大肠癌患者家庭照顾者因素对其照顾负担影响的纵向研究

A longitudinal study of the influence of family caregivers on the burden of care in patients with colorectal cancer

目的:分析大肠癌患者家庭照顾者在患者术后、化疗中期、化疗结束及化疗结束后3个月各时段照顾负担的水平变化情况。方法:本研究采用纵向研究设计,通过便利抽样在北京市、内蒙古自治区、河北省、河南省、江苏省的7家三级甲等医院,对185名大肠癌患者家庭照顾者在4个时间点采用一般自我效能量表、社会支持量表、照顾者照顾能力量表、简易应对方式量表及照顾者反应评估量表进行问卷调查。结果:大肠癌患者家庭照顾者普遍存在照顾负担,对照顾者影响较大的是“时间安排受打扰”和“经济问题”两个维度;照顾负担在随访期间先升后降,在化疗中期较为严重。增加照顾负担的因素为与患者同住、分担照顾患者人数少,照顾者一般自我效能、社会支持、照顾能力欠缺,较少采用积极应对和较多采用消极应对。结论:大肠癌患者家庭照顾者照顾负担随时间先上升后下降。临床医护人员应重点提高照顾者的自我效能、社会支持、照顾能力和促进其采取积极的应对方式。

Objective:To investigate the changes of family caregivers'care burden in patients with colorectal cancer after operation,in the middle of chemotherapy,after chemotherapy and 3 months after chemotherapy.Methods:A longitudinal study design was used to conduct a questionnaire survey including general self-efficacy,social support,family caregiver task,ways of coping and caregiver reaction assessment questionnaire on 185 family caregivers of colorectal cancer patients who met the recruiting criteria in 7 tertiary hospitals located in Beijing,Inner Mongolia,Hebei,Henan and Jiangsu at four time points.Results:The family caregivers of patients with colorectal cancer generally had the burden of care,and the two dimensions of"time disturbed"and"financial difficulties"had a greater impact on caregivers;the burden of care first increased and then decreased during the follow-up period,and was more serious in the mid-term of chemotherapy.The factors that increased the burden of care included living with patients,few people for sharing,caregivers'lacking of general self-efficacy,social support and care ability,less positive coping and more negative coping.Conclusion:The care burden of family caregivers increased first and then decreased with time.Clinical staff should focus on improving caregivers'self-efficacy,social support,care ability and coping styles.