照顾压力对末期病人身体症状与家人照顾者幸福感的影响:一项多中心的纵向研究。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-11-28 DOI:10.1177/08258597231215137
Amy Y M Chow, Anna Y Zhang, Iris K N Chan, Genevieve A Fordjour, Julianna N M Lui, Vivian W Q Lou, Cecilia L W Chan
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引用次数: 0

摘要

目的:研究主要考虑临终关怀环境中患者的结果而不是护理者的结果。家庭照顾者(fc)在临终关怀中的重要性引起了越来越多的认识,越来越多的以照顾者为目标的干预评估证明了这一点。在以病人为导向的居家临终关怀中,fc的附带效益鲜为人知。本研究旨在探讨以患者为导向的护理中FC的结局和改变机制。方法:前后试验研究。我们招募了预期寿命≤6个月的患者,他们参加了由香港服务机构提供的居家临终关怀。在基线(T0)和3个月后(T1)测量患者的症状、照顾压力维度(即照顾感知、共情压力、适应需求)和照顾者的健康方面(即感知健康、积极情绪、生活满意度、精神幸福感)。结果:在T0的345个fc中,113个提供T1测量。服务开始三个月后,家庭义工的照顾压力明显减轻,积极情绪亦有所改善。减轻患者的身体症状预示着FC更好的结果,包括对护理的感知、移情压力和幸福感。护理知觉的改变介导了患者身体症状变化对护理者生活满意度和精神幸福感变化的影响。共情压力的变化介导了患者身体症状与FCs积极情绪之间的变化。结论:以患者为导向的居家临终关怀的附带效益对FCs是令人鼓舞的。病人的身体症状管理关系到家庭护理人员的护理压力和健康。有效成分改变了家庭主妇对照顾和解决共情压力的看法,可能会扩大他们对健康的好处。
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Caregiving Strain Mediates the Relationship Between Terminally Ill Patient's Physical Symptoms and Their Family Caregivers' Wellbeing: A Multicentered Longitudinal Study.

Objectives: Research considered patient outcomes primarily over caregivers in end-of-life care settings. The importance of family caregivers (FCs) in end-of-life care draws growing awareness, evidenced by an increasing number of evaluations of caregiver-targeted interventions. Little is known of FCs' collateral benefits in patient-oriented home-based end-of-life care. The study aims to investigate FC outcomes and change mechanisms in patient-oriented care. Methods: A pre-post-test study. We recruited FCs whose patients with a life expectancy ≤ 6 months enrolled in home-based end-of-life care provided by service organizations in Hong Kong. Patients' symptoms, dimensions of caregiving strain (ie, perception of caregiving, empathetic strain, adjustment demands), and aspects of FCs' wellbeing (ie, perceived health, positive mood, life satisfaction, spiritual well-being) were measured at baseline (T0) and 3 months later (T1). Results: Of the 345 FCs at T0, 113 provided T1 measures. Three months after the service commenced, FCs' caregiving strain significantly reduced, and their positive mood improved. Alleviation of the patient's physical symptoms predicted FC better outcomes, including the perception of caregiving, empathetic strain, and wellbeing. Changes in perception of caregiving mediated the effects of changes in patients' physical symptoms on FCs' changes in life satisfaction and spiritual wellbeing. Changes in empathetic strain mediated the changes between patient's physical symptoms and FCs' positive mood. Conclusions: Collateral benefits of patient-oriented home-based end-of-life care were encouraging for FCs. Patient's physical symptom management matters to FCs' caregiving strain and wellbeing. The active ingredients modifying FCs' perception of caregiving and addressing empathetic strain may amplify their benefits in wellbeing.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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