Construction And Validation Of A Risk Assessment Model For Caregiving Burnout In Family Caregivers Of Children With Malignant Tumor

ObjectiveTo investigate the status quo of caregiving burnout in family caregivers for children with malignant tumor,analyze its influence factors,construct and validate the risk prediction model of caregiving burnout in family caregivers for children with malignant tumor,so as to provide a reference basis for clinical medical staff to screen caregiving burnout high-risk groups and formulate nursing strategies.MethodsThe method of cross-sectional investigation was applied.From November 2021 to April 2022,220 family caregivers of children with malignant tumors from the pediatric oncology department of a tertiary grade-A hospital in Shandong Province were selected by convenience sampling method.The survey was conducted by using general information questionnaire,maslach burnout inventory,big five inventory,psychological adaptation scale,chinese perceived stress scale,perceived social support scale.In order to screen the influencing factors of caregiving burnout and establish a risk assessment model.From May to July 2022,110 family caregivers of children with malignant tumors from the same hospital were recruited for external validation.Establish the original data database and use the statistical software SPSS27.0 to statistical analysis.Statistical methods include descriptive statistical analysis,χ~2text,Mann-Whitney nonparametric test,independent sample T-test,the binary Logistic regression analysis,discrimination and calibration evaluation.Results1.The incidence of caregiving burnout in family caregivers of children with malignant tumors was 45.5%(100/220)in the modeling group and 43.6%(48/110)in the validation group.2.The results of univariate analysis of the modeling group showed that there was a statistically significant difference between the care burnout group and the non-care burnout group in disease stage,health self-evaluation,care duration,comfort score,neuroticism score,coping ability score,self-improvement score,social ability score,psychological growth score,+tension score,sense of loss score,family support score,and friend support score(P<0.05).Logistic regression results showed that the health self-evaluation(less healthy),agreeableness score,neuroticism score,psychological growth score,and family support score were independent influencing factors of caregiving burnout of family caregivers for children with malignant tumor.3.The formula of caregiving burnout risk assessment model for family caregivers for children with malignant tumor was Logit(P)=8.550+1.517×Self-rated health(less healthy)-0.282×agreeableness score+0.203×neuroticism score-0.356×psychological growth score-0.229×family support score.According to the formula of this model,when P≥-4.934,it is considered that family caregivers of children with malignant tumors are at risk of nursing burnout.Model evaluation:Hosmer-Lemeshow test of modeling group shows that,χ~2=1.173,P=0.279,area under ROC curve is 0.904(95%CI0.864～0.943,P<0.001),and the maximum Youden index is 0.682,corresponding sensitivity is79.0%,specificity is 89.2%and best cutoff value is-4.934.4.External verification:There was no statistically significant difference between the data of the modeling group and the validation group(P>0.05).The Hosmer-Lemeshow test in the verification group showed thatχ~2=2.994,P=0.084;the area under the ROC curve is0.893(95%CI0.834～0.953,P<0.001),When the cutoff value is-4.934,the sensitivity is85.4%and the specificity is 71.1%.Conclusion1.The prevalence of caregiving burnout in family caregivers for children with malignant tumor is high.2.Self-rated health(less healthy),agreeableness score,neuroticism score,psychological growth score,family support score are independent influencing factors of caregiving burnout in family caregivers for children with malignant,among which,Self-rated health(less healthy)and neuroticism score are risk factors of caregiving burnout in family caregivers,and agreeableness score,psychological growth score and family support score are protective factors of caregiving burnout in family caregivers.3.The constructed risk assessment model of caregiving burnout can effectively assess the occurrence of caregiving burnout in family caregivers for children with malignant.The assessment model was externally validated,it has good differentiation and calibration ability,which can be promoted and used in clinical practice,providing an assessment tool for medical staff to identify high-risk groups of caregiving burnout at an early stage and providing a basis for early intervention against caregiving burnout,and has positive significance for improving the quality of care for family caregivers and thus improving the quality of life for children with cancer.