癌症晚期患者主要照顾者的需求调查

A survey of the needs in patients with advanced cancer to primary caregivers

目的了解癌症晚期患者的主要照顾者的需求,探讨癌症晚期患者的不同生存期对照顾者需求的影响。方法采用横断面研究设计,通过方便抽样法,将2021年3月至2021年9月四川大学华西第四医院姑息医学科的99例癌症晚期患者的主要照顾者纳入研究,采用主要照顾者一般情况调查表、晚期癌症住院患者家属需求调查表和生存期评价为调查工具进行调查。结果预期生存期<7 d的患者有42例,预期生存期7~30 d的患者有12例,预期生存期30~90 d的患者有16例,预期生存期90~180 d的患者有11例,预期生存期180 d以上的患者有18例。主要照顾者总需求得分(3.6±0.8)分,各维度中以患者症状控制需求得分(4.4±0.9)最高,其次为疾病知识(4.2±0.9)、医护相关行为(4.1±0.9)、临终关怀知识(3.7±1.2)、家属自身健康(3.2±1.2)、丧葬支持(3.1±1.2),以患者心理支持需求得分(2.9±1.3)最低。对于不同预期生存期患者对主要照顾者的需求中,丧葬支持、临终关怀知识、患者心理支持3个维度的需求差异具有统计学意义(P均<0.05)。多重线性回归结果显示预期生存期为90~180 d时,主要照顾者对家属自身健康、疾病知识、丧葬支持、患者心理支持以及患者症状控制的几个维度的需求更大。结论癌症晚期患者的不同生存期对主要照顾者的需求不同。提示医护人员应重视癌症晚期患者照顾者群体,根据患者的不同生存期,有针对性地满足对照顾者各方面需求,提高照顾质量,从而提高患者的生活品质。

Objective To understand the needs of terminal cancer patients for primary caregivers and to explore the impact of different expected survival periods.Methods Primary caregivers of ninety-nine advanced cancer inpatients in Department of Palliative Medicine,West China Fourth Hospital from March 2021 to September 2021,were investigated through the primary caregiver general situation questionnaire,CNQ-PAC and prognostic scale.Results Forty-two patients had a survival expectancy<7 days,twelve 7-30 days,sixteen 30-90 days,eleven 90-180 days,and eighteen more than 180 days.The psychological supports were highest score of demand(4.4±0.9),followed by the knowledge of diseases(4.2±0.9),medical staff behaviors(4.1±0.9),hospice care(3.7±1.2),health status of family members(3.2±1.2),funeral support was(3.1±1.2),and the lowest score is the psychological support need score(2.9±1.3).The patients in different expected survival periods have different needs of funeral support,hospice care,and psychological supports(all P<0.05).Multiple linear regression results showed that when the predicted survival time was 90-180 days,the primary caregivers had greater demands on the dimensions of the health status of family members,the knowledge of diseases,funeral support,the psychological supports of patients and psychological supports of patients.Conclusions Different expected survival periods of patients with advanced cancer impact the needs of primary caregivers.Medical staff should pay attention to the quality of caregivers,meet the needs of caregivers in all aspects according to the prediction of patients'survival.