| Purpose:In order to improve the mental health level of ceregivers,this research describe mental health and depression status in caregivers of cancer patients and analyze the influential factors.Furthermore,the article provides scientific theory basis on how to set up effective intervention measures to provide support to the cancer patients,relatives and caregivers.Method:This study combined the one-to-one semi-structured psychological interviewing method with questionnaire assessment,according to sequential access method,the caregivers of 150 cases of cancer in patients who underwent surgery,radiation and chemotherapy admitted to the oncology department of the Second hospital affiliated to Dalian medical universkty and Zhongshan hospital affiliated to Dalian universkty in Dalian,Liaoning from Jan,2015 to Nov,2015 were selected as an object of study,the mental health status,depression and related influencing factors of caregivers were analyzed.Patient general data survey and disease diagnosis questionnaire,caregiver basic information questionnaire were utilized to obtain a overview of demographic factors,disease siagnosis and treatment.Mental health status,depression and social support were assessed with SCL-90,CES-D,SSRS.Results:(1)It has been found by the study on the mental health status of caregivers of 150 cases of hospitalized cancer patients predominated by gastrointestinal tract cancer,gynecological cancer,head&neck cancer,breast cancer and lung cancer,the SCL-90 total score and score of each factor of cancer caregiver were higher than the Chinese Norm(p=0.000);thereinto,the positive detection rate of anxiety factor headed the list(58.7)%;In the second place was the interpersonal sensitivity(25.3%)and compulsion(21.3%).The mean CES-D score of cancer caregivers was7.77± 6.35,the caregivers who had depression altogether accounted for 12.0%(18 cases).(2)The CES-D(t=3.615,p=0.000)and SCL-90 total score(t=-2.172,p=0.032)of female caregivers were equally markedly higher than that of male caregivers,and the females had markedly higher scores than the males in terms of the factors,interpersonal sensitivity(t=-2.430,p=0.017),anxiety(t=-2.530,p=0.013),depression(t=-3.304,p=0.001)and terror(t=-2.202,p=0.030).(3)The caregivers of different marital status differed from each other significantly in CES-D(F=10.308,p=0.000)and SCL-90 total score(F=7.935,p=0.001),the CES-D and SCL-90 total score of married caregivers were markedly lower than that of the unmarried and widowed ones.The CES-D total score and SCL-90 total score of cancer caregivers had difference in the role of caregiver,the caregivers who played a role of parents had a significantly higher SCL-90 total score(F=9.168,p=0.000)and CES-D total score(F=12.576,p=0.000)than the ones who played other roles had,the caregivers who played a role of spouse ranked the second.(4)The difference in CES-D(F=3.779,p=0.012),SCL-90 total score(F=3.336,p=0.021),anxiety(F=3.611,p=0.015)and depression(F=3.009,p=0.032)factor between the caregivers of different financial conditions was significant,the caregivers whose average monthly income was more than 5000 yuan had the lowest CES-D total score(F=3.906,p=0.010)and SCL-90 total score(F=4.321,p=0.006).The difference in CES-D,SCL-90 total score,compulsion(F=7.803,p=0.000),anxiety(F=4.243,p=0.007)and terror(F=4.850,p=0.003)factor between the caregivers of different working conditions was significant,the in-service caregivers had a markedly lower CES-D total score and SCL-90 total score than the ones who were in other working conditions.(5)The difference in CES-D(F=9.842,p=0.000)and SCL-90 total score(F=10.541,p=0.000)between the different caregivers who assessed their physical condition by themselves was significant,the caregivers who assessed their physical condition as good had a markedly lower score than the ones who assessed their physical condition as poor or average in terms of somatization(F=7.617,p=0.001),compulsion(F=6.359,p=0.002),anxiety(F=6.335,p=0.002),stubbornness(F=4.772,p=0.010)and depression(F=7.113,p=0.001)factor.(6)There was a significant difference in equally the CES-D(F=6.272,p=0.001),SCL-90 total score(F=6.653,p=0.000)and compulsion(F=2.992,p=0.033),interpersonal sensitivity(F=3.005,p=0.032),anxiety(F=3.353,p=0.021),stubbornness(F=3.490,p=0.017),depression(F=3.535,p=0.016)and terror(F=3.372,p=0.020)factor between the caregivers of patients with different course of disease,the caregivers of patients whose course of disease ranged from 3 to 12 months had the highest CES-D total score and SCL-90 total score.