The Influencing Factors Of Communication And Intervention Effect Of Therapeutic Communication System In Colorectal Cancer Couples

Objective: To investigate the current situation of communication between colorectal cancer patients(CRC)and their spousal caregivers and their communication influencing factors.To investigate the intervention effect of Therapeutic Communication System on the communication between CRC patients and their spousal caregivers.Methods:This study includes two parts: Descriptive study and Quasi-experiment study.Descriptive study: 143 CRC patient-spousal caregievr dyads were selected through the convenient sampling method as research subjects in a third-grade class-A hospital in Wuxi,from January 2020 to November 2020.We use general demographic questionnaire,Cancer-Related Communication Problems within Couples Scale(CRCP),Hospital Anxiety and Depression Scale(HADS),Self-perceived Burden Scale(SPBS)and Cancer Behavior Inventory-Brief Version(CBI-B)to investigate the communication status and influencing factors of CRC patients.We use general demographic questionnaire,the CRCP,the HADS,Caregiver Burden Scale for Cancer Patients(CBS-CP)and the CBI-B to investigate the communication status and influencing factors of spousal caregivers.The influencing factors of communication were analyzed by methods of single factor analysis,correlation analysis and multiple linear regression analysis.Quasi-experiment study: From November 2020 to January 2021,20 CRC patients and their spousal-caregivers who met the inclusion criteria were selected as subjects by convenient sampling method to receive Therapeutic Communication System intervention.The CRCP and the HADS were used to measure CRC couples’ outcomes pre-and postintervention.The intervention effect was analyzed by t test method.Results:(1)The communication scores of CRC patients was 8.62±2.16(3～13),and 67.8%of the patients scored 8 or above.The communication scores of spousal caregivers was9.37±2.19(4～13),and 77.6% of them scored 8 or above.(2)Single factor analysis results showed that there were statistical differences in communication scores of CRC patients in terms of different monthly family income(P <0.01),CRC patients’ education level(P<0.01),education level and occupation(working status)of spousal caregivers(P < 0.05).The communication scores of spousal caregivers were different in age,educational level,occupation(working status)and family monthly income between the CRC patients and their spousal caregivers,and the differences were statistically significant(P<0.05).(3)Correlation analysis results showed that the communication scores of CRC patients were positively correlated with their anxiety and depression(P<0.01),and self-perceived burden(P < 0.05),and negatively correlated with their self-efficacy(P < 0.01).Communication scores of CRC patients were positively correlated with anxiety and depression(P<0.05),and caring burden(P<0.01)of spousal caregivers,and negatively correlated with self-efficacy of spousal caregivers(P<0.01).The communication scores of spousal caregivers were positively correlated with their anxiety and depression(P<0.01)and care-taking burden(P<0.01),and negatively correlated with their self-efficacy(P<0.01).The communication scores of spousal caregivers were positively correlated with anxiety,depression and self-perceived burden(P<0.01),and negatively correlated with self-efficacy(P<0.01)of CRC patients.(4)The results of multiple linear regression analysis showed that anxiety and depression of CRC patients,occupation(work status)of the spousal caregivers and self-efficacy of CRC patients and their spousal caregivers were the main predictors of communication among CRC patients,and three regression analyses of communication among CRC patients(alone with patients’ five variables,alone with spousal caregivers’ five variables and at the same time with patient and spousal caregivers’ eleven variables)explained 23.5%,24.3% and 31.7% of the variation in communication scores,respectively.Monthly family income,anxiety and depression of CRC patients,and education level and self-efficacy of spousal caregivers were the main predictors of spousal caregiver communication,and three regression analyses of spousal caregivers communication(alone with spousal caregivers’ seven variables,alone with patinents’ seven variables and at the same time with patient and spousal caregivers’ fourteen variables)explained 51.8%,42.1% and 55.0% of the variation in communication scores,respectively.(5)The communication scores and anxiety and depression scores of both CRC patients and their spousal caregivers were significantly decreased afer the intervention,and the differences were statistically significant(P<0.05 and P<0.05,respectively).Conclusion: There is a certain degree of communication difficulties between CRC patients and their spousal caregivers.The influencing factors of communication in CRC patients includes anxiety and depression of CRC patients,occupation(work status)of spousal caregivers,and self-efficacy of both patients and spousal caregivers.The influencing factors of spousal caregivers’ communication includes monthly family income,anxiety and depression of CRC patients,educational level and self-efficacy of spousal caregivers.Therapeutic communication system can effectively promote the communication of cancer-related issues between CRC patients and their spousal caregivers,and relieve the anxiety and depression of CRC patients and their spousal caregivers.