A Mixed Study On The Benefit Finding Among Caregivers Of Esophageal Cancer Patients

Objective:1.To analyze and describe the status quo and influencing factors of benefit finding of caregivers of esophageal cancer patients;2.Explore the real experience of esophageal cancer caregivers’ benefit finding,understand the source of the benefit finding;3.Identify the key characteristics of caregivers with high level of benefit finding,and supplement to explore the unquantifiable factors that affect their benefit finding.Methods:The mixed method of quantitative questionnaire survey and qualitative semi-structured interview was adopted in this study.Part ONE:Quantitative studyThe convenience sampling method was used to select the caregivers of esophageal cancer patients in the department of thoracic surgery and Oncology of a Third-class hospital in Nanchong city from January 2021 to June 2021 as the research objects.Use of BFS-RC,SCSQ and GSES to investigated 311 caregivers of esophageal cancer patients,to understand the status quo of their benefit finding and related influencing factors.SPSS22.0 software was used for statistical description,and frequency,component ratio,T test,analysis of variance,correlation analysis and multiple linear regression analysis were used to determine the influencing factors of esophageal cancer caregivers’ benefit finding.Part TWO:Qualitative researchAccording to the results of the quantitative study,13 caregivers of esophageal cancer whose benefit finding survey results were high level(score>72)were selected as the interviewees.Semi-structured interviews of qualitative study were used to analyze their benefit finding experience,and relevant influencing factors of benefit finding of caregivers in quantitative study were explored and supplemented.The interview data were imported into Nvivo11 software,coded by two researchers respectively,and analyzed according to Colaizzi seven-step analysis method to extract meaningful statements and conclude the theme.Part Three:The Integrative results of quantitative and qualitative studiesUnder the guidance of cognitive adaptation theory,the top 10 items in the BFS-RC in quantitative studies were integrated with the results of qualitative studies,and the key characteristics of esophageal cancer caregivers with high level of benefit finding were extracted,and corresponding intervention strategies were developed.Results:1.Results of Quantitative study(1)A total of 330 questionnaires were sent out in this survey,and 311 were effectively received with effective recovery rate of 94.24%.(2)The benefit finding score of caregivers of esophageal cancer patients was(72.40±15.63),the score of health behavior was(3.69±0.99)from high to low.Social relationship(3.34±0.83),family relationship(3.34±0.81),acceptance(3.29±0.94),personal growth(3.06±0.93).(3)The results of one-way ANOVA and independent sample T test show that:Caregiver gender(r=2.40,P=0.02),age(F=7.29,P<0.01),marital status(F=3.35,P=0.04),monthly family income(F=4.81,P=0.01)and caregiver-patient relationship(F=4.34,P=0.01)influenced caregivers’ benefit finding.Patients’ medical expenses payment method(F=5.35 P<0.01),self-care ability(F=4.55,P=0.01),course of disease(F=20.95,P<0.01),current treatment method(F=29.94,P<0.01)and disease stage(F=23.51,P<0.01)showed statistically significant difference in benefit finding of caregivers.(4)Correlation analysis results:The positive coping style of esophageal cancer patients’ caregivers was positively correlated with the total score of benefit finding and its various dimensions in Pearson correlation analysis(r=0.391-0.629,P<0.01).Spearman correlation analysis showed that negative coping style was significantly positively correlated with acceptance dimension(r=0.169,P<0.01),and positively correlated with social relationship dimension,health behavior dimension and benefit finding total score(r=0.124-0.140,P<0.05).There was no significant correlation with scores of family relationship dimension and personal growth dimension(P>0.05).There was significant positive correlation between self-efficacy and caregiver’s total score of benefit finding and its dimensions(r=0.393-0.581,P<0.01).(5)Multiple linear regression analysis shows that:patients’ way of paying for medical expenses(medical insurance for urban employees、medical insurance for urban and rural residents)and treatment(surgery),caregivers of positive coping style and self-efficacy,a total of five variables entered the regression equation,explain 51.6%of the total variables.2.Results of qualitative studyThe results of the benefit finding survey showed that the high level of care experience of esophageal cancer caregivers included four major themes and 20 sub-themes,respectively:(1)Feeling of caring(heavy burden,great pressure,inner worry,maladjustment of role);(2)Personal growth(increased disease awareness,increased care experience,internal quality improvement,learning to ease bad emotions,self-ability improvement,personal health literacy increase,self-efficacy enhancement);(3)Perceive multiple supports and learn to be grateful(family support,social support,gratitude to others,altruistic behavior);(4)New insight on life(change of mentality,firm belief,positive response,remolding the concept of money,cherish the present,filial values,planning for the future).3.Integration results of quantitative and qualitative studies(1)Integrating quantitative research results(make my family relationships closer,I pay more attention to family issues,help me to feel the love and support of others)and qualitative research results(family support,cherish the present,social support),multi-angle comprehensive social support of caregivers to maintain high levels of benefit finding.(2)The results of quantitative study(make me have a more healthy lifestyle,make my diet more healthy)and qualitative study(increase in health literacy)can be integrated.Higher health literacy is beneficial for esophageal cancer caregivers to maintain a high level of benefit finding.(3)In addition to qualitative research results(enhanced self-efficacy),a strong sense of self-efficacy is beneficial for esophageal cancer caregivers to maintain a high level of benefit finding.(4)Integrating quantitative research results(leading me to treat things naturally)and qualitative research results(attitude change),a good psychological state is conducive to esophageal cancer caregivers to maintain a high level of benefit finding.(5)Integrating quantitative research results(taught me to control temper)and qualitative research results(learn to ease bad emotions)and(firm belief and positive response)supplement is available,appropriate coping methods and emotional catharsis are conducive to esophageal cancer caregivers to maintain a high level of benefit finding.Conclusion:1.The benefit finding of esophageal cancer patients’ caregivers was at a moderate level,which was influenced by patients’ medical expense payment methods(medical insurance for urban employees、medical insurance for urban and rural residents)and treatment methods(surgery),caregivers’ positive coping styles and self-efficacy.2.The benefit finding experience of esophageal cancer caregivers included caring experience,personal growth,perception of multiple support,learning gratitude,and new life perception.3.Multi-angle and all-round social support,high health literacy,strong sense of self-efficacy,good psychological state,appropriate coping styles and emotional catharsis are the key characteristics of high benefit finding of caregivers.