| Objective1.To investigate the life burden of the caregivers for late stage cancer patients.2.To analyze the influence factors of life burden for caregivers for late stage cancer patients.3.To analyze the influence factors of quality of life for caregivers for late stage cancer patients.4.To explore the effect of cognitive behavioral intervention on life burden for caregivers for late stage cancer patients.MethodsThis study consists of two parts.The first part is a cross-sectional study.Application of convenience sampling method,From November 2018 to December 2018,223 late stage cancer patients who were hospitalized in Tianjin Cancer institution& hospital were enrolled in this study.The general situation questionnaire,Self-assessment Anxiety Scale(SAS),Zarit Caregiver Burden Scale(ZBI)and who quality of life brief form(WHO QOL-BREF)were used to investigate and evaluate the relevant indicators.SPSS25.0 statistical software was used to explore the life burden for caregivers for late stage cancer patients.The second part is a randomized controlled study.from January 2019 to July 2019,90 family caregivers of advanced cancer patients with total score of ZBI score≥21 in the cross-sectional survey were selected as the research objects.The subjects were divided into control arm(45 cases)and experimental arm(45 cases)by random number method.In order to avoid contamination between two groups,the subjects were placed in different floors of the same department,The medical staff in each ward are relatively fixed.The control arm received routine nursing instruction and education while the experimental group received cognitive behavior intervention once a week for eight weeks.General information questionnaire,ZBI scale and WHO QOL-BREF scale were used to assess the life burden for both arms by SPSS25.0 statistical software.ResultsFirst part1.The survey shows that the total score of the care burden was(40.40±12.66),the score for personal and responsibility burden was(23.37±5.54)and(9.07±5.49),respectively.52% of the caregivers were at moderate level and 39.5% of them were at severe level.2.The results of one-way ANOVA showed that: There were significant of between anxiety,age,relationship with patients,working status,time of care,chronic disease,living together with patients,total income,self-care ability and disease awareness among the caregivers for late stage cancer patients(P<0.05).Multivariate analysis showed that anxiety of caregivers,chronic diseases,family income per capita and selfcare ability of patients may be the influencing factors of care burden,which can explain 62.5% of the total variation of care burden.3.Pearson analysis showed that the quality of life and various fields of the main family caregivers of patients with advanced cancer were significantly negatively correlated with the burden of care and all dimensions,and negatively correlated with their anxiety.The burden and dimensions of care were significantly positively correlated with their anxiety(P<0.05).4.The survey shows that the total score of quality of life was(63.94±6.64),Social relations score was(14.04±2.03),The score in environmental field was(12.25±1.93),The score in physiological field was(12.02±1.22),The score in psychological field was(11.98±1.78).5.Univariate analysis of the quality of life of the main family caregivers of advanced cancer patients showed that the caregivers’ anxiety level,care burden level,age,relationship with patients,gender,education level,care time,work status,chronic disease,living with patients,family per capita monthly income,with or without caregivers,patients’ self-care ability,medical security mode and disease awareness There were significant differences in the situation(P<0.05).Multivariate analysis showed that gender,education level,anxiety,care burden,living with patients and selfcare ability of caregivers may be the influencing factors of caregivers’ quality of life,which can explain 63.6% of the total variation of quality of life.Second part1.The baseline were well distributed between the two study arms.2.The results of cognitive behavioral intervention on the burden of care.The scores of care burden and two dimensions in the control arm were higher than before,except for the total score of care burden,the other differences were not statistically significant(P>0.05);the scores of care burden and all dimensions in the experimental arm were lower than before,the differences were statistically significant(P<0.05).After the intervention,the scores of care burden and two dimensions in the experimental arm were significantly lower than those in the control group(P<0.05).The difference between the two arms showed that the burden of care and two-dimensional scores in the experimental group were significantly lower than those in the control group.(P<0.05).3.The results of cognitive behavioral intervention on the quality of life.The scores of life quality and each field in the control arm were lower than before but not significant different(P>0.05)except for the scores in the physiological field.The scores in the experimental arm were significantly higher than before(P<0.05).The results showed that the scores of quality of life and various fields in the experimental arm were higher than those in the control arm(P<0.05).The quality of life and scores difference in various fields in the experimental arm were significantly higher than those in the control group(P<0.05).Conclusion1.The main family caregivers of patients with advanced cancer have heavy burden.Anxiety level of caregivers,chronic diseases,family income per capita and self-care ability of patients were the main influencing factors of care burden.2.There was a significant negative correlation between the quality of life and the burden of care,and a significant negative correlation between the quality of life and their anxiety.The main influencing factors of quality of life were anxiety level,care burden level,gender,education level,living with patients and self-care ability of patients.3.Cognitive behavioral intervention can help the caregivers of advanced cancer patients to understand their psychological problems,improve their cognitive level,scientifically understand the disease-related knowledge of patients,master the skills of nursing care and relaxation training,learn to share with others,accumulate care experience,and reduce the burden of care.4.Cognitive behavioral intervention can help the main family caregivers of patients with advanced cancer to be competent for their role in a good emotional state,improve the quality of life,and provide reference for future clinical intervention research. |
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