| Summary: | 博士 === 國立臺灣大學 === 護理學研究所 === 101 === Caregiver burden is one of the major psychological stressors for family caregivers (FCs). FCs caring for patients with life-threatening advanced lung cancer may experience this burden. However, there is relatively limited longitudinal research in this field. The purposes of this study were to explore the changes and sub-patterns of overall caregiver burden, and to examine the factors that predict changes and sub-patterns in overall caregiver burden over 6 months after lung cancer diagnosis.
A longitudinal design with consecutive sampling was conducted to recruit newly diagnosed lung cancer patient and FC dyads in a medical center in Taiwan. Four time measurements were taken: pre-treatment (T1), 1st (T2), 3rd (T3) and 6th (T4) month post-treatment. Levels of overall caregiver burden were measured at each time point. Latent Class Growth Analysis (LCGA) was conducted to identify the numbers of sub-patterns of overall caregiver burden, while Generalized Estimating Equations (GEE) were used to identify the factors related to changes and sub-patterns of overall caregiver burden and their related factors.
This research found that FCs reported steady moderate levels of overall caregiver burden during the study period and factors that predicted a higher level of burden were FCs who had another sick family member, FCs who did not have another person to provide alternative care, FCs with pain, FCs with fatigue, and FCs with lower self-efficacy in coping with cancer. Even though factors predicting overall caregiver burden were all FC-related factors, patients’ physical function did have a mild correlation with overall caregiver burden. In addition, patients’ physical function had a mild relationship with FCs’ fatigue at the 1st month post-treatment and had a moderate relationship with FCs’ pain at the 3rd month post-treatment. Furthermore, three sub-patterns of overall caregiver burden were identified: (1) Pattern I (higher pattern, 34.7%): FCs in this group reported “relatively higher levels of burden over time” and factors that predicted the burden were FCs who had patients with poor appetite, FCs who did not have another person to provide alternative care, FCs with pain and FCs with lower self-efficacy in coping with cancer; (2) Pattern II (moderate pattern, 56.0%): most FCs in this group reported “steady moderate levels of burden over time” and factors that predicted the moderate level of burden were FCs with male patients, FCs who had patients with higher levels of depression, married FCs, spousal FCs, FCs with fatigue, and FCs with lower self-efficacy in coping with cancer; (3) Pattern III (lower pattern, 9.3%): FCs in this group reported “relatively lower levels of burden”, which showed a small drop at 3rd month post-treatment. The factors that predicted the lower level of burden was FCs’self-efficacy in coping with cancer.
FCs play a central role in providing cancer care. The findings in this study showed that the majority of FCs had at least moderate levels of burden over 6 months after lung cancer diagnosis. Therefore, FCs’ burden distress should be addressed in clinical settings. Factors related to the changes and sub-patterns of FCs’ burden provide further information for clinical setting and designing timely and comprehensive interventions to reduce FCs’ burden, for a better quality of cancer care.
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