Needs Of Primary Caregivers Of Patients With Advanced Cancer And Its Influence Factors

Background:Advanced cancer has become one of the major diseases that seriously endanger human health.Cancer is a tragedy faced by almost every family,and advanced cancer is characterized by extreme pain and the need for intensive care.When a patient with advanced cancer needs two to four family members to care for him,family becomes particularly important.Advanced cancer not only places the patient in physical and mental pain,but also places the primary caregiver with the responsibility of meeting the patient’s various needs.This role includes assisting patients with daily activities,symptom management,drug monitoring,coordinating tests and treatment,and providing emotional support.However,patients are the center of clinical concern,and their primary caregivers tend to be neglected.Obviously,it is necessary to study the needs of primary caregivers for patients with advanced cancer,and meeting the needs of primary caregivers is the basic guarantee for taking good care of patients with advanced cancer.Objective:This study aimed to investigate the demands of primary caregivers of advanced cancer inpatients and to explore the related influential factors to lay foundation for further intervention.Methods:The descriptive cross-sectional study was conducted.From May 2021 to January 2022,totally 168 primary caregivers of advanced cancer inpatients and patients from Palliative medicine in a hospitals in Chengdu were investigated by convenience sampling using self-designed general characteristic questionnaire,CNQ-PAC,Prognostic Scale.All data was entry in Epidata 3.0 and analyzed by using statistical package SPSS26.0 software.Statistical methods: descriptive statistics,Variance analysis and Multiple linear stepwise regression analysis.Results:1.The needs of primary caregivers in advanced cancer patients1.1The total needs score of primary caregivers of patients with advanced cancer was（131.77±29.43）,and the total mean score of needs was（3.66±0.82）.The highest score was symptom control needs（4.37±0.93）,followed by disease knowledge needs（4.11±0.98）,health care related behavior needs（4.10±0.89）,hospice knowledge needs（3.73±1.14）,family health needs（3.38±1.08）and funeral support needs（3.15±1.20）.The psychological support needs score（2.96±1.19）was the lowest.1.2There were 15 items with the unmet rate of primary caregiver needs exceeding 80%,accounting for 41.67%of the total items.It focuses on three dimensions:patient symptom control needs,disease knowledge needs and health care related behavior needs.2.Factors influencing the needs of primary caregivers in advanced cancer patients2.1The impact of general characteristic questionnaire on the needs of primary caregivers in patients with advanced cancerThe three factors（gender,medical burden and self-care ability）had statistical significance on the needs of primary caregivers（P< 0.05）.The primary caregivers of male patients had a higher need for hospice knowledge.The greater the medical burden,the greater the need for psychological support from the primary caregivers.For most of the self-care patients,the primary caregivers had the highest needs for their family health,hospice care knowledge and symptom control.2.2The impact of general characteristic questionnaire on the needs of the primary caregiversThere were statistically significant differences in the needs of the primary caregivers for psychological support and symptom control（P< 0.05）.Primary caregivers who were not employed had a greater need for symptom control.The primary caregivers at work have a stronger need for psychological support.2.3The impact of predicted survival of patients with advanced cancer on their primary caregiver needsThere was statistical difference in the need for hospice knowledge of primary caregivers in predicting survival（P< 0.05）.Primary caregivers of cancer patients with predicted survival of 90-180 days had a high need for hospice knowledge.2.4Multivariate analysis of the needs of primary caregivers of patients with advanced cancerThe heavier the medical burden of the patient,the stronger the need of the primary caregiver for the family’s own health.Primary caregivers’ need for funeral support and hospice knowledge was lower when patients were at predicted survival >180days.Patients who are not working as primary caregivers have a lower need for psychological support.Conclusion:（1）The primary caregivers of patients with advanced cancer have higher needs for symptom control,disease knowledge and health care related behaviors,and the proportion of patients satisfied is low.Therefore,attention should be paid to the needs of the primary caregivers to meet their care needs.（2）The needs of the primary caregiver are influenced by multiple factors,including four factors of the patient（gender,medical burden,ability to take care of oneself,predicted survival）and one factor of the primary caregiver（work status）.（3）Primary caregivers of cancer patients with predicted survival of 90-180 days had a higher need for hospice knowledge.Primary caregiver needs for funeral support and hospice knowledge were lower for cancer patients with predicted survival >180days.