Anxiety,Depresstion,Social Support And Its Related Factors In Primary Family Caregivers Of Cancer Patients

The diagnosis of cancer has not only a significant impact on the affected patients, but also is a distress for their families. Suffering from the distress that their familiy members with cancer, caregivers have to assume the primary responsibility of caring for the patients ,afford the finacial burden ,actively engage in emotion support for the patients, whilst also attempt to manage their own feeling states.These stress-factors could bring negative impact to the caregivers, physical and mental health. It has been reported that the prevalence of emotional distress in caregivers equaled or exceeded that in cancer patients. Family members have been described as co-sufferers in the battle against cancer. The large number of studies have reported a positive relationship between caregivers'and patients'distress. While the caregivers suffer some physical or psychological distress, the quality of care will be affected ,and will be brought some negative factors for the patiens'mental health.so,paying attention to the mental health of family caregivers and the related factors play an important role in providing a foundation of designing interventions,and then improving the level of mental heath of caregivers and support level for the cancer patients. Objective: To investigate anxiety, depression and social support in caregivers of patients with cancer and the related factors. It would provide the foundation of interventions,and that would improve the level of mental heath of caregivers and the caregivers, surport level for the cancer patients.Methodes: The study sample consisted of 106 family caregivers of consecutive hospitalized cancer patients at department of comprehensive diagnosis and therapeutic center in Xijing hospital between Octobor and December in 2006 . Depression ,anxiety and social surport were assessed with CES-D, SAS, SSRS respectively.The general condition of the caregivers and disease information of the patients were collected with questionnaires designed by author.Results:1. The mean depression scores of caregivers on the CES-D was 18.75,it was significantly higher than the normal samples and exceeded the cut off of 16 for clinic depression. 55.7% of caregivers reported CES-D scores which exceed the cut-off. Caregivers aged 26～50 years old, caregivers in lower income level and lower availability of SRSS, caregivers of patients with multiple symptoms,male patients and the patients with cancer in digestive system reported higher prevalence of CESD-defined depression compared with their counterparts. The results from the multiple regression showed that depression in caregivers were related with patients symptom status ,cancer stage, caregivers income level and availability of SSRS.The availability of SSRS was negatively correlated to the level of depression . Patients symptom status were the significantly factors that affect caregivers'depression .2. The mean level of anxiety scores in caregivers on the SAS was 33.94.Their level of anxiety was significantly higher than normal. In 106 caregivers, 22.6% (24) had been reported that their SAS scores exceeded thresholds for clinical anxiety.There were 23 caregivers with anxiety symptoms also with depression symptoms. The high anxiety index was significantly associated with the caregiver's reported more patients symptoms ,and the spouses of the patients were also at the high risk of anxiety .3. The mean level of social support scores in caregivers on the SSRS was 40.54.It was higher than normal samples .Caregivers aged above 50 years-old reported lower level of subjective support scores and lower availability of SRSS. caregivers who received education more than 12 years have higher availability of support than those who received short one ;officials, company staffers, intelligentsias all have significant higher objective support scores than the others ;the caregievers who have to pay for the whole medical-fee get significant lower objective support than the ones who have medicare insurance;the objective support of the caregivers is higher in the later phase of cancer patients than the in earlier phase .4. The scores of social support in non–depression caregivers were higher than in the depression ones,and availability of social support scores were significantly increased in previous group;the correlation analyse between depression and social support showed :the availability of social support scores correlated negtively with depreession.Conclusion: A high level of depression and anxiety existed in caregivers of cancer patients.The psychological distress of caregivers was influenced not only by sociodemographics factors of themselves,but also by sociodemographics factors of the patients and patients'state of cacer. Spouses of patients, Caregivers aged 26～50 years old, caregivers in lower income level and lower availability of SRSS, caregivers of patients with multiple symptoms,male patients and the patients with cancer in digestive system are the specific groups at high risk for distressed. Health care personnel should treat the patient and their family members as a'patient-caregiver dyad', while the cancer patients were given treatment, the caregivers'distress should be concerned; while health care personnel provide interventions to the caregivers,we should considered of the aspect of patients factors. Health care personnel should actively talk with patients and their caregivers,and be aware of their psychological distress and it's effected factors and, if necessary, should provide direction interventions,to improve the level of mental health in caregivers,and then to improve the level of surport for patients.