晚期癌症姑息治疗患者照顾负荷和家庭亲密度及适应性的相关性分析

摘要

目的 调查晚期癌症姑息治疗患者照顾负荷和家庭亲密度及适应性的现况,研究其家庭亲密度及适应性对照顾负荷的影响.方法 采用癌末照顾负荷量表和家庭亲密度及适应性量表,对102例晚期癌症姑息治疗患者的主要照顾者进行调查,按照顾负荷总得分分为高低2组,即≥52分者49例为高分组,<52分者53例为低分组,采用独立样本t检验比较2组家庭亲密度和适应性得分的差异情况;采用Pearson相关性分析,分析照顾负荷与家庭亲密度及适应性的相关性;采用Pearson相关性分析与多元线性回归分析家庭亲密度及适应性对照顾负荷的影响.结果 晚期癌症姑息治疗患者照顾负荷量表总负荷得分为(52.29±10.83)分;高分组的亲密度不满意程度、适应性不满意程度得分,均高于低分组,差异有统计学意义(P<0.05),家庭实际亲密度、实际适应性得分均低于照顾负荷低分组,差异有统计学意义(P<0.01).照顾总负荷,分别与实际亲密度(r=-0.512,P=0.011)、实际适应性(r=-0.498,P=0.024)、亲密度不满意程度(r=0.421,P=0.042)、适应性不满意度(r=0.489,P=0.038)相关性有统计学意义(P<0.05).多元回归分析显示,实际亲密度、实际适应性、亲密度不满意程度和适应性不满意度,均为照顾负荷的影响因素.结论晚期癌症姑息治疗患者照顾负荷程度整体呈中度水平,改善家庭亲密度和适应性,有助于降低患者的照顾负荷.%Objective To investigate the caregiver burden and family cohesion and adaptability of advanced cancer patients with palliative care, and to study the effects of family cohesion and adaptability on caregiver burden. Methods The caregiver burden scale and family adaptability and cohesion scale of terminal cancer (FACES Ⅱ-CV) were used to investigate the main caregivers of 102 cases of advanced cancer patients with palliative care. According to the survey results, 49 cases with score ≥52 were included in high score group and 53 cases with score <52 points in low score group. The score of family cohesion and adaptability in 2 groups were compared and analyzed using two samples t test and the effect of family cohesion and adaptability on care burden was analyzed using Pearson correlation analysis and multivariate linear regression analysis. Results The average score of the caregiver burden scale of patients with palliative care was 52.29 ±10.83. The scores of intimacy dissatisfaction and adaptability dissatisfaction in high score group were significantly higher than those in low score group (P<0.05) but the scores of genuine intimacy and actual adaptability were significantly lower than those of low score group (P<0.01). The total load was negatively correlated with actual cohesion (r=-0.512, P=0.011) and actual adaptability (r=-0.498, P=0.024), but significantly positively correlated with the degree of intimacy dissatisfaction (r=0.421, P=0.042)and adaptive dissatisfaction (r=0.489, P=0.038). Multiple regression analysis showed that actual cohesion, actual adaptability, intimacy dissatisfaction and adaptability dissatisfaction were influence factors of caregiver burden. Conclusion The caregiver burden of advanced cancer patients with palliative care is moderate load. Improve family cohesion and adaptability should help to reduce the patient's care load.