Cancer Caregiver Anxiety Over Time: The Influence of Palliative Care.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2024-10-23 DOI:10.1177/08258597241284287
Laura A Siminoff, Maureen Wilson-Genderson, Marcin Chwistek, Maria D Thomson
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Abstract

Objectives: To explore anxiety experienced by caregivers providing home-based, end-of-life care to patients with cancer. We examined the relationship between caregiver anxiety and receipt of palliative care by the patient. Methods: A case series of terminal cancer patient-caregiver dyads (n = 223) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 12 months or until patient death. Data collected included qualitative, quantitative, and observational data; this analysis utilizes the quantitative data. Longitudinal Latent Growth Models were used to characterize the heterogeneity of primary caregiver anxiety over time. The influence of palliative care on caregiver anxiety over time was assessed. Characteristics associated with membership in the trajectory groups rendered from those models are presented. Results: The majority of caregivers were female (73.9%), white (54.9%), and patient spouses (45.3%). Three classes of caregivers were identified based on their anxiety scores over time (low, elevated, and high). The 2 groups who had elevated and high anxiety had significant increases in anxiety over time. Controlling for patient receipt of palliative care attenuated those increases. Caregivers with the lowest level of anxiety were more likely to be Black, report fewer symptoms of depression or caregiver burden and higher self-rated physical health. Caregivers who were younger reported higher anxiety. Conclusions: Our analysis detected 3 distinct cancer caregiver groups reporting low, elevated, and very high levels of anxiety. Caregivers with elevated or high anxiety also demonstrated increasing anxiety overtime; however increases were attenuated with patient receipt of palliative care. For cancer caregivers with elevated and high levels of anxiety, palliative care buffers further deterioration of their mental health.

癌症护理者的焦虑随时间变化:姑息治疗的影响。
目的探讨为癌症患者提供居家临终关怀服务的护理人员所经历的焦虑。我们研究了护理人员的焦虑与患者接受姑息治疗之间的关系。研究方法我们从弗吉尼亚州和宾夕法尼亚州的肿瘤诊所招募了癌症晚期患者-护理者二人组(n = 223),并对其进行了为期 12 个月的随访,直至患者去世。收集的数据包括定性、定量和观察数据;本分析使用的是定量数据。纵向潜在增长模型用于描述主要照顾者焦虑随时间变化的异质性。评估了姑息关怀对照顾者焦虑随时间变化的影响。本文介绍了根据这些模型得出的轨迹群体成员的相关特征。研究结果大部分护理人员为女性(73.9%)、白人(54.9%)和病人配偶(45.3%)。根据护理人员随时间变化的焦虑评分,确定了三类护理人员(低焦虑、高焦虑和高焦虑)。随着时间的推移,焦虑升高和高度焦虑的两组护理人员的焦虑程度显著增加。如果将病人接受姑息关怀的情况作为控制因素,则焦虑程度的增加会减弱。焦虑程度最低的照护者更有可能是黑人,他们报告的抑郁症状或照护者负担较少,自我评价的身体健康状况较高。较年轻的照护者焦虑程度较高。结论:我们的分析发现了三个不同的癌症照护者群体,分别报告了较低的、较高的和非常高的焦虑水平。焦虑程度升高或极高的护理人员也表现出焦虑程度随时间推移而增加;但患者接受姑息治疗后,焦虑程度的增加有所减弱。对于焦虑水平升高和高度焦虑的癌症护理者来说,姑息治疗可以缓冲其心理健康的进一步恶化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.
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