(7)There was a significant difference in equally the CES-D(F=3.038,p=0.008),SCL-90 total score(F=3.084,p=0.011)and compulsion(F=3.296,p=0.008),interpersonal sensitivity(F=2.809,p=0.019),anxiety(F=2.657,p=0.025),stubbornness(F=3.556,p=0.005)and depression(F=4.163,p=0.001)factor between the caregivers of patients with different kinds of cancer,the caregivers of patients with head & neck cancer had the highest CES-D and SCL-90 total score,which was markedly higher than that of patients with other kinds of cancer,followed by the caregivers of patients with lung cancer and gastric and intestinal cancer.(8)There was a significant difference in CES-D(F=4.681,p=0.004)and SCL-90 total score(F=2.998,p=0.033)between the caregivers of patients with different cancer staging,the caregivers of patients with IV-stage cancer had a markedly higher SCL-90 total score than the ones of patients in other three kinds of staging.The caregivers of patients with metastatic cancer had a markedly higher CES-D(t=14.080,p=0.000)and SCL-90 total score(t=3.289,p=0.001)than the ones of patients without metastatic cancer;the caregivers of patients who suffered from cancer pain had a markedly higher CES-D(t=14.482,p=0.000)and SCL-90 total score(t=3.333,p=0.002)than the ones of patients who didn’t suffer from cancer pain.(9)The social support total score of cancer caregivers was 39.30±5.42 points,which was markedly higher than domestic Norm(t=10.718,p<0.01).The CES-D total score of cancer caregivers was notably negatively correlated with the objective support(r=-0.315),subjective support(r=-0.359),support availability(r=-0.384)and social support total score(r=-0.463).The SCL-90 total score of cancer caregivers was notably negatively correlated with the objective support(r=-0.216),subjective support(r=-0.310),support availability(r=-0.234)and social support total score(r=-0.344).(10)The result of multiple stepwise regression analysis showed that,the main influencial factors of mental health status of cancer caregivers included: education background of caregiver(b=-0.382),whether the patient had a cancer pain(b=0.232),the self-assessed physical condition(b=-0.209)and subjective support(b=-0.184)of caregiver,the model statistically significant(F=23.14,p=0.000).The result of binary variable multiple Logistic regression analysis showed that,the factors influencing the depressive condition of cancer caregiver included: patient’s cancer staging(b=2.470).the self-assessed physical condition(b=0.361)and education background(b=0.061)of caregiver,the model statistically significant(c2=44.94,p=0.000).Conclusions:(1)Compared with the healthy adults in China,the mental health level of cancer caregivers was relatively low.The mental problems that are most likely to occur in cancer caregivers were: anxiety,interpersonal sensitivity and compulsion;the incidence rate of depression was 10.67%.(2)Compared with males,the female cancer caregivers had a relatively poor mental health status,and higher level of depression,it is more likely for them to develop interpersonal sensitivity,anxiety and terror.(3)The mental health status,depression of married caregivers were markedly better than that of the unmarried and widowed ones.;The mental health status,depression of roles of cancer caregivers,the caregivers who played a parental role is the worst,followed by the ones who played a role of spouse.(4)The caregivers whose average monthly income lies between 1000 and 2999 yuan had the poorest mental health status and highest level of depression;the in-service caregivers had the best mental health status and lowest level of depression.(5)The better the self-assessed physical condition of caregivers is,the better their mental health,depression status is.(6)The caregivers of patients whose course of disease ranged from 3 to 12 months,who had suffered from head & neck cancer,who had a IV-staging cancer,who already had a metastatic cancer or who had cancer pain had the poorest mental health,depression status.(7)The better the social support to cancer caregiver is and the higher the social support level is,the better their mental health status is.(8)The mental health levels strengthens with the increase of caregiver’s education background,caregiver’s self-assessed physical condition,subjective support and weakens with the emergence of cancer pain.The patient’s cancer staging is risk factor,the self-assessed physical condition of caregiver and education background of caregiver are protective factors. |
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