晚期癌症患者家庭主要照顾者预期性悲伤现状及其影响因素分析
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摘要
目的:调查晚期癌症患者家庭主要照顾者预期性悲伤的现状,并分析其影响因素。方法:采用便利抽样的方法,选取2018年7-9月在天津某三级甲等肿瘤医院住院治疗的164名晚期癌症患者的家庭主要照顾者为研究对象,采用一般资料调查表、预期性悲伤量表(AGS)和心理弹性量表(CD-RISC)进行调查,采用多元线性回归分析晚期癌症患者家庭主要照顾者预期性悲伤的影响因素。结果:晚期癌症患者家庭主要照顾者预期性悲伤得分为(83.46±16.00)分;多元逐步回归分析结果显示,晚期癌症患者家庭主要照顾者的年龄、性别、文化程度、与患者的关系、获知患者疾病时间、患者自理程度及心理弹性是其预期性悲伤的影响因素(P<0.05)。结论:晚期癌症患者家庭主要照顾者存在较为严重的预期性悲伤,医护人员应重视照顾者的心理状况,采取有效的措施,促进其身心健康。
Objective: To investigate the current status of Anticipatory Grief among major family caregivers of patients with advanced cancer and to explore its influencing factors. Methods: Totally 164 primary family caregivers of patients with advanced cancer were investigated by general information questionnaire, Anticipatory Grief Scale(AGS) and the Connor-Davidson Resilience Scale(CD-RISC). Multiple linear regression was used to analyze the main influencing factors of Anticipatory Grief among primary family caregivers of patients with advanced cancer. Results: The mean score of Anticipatory Grief Scale was(83.46±16.00). Multiple linear regression analysis showed that age, gender, educational background, relationship with patients, time of knowing disease, illness condition and mental resilience were the main factors(P<0.05). Conclusion: The primary family caregivers of patients with advanced cancer have serious Anticipatory Grief. The medical staff should pay attention to the mental status of the caregivers and take effective measures to promote their physical and mental health.
Objective: To investigate the current status of Anticipatory Grief among major family caregivers of patients with advanced cancer and to explore its influencing factors. Methods: Totally 164 primary family caregivers of patients with advanced cancer were investigated by general information questionnaire, Anticipatory Grief Scale(AGS) and the Connor-Davidson Resilience Scale(CD-RISC). Multiple linear regression was used to analyze the main influencing factors of Anticipatory Grief among primary family caregivers of patients with advanced cancer. Results: The mean score of Anticipatory Grief Scale was(83.46±16.00). Multiple linear regression analysis showed that age, gender, educational background, relationship with patients, time of knowing disease, illness condition and mental resilience were the main factors(P<0.05). Conclusion: The primary family caregivers of patients with advanced cancer have serious Anticipatory Grief. The medical staff should pay attention to the mental status of the caregivers and take effective measures to promote their physical and mental health.
引文
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[14]何苗,张静.化疗期癌症患者主要照顾者心理弹性状况及其影响因素分析.现代临床护理,2016,15(6):5-10.He M,Zhang J.Cancer patients with chemotherapy period main caregivers psychological elastic condition and its influencing factors analysis.Modern Clinical Care,2016,15(6):5-10.
[15]Burke LA,Clark KA,Ali KS,et al.Risk factors for anticipatory grief in family members of terminally ill veterans receiving palliative care services.J Soc Work End Life Palliat Care,2015,11(3-4):244-266.
[16]Nielsen MK,Neergaard MA,Jensen AB,et al.Preloss grief infamily caregivers during end-of-life cancer care:a nationwide populationbased cohort study.Psychooncology,2017,26(12):2048-2056.
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[18]刘乃志,李英芬,刘景萍,等.安宁疗护与预期性悲伤.安宁疗护杂志,2005,10(3):286-296.Liu NZ,Li YF,Liu JP,et al.Hospice care and anticipatory grief.Journal of Hospice Care,2005,10(3):286-296.
[19]Tomarken A,Holland J,Schachter S,et al.Factors of complicated grief pre-death in caregivers of cancer patients.Psycho-Oncology,2008,17(2):105.
