| Objectives1 To understand the current level of patients’ pain,fatigue and sleep disturbance reporting by colorectal cancer patients,family caregivers and nurses,and compare the discrepancies and consistency.To analyze the influencing factors of the symptom incongruence and consistency among colorectal cancer patients and caregivers2 To explore the relationship between symptom incongruence,negative mood,intimacy relationship and quality of life,and how it affects between in colorectal cancer patients and family caregivers.MethodsThis was a cross-sectional study which was carried out in three teriteray hospitals.A survey was conducted with 271 dyads with colorectal cancer and 70 colorectal cancer patient-nurse dyads recruited using a convenience sampling method.Seven questionnaires were used,including self-designed forms collecting participants’ general information.Descriptive statistical methods and the structural equation model etcetera were used to analyze dataResults1.Patient-caregiver:Family caregivers underestimated the incidence of pain in patients,overestimated the incidence of sleep disturbance and underestimated the severity of sleep disturbance(p<0.05).Patient-nurse:Nurses underestimated the incidence of fatigue and sleep disturbance in patients,underestimating the severity of pain and fatigue and overestimating the severity of sleep disturbance in patients(p<0.05).2.The consistency of the assessment of pain,fatigue and sleep disturbance in the patient and family caregiver groups was 0.672,0.831 and 0.545,with a high consistency and statistical significance(p<0.05).The assessment consistency of pain,fatigue and sleep disturbance in the patient and nurse groups was 0.389,0.163 and 0.098,the consistency was poor and only the pain consistency was statistically significant(p<0.05).3.Results showed the factors that affected the difference in symptom assessments between patients,family caregivers and nurses were only the patient’s chemotherapy cycle,monthly household income,place of residence,cancer type,the degree of need for care,working state and marital status,education level of family caregivers and educational level and the number of caring patient of nurses There were three aspects that influenced the consistent of symptoms assessment between patients,family caregivers and nurses.Patients:degree of understanding of the disease,number of accompanying diseases,diagnosis time,related knowledge needs,the degree of need for care and religious.Family caregivers:the degree of patients’ need for care,daily caring time,the frequency of attending lectures on tumor and religion.Nurses:the number of caring patient,the frequency of attending lectures on tumor and the degree of patients’ need for care.4.Path analysis showed that the symptom incongruence can directly affect the dyadic quality of life between patients and family caregivers.The symptom incongruence can also indirectly affect the dyadic quality of life,mediating by negative mood and intimate relationship(B=-0.238,p<0.001,B=-0.358,p<0.001).Conclusions1.There were a difference in incidence of pain and sleep disturbance,and in severity of sleep disturbance between colorectal cancer chemotherapy patients and family caregivers.There were a difference in incidence of fatigue and sleep disturbance,and in severity of pain,fatigue and sleep disturbance between colorectal cancer chemotherapy patients and nurses.2.Colorectal cancer chemotherapy patients and family caregivers have high consistency in assessment of pain,fatigue and sleep disturbance in patients.Colorectal cancer chemotherapy patients and nurses have poor consistency in assessment of pain,fatigue and sleep disturbance in patients.3.The sleep disturbance incongruence can directly affect the dyadic quality of life between colorectal cancer chemotherapy patients and family caregivers.The symptom incongruence can also indirectly affect the dyadic quality of life,mediating by negative mood and intimate relationship... |
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