Trajectories And Predictors Of Benefit Finding In Caregivers Of Patients With Colorectal Cancer

Objectives1.To investigate the level and its influencing factors of caregivers’ benefit finding in colorectal cancer patients during the postoperative recovery period.2.To analyze the overall level and change trend of caregivers’ benefit finding in patients with colorectal cancer between the postoperative recovery period period(T1),after the end of first chemotherapy(T2),middle chemotherapy(T3),and post-chemotherapy(T4).3.Latent Class Growth Model(LCGM)was used to investigate the types and characteristics of caregivers’ benefit finding of colorectal cancer patients.4.To analyze the influencing factors of different locus types of caregivers’ benefit finding in different periods of colorectal cancer patients,and the predictive indicators of different groups of caregivers’ benefit finding were discussed.Methods1.Study on the status and influencing factors for caregivers’ benefit finding of colorectal cancer patients during the postoperative recovery period.In this study,colorectal cancer patients and their main caregivers from two Grade A hospitals in Yangzhou were selected as research objects by means of convenience sampling.General data questionnaire,Caregiver Benefit Finding Scale,the Mishel Uncertainty in Illness Scale for Family Members,the Simplified Coping Style Questionnaire,and the Perceived Social Support Scale were used to collect relevant data during the postoperative recovery period period.The collected data were input by two-person check method,and statistical analysis was conducted by SPSS 26.0.The count data were described by frequency and component ratio.The measurement data conforming to normal distribution were described by mean±standard deviation,and otherwise described by M(P25-P75).We analyzed the influence of general information on caregivers’ benefit finding by using independent sample t test and one-way analysis of variance.Pearson and Spearman correlation analysis were used to test the correlation between caregivers’ benefit finding and disease uncertainty,positive coping,negative coping and social support.We analyzed the influencing factors of caregivers’ benefit finding in colorectal cancer patients by using the multiple linear regression.2.Study on the identification and prediction factors of the locus of caregivers’ benefit finding of colorectal cancer patients.Longitudinal follow-up was conducted for postoperative recovery period(T1)caregivers after the end of first chemotherapy(T2),middle chemotherapy(T3),and post-chemotherapy(T4)by using the Caregiver Benefit Finding Scale,the Mishel Uncertainty in Illness Scale for Family Members,the Simplified Coping Style Questionnaire,and the Perceived Social Support Scale.The collected data were input by two-person check.SPSS 26.0 and Mplus 8.3 were used for statistical analysis.We used the repeated measurement analysis of variance to explore the overall score and change trend of caregivers’ benefit finding during the period T1-T4.Linear Class Growth Model(LCGM)was used to explore the potential category grouping of caregivers’ benefit finding.We analyzed the effects of general information,cognitive and psychosocial factors on the caregivers’ benefit finding of colorectal cancer patients by univariate analysis.The predictors of the trajectory types of changes of caregivers’ benefit finding were conducted by the multiple logistic regression analysis.Results1.A cross-sectional survey of caregivers’ benefit finding of colorectal cancer patients during the postoperative recovery period.(1)The total score of caregivers’ benefit finding in colorectal cancer patients was(65.02±6.16)during the postoperative recovery period,which was in the lower middle level.Independent sample T-test and one-way analysis of variance showed that there were significant differences among caregivers’ benefit finding of colorectal cancer patients(P<0.05),including the way of medical payment,enterostomy or not,caregiver gender,education level,per capita monthly family income,total score of disease uncertainty,positive coping,negative coping and social support.(2)Correlation analysis showed that the caregivers’ benefit finding of colorectal cancer patients was negatively correlated with the total score of disease uncertainty(r=-0.314),positively correlated with the positive coping(r=0.400),negatively correlated with the negative coping(r=-0.257),and positively correlated with the total score of social support(r=0.394).(3)Multiple linear regression showed that the way of medical payment of colorectal cancer patients,the education level of caregivers,disease uncertainty,positive coping and social support were factors influencing the caregivers’ benefit finding of colorectal cancer patients,accounting for 36.40%of the total variation(P<0.05).2.Longitudinal follow-up of benefit finding trajectories of caregivers with colorectal cancer patients.(1)The scores of 152 caregivers’ benefit finding at T1,T2,T3 and T4 were(64.90±5.94),(68.76±6.96),(67.75±6.40)and(72.76±9.71)points.The total score of the caregiver’s benefit finding showed an increasing trend,and slightly decreased in T3,with statistical significance(P<0.05).(2)In our study,we classified caregivers’ benefit finding into three groups by the Latent Class Growth Model(LCGM),which were the high level of sustained growth(Cl),the medium level of stable growth(C2),and the low level of slow growthl(C3),accounting for 24.34%,53.29%and 22.37%respectively.(3)Univariate analysis showed that indicators of benefit finding of caregivers of colorectal cancer patients were:the way of medical payment,enterostomy or not,per capita monthly family income,T1 and T3 disease uncertainty,T1-T4 positive coping,T2-T4 negative coping,and T1-T2 social support.(4)Multiple logistic regression analysis showed that the indicators that could predict the development of caregivers of colorectal cancer patients into the high level of sustained growth(C1)included medical insurance,T1 disease uncertainty,T4 positive coping and T1 social support,compared with the low level of slow growthl(C3).Compared with the low level of slow growthl(C3),the indicators of caregivers developing into the medium level of stable growth(C2)included medical insurance and T4 positive coping.Conclusions1.The overall score of caregiver’s benefit finding of colorectal cancer patients was at a medium or below level during the postoperative recovery period,and it was needed to be further improved.The way of medical payment,education level,disease uncertainty,positive responses and social support are the factors influencing the benefit finding for patients with colorectal cancer during the postoperative recovery period.2.In four different time periods of patients with colorectal cancer,the benefit finding of caregivers showed a gradual upward trend,and slightly decreased at T3.3.The group heterogeneity of benefit finding was existed in caregivers of colorectal cancer patients,showing three different trajectories:high level of sustained growth(24.34%),medium level of stable growth(53.29%)and low level of slow growth(22.37%).4.The way of medical payment of colorectal cancer patients,the T1 disease uncertainty,the T4 positive coping and the T1 social support play an important role in distinguishing and discriminating the locus types of changes in caregivers’ benefit finding,it providing an important reference for future research on the development of changes in caregivers’ benefit finding of patients with colorectal cancer.