| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 102 === Hepatocellular carcinoma was the second leading cause of cancer deaths in Taiwan in 2012. The poor prognosis in patients with hepatocellular carcinoma not only heavily impacts the quality of life and mental health of both patients and family caregivers, but it also increases the caregivers’ supportive care needs. Most previous studies on caregivers’ supportive care needs included patients at diagnosis or terminal cancer patients. Few studies focused on primary caregivers of patients with intermediate or advanced stage hepatocellular carcinoma. This study aims to investigate the supportive care needs in primary caregivers of patients with intermediate and advanced stage hepatocellular carcinoma. The purposes of this study were: (1)to explore the relationships of primary caregivers’ supportive care needs with patients’ demographic profiles, treatments, performance status and patients’quality of life; (2)to explore the relationships of primary caregivers’ supportive care needs with primary caregivers’ demographic profiles, anxiety and depression status, durations and patterns of care;and (3) to explore the supportive care needs and important explanatory factors.
We conducted a cross-sectional, structured questionnaire survey with purposive sampling in a medical center in Northern Taiwan. Structured questionnaires include: (1) The Patients’ Part: patients’ demographic profiles, performance status assessed by Karnofsky Performance Status Scale, and quality of life assessed by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and similar questionnaire module for hepatocellular carcinoma (EORTC QLQ-HCC18) (2)The Primary Caregivers’ Part: primary caregivers’ demographic profiles, supportive care needs assessed by Supportive Care Needs Survey-Partners &; Caregivers 45 (SCNS-P&;C 45), and psychological distress status assessed by Hospital Anxiety and Depression Scale (HADS). Data were analyzed by descriptive statistics, independent samples t-test, Pearson’s correlation, one way-ANOVA, and Generalized Estimating Equations.
Nighty pairs of eligible patients and their primary caregivers were recruited. 72.2% of recruited primary caregivers were female with mean age of 47.1 years old.The results indicated that: (1) health care needs was the highest unmet supportive care needs of caregivers, followed by information needs, psychological and emotional needs, and social and work needs; (2) poorer physical and emotional functions, poorer global health status/quality of life, pain, fatigue, and lower sexual interest of patients were correlated with higher supportive care needs of caregivers (p<0.05); (3) higher levels of anxiety and depression among caregivers were correlated with higher supportive care needs of caregivers(p<0.05) ;and (4) higher level of anxiety among primary caregivers was an important determinant of increases in information needs, health care needs, psychological and emotional needs, social and work needs, and total supportive care needs of caregivers.
In conclusion, the primary caregivers’ anxiety status heavily influenced their supportive care needs, and clinical staff should be concerned with this issue. The main sources of anxiety in caregiver and the effective ways to express emotions properly are both important areas for further research. This study provides valuable information about supportive care needs in primary caregivers of patients with heaptocellular carcinoma and it is helpful in clinical care, education and future research in nursing.
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