Fear of Cancer Recurrence and Its Impacts on Quality of Life in Family Caregivers of Patients With Head and Neck Cancers

頭頸癌病人之家屬照顧者害怕癌症復發及對其生活品質的影響

林青蓉(Ching-Rong Lin) ； 陳淑卿(Shu-Ching Chen) ； 張東杰(Joseph Tung-Chien Chang) ； 方圓媛(Yuan-Yuan Fang) ； 賴裕和(Yeur-Hur Lai)

《The Journal of Nursing Research》 24卷3期 (2016/09) Pp. 240-248

https://doi.org/10.1097/jnr.0000000000000169

摘要

背景 害怕癌症復發是癌症病患之家屬照顧者主要的關注焦點之一。目的 本研究目的為：⑴探討頭頸癌病患之家屬照顧者害怕復發的經驗，⑵比較照顧完成癌症治療後不同期間之病患的家屬照顧者害怕復發的程度差異，及⑶探討頭頸癌病患之家屬照顧者害怕復發與其生活品質的關係。方法 本研究採橫斷式研究於北台灣某醫學中心放射腫瘤門診收集資料。研究調查問卷包括：照顧者害怕癌症復發量表（FCRI-c）、SF-12健康調查問卷（SF-12）及背景資料表。統計方法採用變異數（ANOVA）及事後檢定，比較完成癌症治療後不同期間之病患的照顧者害怕復發及生活品質的差異，以Pearson's相關分析照顧者害怕復發與生活品質的關係。結果 本研究共收集250位照顧者，害怕復發的經驗中，照顧者採用多種因應策略與再確認方式來面對復發的擔心。病患完成癌症治療後期間（3至6個月或／及大於6至12個月）越短，照顧者害怕復發嚴重度及整體性的擔心，顯著高於病患已完成癌症治療後期間長達五年以上的照顧者。照顧者害怕癌症復發與其生理及心理層面的生活品質皆呈顯著負相關。結論／實務應用 本研究結果顯示，相對於完成癌症治療後期間較長之病患的照顧者，完成治療後期間較短之病患的家屬照顧者有較高的害怕復發困擾。臨床上，健康照護人員可根據癌症病患完成癌症治療後不同期間，察覺照顧者害怕病患癌症復發的情形，並提供適時的關注與適當的支持。建議未來應發展並測試幫助頭頸癌之照顧者有效因應害怕復發困擾的措施，以提升其生活品質的研究。

關鍵字

癌症 ； 照顧者 ； 害怕癌症復發 ； 生活品質

並列摘要

Background: Fear of cancer recurrence (FCR) is a major concern for family caregivers (FCs) caring for patients with head and neck cancers (HNCs). Purpose: This study (a) investigated the FCR experience of HNC FCs, (b) compared the differences in the FCR levels of FCs while taking care of patients with different lengths of time since completing major treatments (posttreatment durations), and (c) examined the correlation between FCR and quality of life (QOL) in these FCs. Methods: A cross-sectional study was conducted in the radiation outpatient department of a medical center in northern Taiwan. A set of questionnaires, including the Fear of Cancer Recurrence Inventory-Caregiver version and the Medical Outcomes Short- Form Health Survey, and a background information form were employed. One-way analysis of variance was used to examine the differences in the FCR and QOL among groups of FCs taking care of patients with different posttreatment durations (typically concurrent chemoradiotherapy). Pearson’s correlation was used to identify the relationship between FCR and QOL. Results: Two hundred fifty FCs were recruited in this study. The FCs used several coping and reassurance strategies to address their FCR experiences. Those FCs who cared for patients with short posttreatment durations (3Y6 and 6Y12 months) showed significantly higher overall FCR levels and higher FCR severity levels than those who cared for patients with long posttreatment durations (more than 5 years). High FCR was negatively correlated with physical and mental QOL. Conclusions/Implications for Practice: The results suggest that FCs caring for patients with a relatively short posttreatment duration experience higher levels of FCR than those caring for patients with a longer posttreatment duration. In clinical settings, healthcare providers should use posttreatment duration as an indicator of risk of FCR in caregivers to address FCR and provide appropriate support. Future research should develop and examine interventions to help HNC FCs cope effectively with their FCR and improve their QOL.

並列關鍵字

cancer ； caregiver ； fear of cancer recurrence (FCR) ； quality of life (QOL)

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