[20]刘晓惠,王凌云,赵洁,等.社区晚期癌症患者家属身心副反应的质性研究.中国全科医学,2015(28):3505-3508.Liu XH,Wang LY,Zhao J,et al.Qualitative research on physical and mental side effects of family members of patients with advanced cancer in community.Chinese General Medicine,2015(28):3505-3508.
[21]Fleming DA,Sheppard VB,Mangan PA,et al.Caregiving at the end of life:perceptions of health care quality and quality of life among patients and caregivers.Journal of Pain&Symptom Management,2006,31(5):407.
[22]Bernard LL,Guarnaccia CA.Two models of caregiver strain and bereavement adjustment:a comparison of husband and daughter caregivers of breast cancer hospice patients.Gerontologist,2003,43(6):808.
[23]魏国英,郭秀泉,张献珍.肿瘤患者社会环境状况及配偶心理的调查分析.齐齐哈尔医学院学报,2002,23(1):81,83.Wei GY,Guo XQ,Zhang XZ.Investigation and analysis of social environment and spouse psychology of cancer patients.Journal of Qiqihar Medical College,2002,23(1):81,83.
[24]陈瑜.悲伤情绪的研究及其在临终病人家属护理中的应用.护理研究,2006,20(1):15-17.Chen Y.Research on sadness and its application in the care of family members of end-of-life patients.Chinese Nursing Research,2006,20(1):15-17.
[25]Pusa S,Persson C,Sundin K.Significant others'lived experiences following a lung cancer trajectory:from diagnosis through and after the death of a family member.European Journal of Oncology Nursing,2012,16(1):34-41.
[26]Min JA,Yoon S,Lee CU,et al.Psychological resilience contributes to low emotional distress in cancer patients.Supportive Care in Cancer,2013,21(9):2469-2476.
[27]王慧荣,尹心红,周丽,等.大肠癌病人照顾者心理弹性和应对方式的相关性研究.护理研究,2014,28(3):288-290.Wang HR,Yin XH,Zhou L,et al.Study on the correlation between mental resilience and coping style of caregivers of patients with colorectal cancer.Chinese Nursing Research,2014,28(3):288-290.
[2]肖惠敏,郑建伟,兰秀燕,等.晚期癌症患者生存质量对家庭照顾者生存质量的影响.中华护理杂志,2015,50(4):415-419.Xiao HM,Zheng JW,Lan XY,et al.Effect of quality of life of patients with advanced cancer on quality of life of family caregivers.Chinese Journal of Nursing,2015,50(4):415-419.
[3]于文华,陆宇晗,路潜,等.癌症患者主要照顾者预期性悲伤的研究进展.中华护理杂志,2018,53(6):730-735.Yu WH,Lu YH,Lu Q,et al.Research progress of anticipatory grief in primary caregivers of cancer patients.Chinese Journal of Nursing,2018,53(6):730-735.
[4]Koutrouli N,Anagnostopoulos F,Griva F,et al.Exploring the relationship betweenposttraumatic growth,cognitive processing,psychological distress,and social constraints in a sample of breast cancer patients.Women&Health,2015,56(6):650-667.
[5]陆宇晗,关珊.肿瘤专科护士对癌症患者家属悲伤干预的护理实践.国际护理学杂志,2007,26(1):70-72.Lu YH,Guan S.Nursing practice of grief intervention in family members of cancer patients by oncology nurses.International Nursing Science Chi,2007,26(1):70-72.
[6]Nielsen M K,Neergaard M A,Jensen AB,et al.Psychological distress,health,and socio-economic factors in caregivers of terminally ill patients:a nationwide population-based cohort study.Supportive Care in Cancer,2016,24(7):1-11.
[7]Stroebe MS,Folkman S,Hansson RO,et al The prediction of bereavement outcome:development of an integrative risk factor framework.Social Science&Medicine,2006,63(9):2440-2451.
[8]Theut SK,Jordan L,Ross LA,et al.Caregiver's anticipatory grief in dementia:a pilot study.International Journal of Aging&Human Development,1991,33(2):113.
[9]Johansson AK,Sundh V,Wijk H,et al.Anticipatory grief among close relatives of persons with dementia in comparison with close relatives of patients with cancer.American Journal of Hospice&Palliative Medicine,2013,30(1):29-34.
