Influence Of Diagnosis Disclosure On Quality Of Life Of Lung Cancer Patients And Main Caregivers’ Burden

ObjectiveThe influence of diagnosis disclosure on quality of life of lung cancer patients and main caregivers’ burden was analyzed so as to provide evidence-based medical research evidence for disclosure/nondisclosure of lung cancer diagnosis in clinical practice.The influencing factors of care burden were analyzed to provide reference for generating strategies of diagnosis disclosure.Method1.A cross-sectional and convenient sampling method was used to conduct questionnaire surveys among 330 lung cancer patients in The First Affiliated Hospital of Zhengzhou University at admission,at discharge and at 1 month after discharge.The status of diagnosis disclosure in lung cancer patients were analyzed.Patients were divided into disclosure group and nondisclosure group according to whether the patients were informed of their diagnosis by family members from hospitalization and confirmed diagnosis to 1 month after discharge.The effects of disclosure/nondisclosure on patients’ negative emotions[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)],disease perception[Brief Illness Perceptions Questionnaire-Revised(BIPQ)],and quality of life[The Quality of Life Questionnaire-Core 30(QLQ-C30)]were analyzed.2.At 1 month after discharge,the Caregiver Burden Scale for Cancer Patients(CBS-CP)was used to investigate main caregivers,and their burden was analyzed.Main caregivers with CBS-CP scores ≥87 points were included in the overburdened group,and those with CBS-CP scores<87 points were included in the lighter burden group.The risk factors of main caregivers’ overburden were analyzed.3.((?)±s)was used for statistical description of measurement data,and the measurement data was analyzed by independent-sample t test.n(%)was used for statistical description of enumeration data,and χ2 test,continuous correction χ2 test,and the Fisher’s exact test were used for verification.Wilcoxon signed-rank test was used for comparison of ranked data.The variance analysis of repeated measurement data and LSD-t test were used to compare the SAS scores and SDS scores of the disclosure group and the nondisclosure group at admission,discharge,1 month after discharge.Single factor analysis and disordered multinomial Logistic regression analysis were conducted to screen the factors affecting main caregivers’ burden.Results1.135 lung cancer patients were informed of the diagnosis from hospitalization and confirmed diagnosis to 1 month after discharge,with a disclosure rate of 40.91%(135/330).The remaining 195 patients were concealed during the period.The SAS scores of the nondisclosure group were increased,while SAS scores of the disclosure group were decreased at discharge and at 1 month after discharge,compared with those at admission.Besides,SAS scores of the disclosure group were lower than those of the nondisclosure group at discharge and at 1 month after discharge.SDS score of the disclosure group was higher than that of the nondisclosure group at discharge,but the SDS score was lower than the nondisclosure group at 1 month after discharge(P<0.05).The score of understanding of knowledge about the disease and total score in BIPQ of the disclosure group was higher than that of the nondisclosure group at discharge.The scores of self-control of the disease and understanding of knowledge about the disease of the disclosure group were higher than those of the nondisclosure group at 1 month after discharge.Additionally,scores of effect of the disease on life and emotional impact of the disclosure group were lower than those of the nondisclosure group(P<0.01).Scores of different dimensions in QLQ-C30 of the disclosure group were higher than those of the nondisclosure group 1 month after discharge(P<0.01).2.The scores of different dimensions in main caregivers’ CBS-CP from high to low were psychological,physical,social,economic and concept of disease burden.Besides,and the psychological,physical,social,economic and concept of disease burden scores of main caregivers of the disclosure group were lower than those of the nondisclosure group(P<0.05).The overburden rate of main caregivers of the disclosure group was 40.00%(54/135)which lower than 53.85%(105/195)in the nondisclosure group(χ2=6.126,P<0.05).Univariate analysis found that the proportions of relatively caregivers age ≥50 years,main caregivers having jobs,with family monthly income<3000 yuan,average daily care time ≥ 10 h,nondisclosure rate,chronic diseases≥2 kinds and patients’ sleep time<8 h in the overburden group were higher than those in the lighter burden group.The proportions of caregivers with high education level,with nursing experience and living with the patient,and high social support level were lower than the lighter burden group(P<0.05).There was no statistically significant difference in other data between the 2 groups(P>0.05).Multivariate Logistics regression analysis found that ≥50 years,average daily care time ≥10 h and nondisclosure were risk factors for main caregivers’ burden(P<0.05,OR>1),while main caregivers have high school degree or above education level,monthly family income ≥ 3000 yuan,medium and high social support and patient’s sleep time ≥8 h were protective factors(P<0.05,OR<1).Conclusions1.Concealing the condition cause anxiety and depression in lung cancer patients,affecting their quality of life,while diagnosis disclosure is helpful for lung cancer patients to adjust their emotions and form positive disease perception,thus improving quality of life.2.The overburden rate of main caregivers of the disclosure group was lower than in the nondisclosure group.Nondisclosure was risk factor for main caregivers’burden,informing patients of the diagnosis help reduce the burden.