Subjective Burden And Its Influence Factors Among Caregivers Of Rectal Cancer Patients With Two Sorts Of Surgery

Radical resection surgery,including abdominal perineal resection (Miles) and low anterior resection (LAR),remains the mainstay of therapy for patients with rectal cancer in China at present. Due to bowel way changed,physiological discomfort,low self-esteem and social barriers are quite common in patients after Miles surgery. About 80% patients will suffer from defecation dysfunction,manifested as low anterior resection syndrome(LARS),which can be long-standing and limit social activities of patients.Therefore,postoperative patients tend to rely on the care of families. Caregivers of cancer patients may also have certain burden and emotional stress,which affect the quality of caring and their own health. Resently, cross-sectional studies on caregiver burden of Miles patients are rising,while longitudinal study on that of LAR patients are infrequent. Furthermore,comparative study on caring burden of patients with colostomy or anus-preserved haven’t been reported yet. Studies on rectal cancer caregivers are insufficient.Objective To investigate caregivers’subjective burden of LAR and Miles patients within three postoperative months,and provide evidence for rectal cancer continuity nursing through comparing the influence factors of burden in different postoperative stages between two groups.Method Convenience sampling method was used to select 200 cases of LAR and Miles postoperative patients and their primary caregivers from October 2013 to November 2014 in first affiliated hospital of Chongqing medical university.Collectting general information of patients and caregivers,then evaluating quality of life (Quality of Life Questionnaire-Core 30) and intestinal function (Low anterior resection syndrome scale was applied to LAR patients,Artificial anal function evaluation scale was applied to Miles patients) for patients;assessing caregivers’ burden(Zarit caregiver burden interview) and anxiety,depression(Hospital Anxiety and Depression Scale) for caregivers when patients discharged and in three postoperative months. Comparing caregivers’burden and the influence factors between LAR and Miles group.All data inputted into SPSS 18.0 for statistical analysis.Results 1.166 patients and their informal caregivers including 85 cases in LAR group and 81 cases in Miles group completed the three-months postoperative follow-up and recycled effective questionnaires.2.At discharge,the score of caring burden was LAR vs. Miles=35.42±12.94 points vs.42.42±12.38 points,P=0.032,with heavier burden in Miles group.After 3 months,the score was LAR vs. Miles=24.98±11.06 points vs.28.09±12.28 points,P=0.088,no statistical differences was found between two groups.3.Bowel function was significantly damaged and there was no significant improvement within 3 months after surgery in two kinds of surgical patients.Patients’quality of life in early postoperative was decreased signiflcantly,and even more serious in Miles group.After 3 months,QOL was overall improved and there was no significant difference between two groups4.At discharge, caregivers of patients with postoperative complications and impaired cognitive and emotional functions had heavier burden.After 3 months,the intestinal function and QOL of patients had the most prominent influence on caring burden.5.Caregivers burden in two groups were positively correlated with anxiety and depression at different postoperative stages:the heavier burden,the higher degree of anxiety and depression.Conclusion Caring burden in LAR group is not lower than that of Miles group in the third postoperative month.Caregivers’psychological demands in LAR group and Miles group should be placed in an equal status.Intestinal function and general QOL of patients after surgery had the most significant impact on caregivers’burden,which can be reduced by the most fundamental measures:ameliorating patients’ intestinal symptoms and improving their quality of life.