[10]Glick DR,Motta M,Wiegand DL,et al.Anticipatory grief and impaired problem solving among surrogate decision makers of critically ill patients:a cross-sectional study.Intensive&Critical Care Nursing,2018.
[11]辛大君.晚期癌症患者及其家属悲伤反应研究.泸州:西南医科大学,2016.Xin DJ.Research on the sad response of patients with advanced cancer and their families.Luzhou:Southwest Medical University,2016.
[12]Connor KM,Davidson JR.Development of a new resiliencescale:the Connor-davidson Resilience Scale(CD-RISC).Depression Anxiety,2003,18(2):76-82.
[13]Yu X,Zhang J.Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese people.Social Behavior&Personality An International Journal,2007,35(1):19-30.
[14]何苗,张静.化疗期癌症患者主要照顾者心理弹性状况及其影响因素分析.现代临床护理,2016,15(6):5-10.He M,Zhang J.Cancer patients with chemotherapy period main caregivers psychological elastic condition and its influencing factors analysis.Modern Clinical Care,2016,15(6):5-10.
[15]Burke LA,Clark KA,Ali KS,et al.Risk factors for anticipatory grief in family members of terminally ill veterans receiving palliative care services.J Soc Work End Life Palliat Care,2015,11(3-4):244-266.
[16]Nielsen MK,Neergaard MA,Jensen AB,et al.Preloss grief infamily caregivers during end-of-life cancer care:a nationwide populationbased cohort study.Psychooncology,2017,26(12):2048-2056.
[17]Hudson PL,Thomas K,Trauer T,et al.Psychological and social profile of family caregivers on commencement of palliative care.Journal of Pain&Symptom Management,2011,41(3):522-534.
[18]刘乃志,李英芬,刘景萍,等.安宁疗护与预期性悲伤.安宁疗护杂志,2005,10(3):286-296.Liu NZ,Li YF,Liu JP,et al.Hospice care and anticipatory grief.Journal of Hospice Care,2005,10(3):286-296.
[19]Tomarken A,Holland J,Schachter S,et al.Factors of complicated grief pre-death in caregivers of cancer patients.Psycho-Oncology,2008,17(2):105.
[20]刘晓惠,王凌云,赵洁,等.社区晚期癌症患者家属身心副反应的质性研究.中国全科医学,2015(28):3505-3508.Liu XH,Wang LY,Zhao J,et al.Qualitative research on physical and mental side effects of family members of patients with advanced cancer in community.Chinese General Medicine,2015(28):3505-3508.
[21]Fleming DA,Sheppard VB,Mangan PA,et al.Caregiving at the end of life:perceptions of health care quality and quality of life among patients and caregivers.Journal of Pain&Symptom Management,2006,31(5):407.
[22]Bernard LL,Guarnaccia CA.Two models of caregiver strain and bereavement adjustment:a comparison of husband and daughter caregivers of breast cancer hospice patients.Gerontologist,2003,43(6):808.
[23]魏国英,郭秀泉,张献珍.肿瘤患者社会环境状况及配偶心理的调查分析.齐齐哈尔医学院学报,2002,23(1):81,83.Wei GY,Guo XQ,Zhang XZ.Investigation and analysis of social environment and spouse psychology of cancer patients.Journal of Qiqihar Medical College,2002,23(1):81,83.
[24]陈瑜.悲伤情绪的研究及其在临终病人家属护理中的应用.护理研究,2006,20(1):15-17.Chen Y.Research on sadness and its application in the care of family members of end-of-life patients.Chinese Nursing Research,2006,20(1):15-17.
[25]Pusa S,Persson C,Sundin K.Significant others'lived experiences following a lung cancer trajectory:from diagnosis through and after the death of a family member.European Journal of Oncology Nursing,2012,16(1):34-41.
[26]Min JA,Yoon S,Lee CU,et al.Psychological resilience contributes to low emotional distress in cancer patients.Supportive Care in Cancer,2013,21(9):2469-2476.
[27]王慧荣,尹心红,周丽,等.大肠癌病人照顾者心理弹性和应对方式的相关性研究.护理研究,2014,28(3):288-290.Wang HR,Yin XH,Zhou L,et al.Study on the correlation between mental resilience and coping style of caregivers of patients with colorectal cancer.Chinese Nursing Research,2014,28(3):288-290.