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癌症临终关怀照顾者的自我护理行为:照顾任务、负担和心理健康的作用。

Cancer Hospice Caregivers' Self-care Behaviors: The Role of Caregiving Tasks, Burden, and Mental Health.

出版信息

J Hosp Palliat Nurs. 2023 Oct 1;25(5):286-295. doi: 10.1097/NJH.0000000000000962. Epub 2023 Jun 22.

Abstract

Cancer hospice family caregivers provide intensive support for patients at the end of life, sometimes at the expense of self-care. This secondary analysis examined the role of caregiving burden, activities of daily living, and mental health on self-care behaviors among cancer hospice family caregivers. Logistic regression models were adjusted for sociodemographic and caregiver characteristics, and model fit was evaluated with Hosmer-Lemeshow tests. Participants (N = 86) were mostly women (n = 62, 72.09%), White (n = 76, 88.37%), and spousal caregivers (n = 44, 51.16%). Almost half reported not getting enough rest (47.67%), time to exercise (47.67%), or time to slow down and rest when feeling ill (46.51%). Caregivers with better mental health reported being more likely to have enough time to exercise (adjusted odds ratio [OR adj ], 1.15, [1.05, 1.26]; P = .004), rest (OR adj , 1.11, [1.01, 1.22]; P = .031), and slow down when ill (OR adj , 1.16, [1.04, 1.30]; P = .010). Controlling for sociodemographic and caregiver characteristics, men caregivers had 88% lower odds of being able to rest when ill (OR adj , 0.12, [0.03, 0.52]; P = .005) compared with women. Number of care tasks, not caregiving burden, was associated with self-care behaviors. Findings provide a preliminary understanding of factors related to caregiver self-care and have implications for increased assessment of caregiver mental health and self-care needs to better support family-oriented hospice care.

摘要

癌症临终关怀家庭护理人员为生命末期的患者提供密集支持,有时以自我护理为代价。这项二次分析研究了照顾负担、日常生活活动和心理健康对癌症临终关怀家庭护理人员自我护理行为的影响。逻辑回归模型调整了社会人口统计学和护理人员特征,并通过 Hosmer-Lemeshow 检验评估模型拟合度。参与者(N=86)主要为女性(n=62,72.09%)、白人(n=76,88.37%)和配偶护理人员(n=44,51.16%)。近一半的人报告休息时间不足(47.67%)、锻炼时间不足(47.67%)或生病时放慢速度和休息时间不足(46.51%)。心理健康状况较好的护理人员报告说,他们更有可能有足够的时间锻炼(调整后的优势比[OR adj],1.15,[1.05,1.26];P=.004)、休息(OR adj,1.11,[1.01,1.22];P=.031)和生病时放慢速度(OR adj,1.16,[1.04,1.30];P=.010)。在控制社会人口统计学和护理人员特征后,男性护理人员在生病时休息的可能性低 88%(调整后的优势比[OR adj],0.12,[0.03,0.52];P=.005)与女性相比。照顾任务的数量,而不是照顾负担,与自我护理行为有关。研究结果初步了解了与护理人员自我护理相关的因素,并对增加对护理人员心理健康和自我护理需求的评估有一定意义,以更好地支持以家庭为导向的临终关怀。

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