The Relationship Between Self-Disclosure,Psychological Distress And Quality Of Life Of Primary Caregivers Of Patients With Esophageal Cancer After Operation

ObjectiveIn this study,a cross-sectional survey was conducted on self-disclosure,psychological distress and quality of life of major caregivers of patients with esophageal cancer after surgery,to detect the relevant influencing factors of the three and the existence of mediating effect,so as to provide theoretical basis for further active and effective intervention research and promote physical and mental health of major caregivers of patients with esophageal cancer after surgery.MethodsThis study used a convenient sampling method from November 2018 to July 2019 to conduct a questionnaire survey on primary caregivers of patients with esophageal cancer after compliance with standards in a tertiary Class A tumor hospital in Henan Province.The questionnaire mainly includes: General information questionnaire,Distress Disclosure Index(DDI),Kessler Psychological Distress Scale(K10),and Chinese version of quality of life questionnaire for caregivers of cancer patients(QOL scale-family).In this study,a total of 260 questionnaires were issued and 245 valid questionnaires were recovered,with an effective recovery rate of 94.23%.SPSS20.0 statistical software was used to input and analyze effective data.Statistical analysis methods included descriptive statistical analysis,single-factor analysis,pearson correlation analysis,multiple linear regression and mediation effect test.Results1 The self-disclosure score of the main caregivers of 245 postoperative patients with esophageal cancer was(39.78 ± 6.313)points,which was at a moderately high level.Among them,low level self-disclosure accounted for 6.2%,middle level self-disclosure accounted for 62.4%,and high level self-disclosure accounted for 31.4%.Among the entries,the highest score is the first entry,for: When I am sad,I usually talk to my friends.And the lowest score is the third entry,for: When unpleasant things happen to me,I often find someone to talk about these things.And whether the patient was informed,the caregiver's gender,and the caregiver's residential self-disclosure score were statistically different(P<0.05).2 The psychological distress score of the main caregivers of 245 postoperative patients with esophageal cancer was(21.78±6.810)points,which was above the average level,and the detection rate of psychological distress was 74.3%.Moreover,the items that the caregiver felt nervous and tired on this scale had the highest score.The patient's age,family monthly income,tumor stage,treatment method,whether the patient knows,reflux,and difficulty eating,the gender and educational level of the caregiver can affect the psychological distress level of the study subjects,and the difference is statistically significant(P<0.05).3 The quality of life score of the main caregivers of 245 postoperative patients with esophageal cancer was(178.44 ± 31.613)points,which was at a medium level.In the dimensions of the scale,the caregivers scored the highest in physical health,followed by mental health,social health,and mental health.In addition,the patient's monthly household income,tumor staging,treatment methods and reflux,and caregiver's gender,long-term residence,relationship with patients,whether living with patients,whether suffering from chronic diseases,and whether there is a co-caregiver can affect the quality of life of the study subjects,and the difference is statistically significant(P<0.05).4 Self-disclosure of primary caregivers of patients with esophageal cancer after surgery was significantly negatively correlated with psychological distress(r =-0.344,P<0.05),positively correlated with quality of life and four dimensions(r = 0.519,0.400,0.393,0.407,0.492,P< 0.05),and psychological distress was negatively correlated with quality of life and four dimensions(r =-0.364,-0.297,-0.335,-0.255,-0.273,P< 0.05).5 Taking the quality of life score as the dependent variable and using statistically significant variables as independent variables to perform multivariate linear stepwise regression analysis showed that the patient's tumor stage,long-term residence,whether suffering from chronic disease,and whether living with the patient,the treatment method and the relationship with the patient entered the regression equation,which are the factors affecting the quality of life(P<0.05),and explained the variation of the quality of life of the dependent variable by 27.6%.6 Psychological distress has a partial mediating effect between self-disclosure and quality of life,accounting for 13.92% of the total effect.Conclusions1 The self-disclosure and quality of life of the primary caregivers of patients with esophageal cancer after surgery were at a medium level,but the detection rate of psychological distress was 74.3%.2 The patient's tumor stage is the biggest factor affecting the quality of life of the main caregivers of patients with esophageal cancer after surgery,followed by the treatment method,the long-term residence of the caregiver,whether they have chronic diseases,whether they live with the patient,and the relationship with the patient.3 Self-disclosure and psychological distress of the main caregiver of patients with esophageal cancer after surgery are important factors affecting the quality of life of the caregiver,and there is a correlation between the three.Self-disclosure and psychological distress are negatively correlated,and positively related to quality of life.Quality of life is negatively correlated,and psychological distress plays a part of the mediating role between self-disclosure and quality of life.