老年癌症患者照顾者的支持角色、照顾者负担和决策偏好。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology Pub Date : 2024-11-01 DOI:10.1016/j.jgo.2024.102079

Wing Sze Lindsay Chan , Vasi Naganathan , Abby Fyfe , Alina Mahmood , Arnav Nanda , Anne Warby , Duong Pham , Natalie Southi , Sarah Sutherland , Erin Moth

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引用次数: 0

摘要

介绍：老年癌症患者非常重视重要他人及其照顾者对治疗决策的看法。了解照护者提供的支持以及他们对参与治疗决策的看法，有助于我们改善与患者及其支持者的沟通。我们旨在描述老年癌症患者照顾者的角色、负担和决策偏好：我们在澳大利亚悉尼的三个中心对癌症老年人（≥65 岁）的照顾者进行了横断面调查。采用李克特量表对护理类型、频率和提供护理的角度进行了评估。通过修改后的 "控制偏好量表"（Control Preferences Scale）评估了在治疗决策中的首选角色和感知角色，并通过扎里特负担指数（ZBI-12）评估了照护者的负担。通过卡方检验或 t 检验对不同组别（不同文化和语言背景 [CALD]、性别和照顾者年龄≥ 65 岁）在决策中的首选角色和照顾者负担进行比较：共收回 114 份调查问卷（23 份部分完成）。照顾者特征：中位数年龄 55 岁（24-90 岁不等），女性（74%），子女（49%）和配偶（35%）。护理对象特征：中位年龄 75 岁（65-96 岁不等），正在接受抗癌治疗（85%），有 CALD 背景（44%）。照护者经常参与沟通和信息收集（45 % - 80 %），支持工具性日常生活活动（IADLs）（43 % - 81 %）多于支持基本日常生活活动（ADLs）（2-13 %）。大多数患者（91%）希望在讨论治疗方案时在场。他们在治疗决策中的首选角色是被动型（66%）、合作型（30%）和主动型（4%），其中大多数人（72%）扮演自己首选的角色。首选角色与照顾者的年龄（p = 0.01）和 CALD 背景（p = 0.04）有关，年轻的照顾者（讨论：老年癌症患者的照护者扮演着不同的支持角色，尤其是在沟通和信息收集方面。照护者更愿意参与治疗方案的讨论，但在治疗决策中更倾向于扮演被动的角色，以维护患者的自主权。在支持患者决定治疗方案和护理方向时，了解照护者的沟通偏好是一个重要的考虑因素。

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Support roles, carer burden, and decision-making preferences of carers of older adults with cancer

Introduction

Older adults with cancer value the perspectives of significant others and their carers regarding decision-making about treatment. Understanding the support provided by carers, and their perspectives on involvement in treatment decision-making, can help us improve our communication with patients and their supports. We aimed to describe the roles, burden, and decision-making preferences of carers of older adults with cancer.

Materials and Methods

We performed a cross-sectional survey of carers of older adults (≥65y) with cancer at three centres in Sydney, Australia. Type, frequency, and perspectives on providing care were evaluated using Likert scales. Preferred and perceived role in treatment decision-making by modified Control Preferences Scale, and carer burden by Zarit Burden Index (ZBI-12), were evaluated. Preferred role in decision-making and carer burden were compared between groups (culturally and linguistically diverse backgrounds [CALD], sex, and carer age ≥ 65) by chi-squared or t-tests.

Results

One-hundred and fourteen returned surveys were included (23 partially completed). Carer characteristics: median age 55y (range 24–90), female (74 %), child (49 %) and spouse (35 %) of the care-recipient. Care-recipient characteristics: median age 75y (range 65–96), receiving anti-cancer treatment (85 %), and CALD background (44 %). Carers were frequently involved in communication and information gathering (45 % -80 %) and supported instrumental activities of daily living (IADLs) (43 % - 81 %) more frequently than basic activities of daily living (ADLs) (2–13 %). Most (91 %) preferred to be present when treatment options were discussed. Their preferred role in treatment decision-making was passive in 66 %, collaborative in 30 %, and active in 4 %, with most (72 %) playing their preferred role. The preferred role was associated with carer age (p = 0.01) and CALD background (p = 0.04), with younger (<65y) carers and those caring for CALD older adults preferring a more passive role. Carer burden was ‘low’ in 29 %, ‘moderate’ in 31 %, and ‘high’ in 39 %, and providing psychological support was rated most challenging.

Discussion

Carers of older adults with cancer play varied support roles, particularly in communication and information gathering. Carers prefer to be present for discussions about treatment options, though favour a passive role in treatment decision-making, upholding patient autonomy. Understanding the communication preferences of carers is an important consideration when supporting the patient in deciding treatment options and direction of care.

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来源期刊

Journal of geriatric oncology ONCOLOGY-GERIATRICS & GERONTOLOGY

CiteScore

5.30

自引率

10.00%

发文量

379

审稿时长

80 days

期刊介绍： The Journal of Geriatric Oncology is an international, multidisciplinary journal which is focused on advancing research in the treatment and survivorship issues of older adults with cancer, as well as literature relevant to education and policy development in geriatric oncology. The journal welcomes the submission of manuscripts in the following categories: • Original research articles • Review articles • Clinical trials • Education and training articles • Short communications • Perspectives • Meeting reports • Letters to the Editor.