshowed that burden was great in both terminal cancer patients and their caregivers and was perceived to bemore severe by caregivers. Our study also showed that burden was the factor most predicting satisfactionabout overall care in both groups.