| Summary: | 碩士 === 長庚大學 === 護理學研究所 === 95 === The literature has shown that those who take care of cancer patients receiving palliative therapy must accept the situations that accompany the patient’s unstable illness, such as the high demand for care, the heavy burden of care, and a reduced quality of life. On the other hand, those who take care of cancer patients receiving curative therapy must bear the suffering due to the patient’s illness, acquire the skills required for providing care in a limited period of time, face the stress owing to treatment efficacy, and accept the compromised quality of life as well. Therefore, caregivers face difficulties whether patients receive curative or palliative treatments. Clinical nurses should not subjectively judge the level of quality of life between these two caregiver groups, but should understand if there are any differences in the quality of life between these two groups through evidence-based research. Moreover, clinical nurses should investigate factors influencing the quality of life of caregivers in order to offer them practical assistance.
Therefore, this study not only compared the quality of life of those caring for patients receiving curative therapy with those caring for patients receiving palliative therapy, but also investigated, after adjusting for the impact of the social demographics, disease-related factors, level of dependence in daily activities, and level of symptom distress of the patients, as well as the social demographics, health status, work intensity, and subjective caregiving burden of the family caregivers, whether there were any differences in quality of life between these two types of caregivers. The purpose of this study was to help nursing staff understand the differences in quality of life between these two caregiver groups and to determine if the type of therapy was really a factor impacting the quality of life of the caregivers, and further, to be a source of evidence for nurses in providing pracital assistance to caregivers.
A cross-sectional survey was conducted by using a convenience sample of 50 caregivers who had patients receiving curative therapy and 50 caregivers who had patients receiving palliative therapy from a northern medical center between 6 December 2006 and 14 Feburary 2007. Instruments used in this study included the following: (1) the social demographics, and disease- and treatment-related data of the patients; (2) the Enforced Social Dependency Scale—for measuring the level of dependence of daily activities of the patients; (3) the Symptom Distress Scale—for the level of symptom distress of the patients; (4) the demographics and health data of the primary caregivers; (5) the work intensity of the primary caregivers; (6) the Caregiver Reaction Assessment—for the subjective caregiving burden of the primary caregivers; and (7) the Caregiver Quality of Life Index-Cancer—for the quality of life of the primary caregivers. Medical chart reviews and personal interviews were used for data collection. Descriptive statistics and multiple regression were used for statistical analysis.
The results of this study suggested that in univariate analysis, caregivers who have patients undergoing curative therapy had a significantly better quality of life than their counterparts who provided palliative care to patients. However, the “type of treatment” was not an influencing factor of the caregiver’s quality of life when multiple regression analysis was conducted and other influencing factors were controlled. Therefore, the quality of life of a cancer patient’s caregiver was not associated with the type of treatment, but was influenced by the patient’s level of symptom distress, as well as educational level, financial status and subjective caregiving burden of family caregivers. When patients suffered from a higher level of symptom distress, and their family caregivers had an educational level less than high school, reported that their financial status could not make ends meet, as well as experienced greater subjective caregiving burden, the quality of life of family caregivers would be lower. Nurses should provide the best care and services to cancer patients as well as to their caregivers, on an equal basis, no matter what kind of treatments the patients received. In addition, nurses should pay special attention to those caregivers who are at a disadvantaged status, such as with lower educational level and insufficient financial status, and make every effort to appropriately manage symptom distress of the patients and relieve the subjective caregiving burden of family caregivers. With these efforts, the quality of life of family caregivers may be improved to achieve the optimual level.
Key words:
Curative therapy, Palliative therapy, Primary caregiver, Quality of life
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