肺癌患者家庭照顾者负担与生活质量及其影响因素分析

The caregiver burden and related factors on quality of life among caregivers for patients with lungcancer

目的分析北京肺癌患者的家庭照顾者负担对生活质量的影响。方法采用方便抽样法，于2017年8—10月选择在北京市某三甲医院就诊的明确诊断为原发性肺癌患者的336例家庭照顾者作为调查对象。运用照顾者压力反应评估量表（CRA）、世界卫生组织生存质量测定量表简表（WHOQOL-BREF）及人口学基本情况问卷对照顾者进行评估。不同人口学特征变量差异的比较均采用χ2检验或Fisher精确检验，以生存质量量表的4个维度为因变量，将照顾者负担5个维度和人口学特征变量为自变量，以逐步引入-剔除法（引入和剔除检验水平均设置为0.15），按照多重线性回归模型进行拟合。结果肺癌患者家庭照顾者负担中自尊、时间安排受打扰、经济、健康和缺乏家庭支持维度得分分别为（4.30±0.47）分、（3.55±0.74）分、（3.10±0.91）分、（2.60±0.78）分和（2.32±0.73）分。多重线性回归结果显示，婚姻、职业、与患者关系等社会人口学因素及照顾者健康、自尊、经济维度负担是影响照顾者生活质量的因素。结论肺癌患者的家庭照顾者负担主要体现在时间受打扰和经济问题，照顾者负担中的健康、经济和自尊（按反向计分）与生活质量呈负相关。

ObjectiveTo explore the influence of caregiver burden on quality of life among caregivers for patients with lung cancer in Beijing.MethodsFrom August to October in 2017, 336 caregivers for patients with primary lung cancer from a large tertiary hospital were recruited to this survey by convenient sampling method. The Caregiver Reaction Assessment （CRA） and the WHO Quality of Life-BREF （WHOQOL-BREF） Instruments were used to evaluate the caregiver burden and quality of life. The demographic characteristics were evaluated using Pearson chi-square or Fisher′s exact tests. In addition, using the 4 dimensions of quality of life scale as the dependent variables while the 5 dimensions of caregiver burden and demographic variables as the explanatory variables, we conducted the multiple linear stepwise regression analysis （the defaults were 0.15 for FORWARD and BACKWARD）.ResultsThe scores of family caregivers′ esteem, impact on schedule, impact on finances, impact on health and lack of family support were 4.30±0.47、3.55±0.74、3.10±0.91、2.60±0.78、2.32±0.73, respectively. Regression results showed that demographic factors, including marriage, occupation and relationship with patients and impact on health, caregivers′ esteem and impact on finances dimensions of caregiver burden were the factors which influenced the quality of life of caregivers.ConclusionsThe caregiver burden in patients with lung cancer is mainly focused on impact on schedule and finances. Impact on health, finances and caregivers′ esteem （seven items were reverse-scored） are significantly negatively correlated with quality of life of caregivers.