Study On The Care Feelings And Stress Reaction Of The Spouses Of Young And Middle-aged Cancer Patients Who Are At Door’s Death

ObjectiveThe purpose of this study was to understand the positive feelings,care burden and stress response of the spouses of the young and middle-aged cancer patients,to explore the correlation and influencing factors among the three,in order to better understand the spouse’s care experience of the dying patients and provide evidence and guidance for nursing interventions for spouses at the end of cancer.MethodsThis study used a mixed research methodology,including a quantitative part of the questionnaire and a semi-structured interview of the qualitative part.In the quantitative research part,this study used the convenience sampling method to study the spouses of 150 young and middle-aged cancer patients hospitalized in the Department of Oncology,in Fujian Medical University Union Hospital from December 2016 to June 2018,by adopting self-made general information questionnaire,Positive Aspects of Caregiving(PAC),Caregence burden inventory(CBI),Stress Response Questionnaire(SRQ),Social Support Assessment Questionnaires were conducted by Social Science Research Solutions(SSRS)using IBM SPSS 20.0 statistical analysis.In the qualitative research part,the phenomenological research method was used to select the spouses of 10 cancer patients hospitalized in Fujian Medical University Union Hospital by the purpose sampling method.The semi-structured deep interview method was used to understand the spouse.The patient’s care experience during the sudden death period was analyzed by Colaizz method.Results 1.The research results of quantitative part(1)In 150 cases of young and middle-aged cancer patients,the total score of the positive care feelings of the spouses during the patients’ dying period was(34.20+5.82)in total,however the score of self-affirmation was low,which was(18.11+4.66).Studies have shown that males,whose age are between 45 and 60 years old and who have religious beliefs and have been remarried have more positive care feelings.(2)The spouse care burden score is(60.26+14.14)in total,and the time-dependent dimension is the noticeably high.Among them,2.0% is light burden,60.0% is medium burden,and 38.0% is high burden.The burden of care during the dying period is closely related to the age,current place of residence,whether or not they have chronic diseases,medical payment methods,total social support scores,and the number of medical equipment used on the patients on that day.(3)The total score of the spouse stress reactive-which is(67.67+19.92)was significantly higher than the domestic norm,with(53.67+18.99),and the psychological response dimension was the most obvious.The level of stress reaction was affected by spouses’ gender,age of marriage,recent physical discomfort,whether there were other family members’ offering alternative care,total social support score,total score of care burden,and number of patients injections.(4)The stress reaction of the spouses of the young and middle-aged cancer patients was significantly negatively correlated with the positive feelings of care and the scores of each dimension.Except that the physiological response,psychological reaction and time-dependent burden dimension were not significantly correlated,the spousal stress response and each dimension were significantly positively correlated with the care burden and each dimension.2.The qualitative part of the study gives out the following 5 indications:(1)when encountering the dying symptoms of the patients,their spouses feel deeply uncomfortable and has troubles with diet and taking good care of themselves.(2)There is a communication barrier between the patients and their spouses during this period,and their emotions are deeply attached.(3)They are faced with the upcoming change of the role-becoming a widow,the sadness is deepened and they are in a state of high vigilance.(4)In the face of dying of the patient,the spouses have different attitudes,either to accept it or avoid talking about it.(5)The focus of life changes.They begin to reflect the essence of life,which changes more or less their methodology.ConclusionThe positive feelings of spouse care for young and middle-aged cancer patients are generally at the lower-middle level,and the burden of care is at a moderate to severe level.The self-affirmation score of the spouses in the care process is low,and the limits of time causes the high burden of the care.They are influenced by different aspects.From the qualitative interviews,it is concluded that the spouse is uncomfortable when facing the patient’s painful symptoms.There exist problems such as care troubles,communication obstacles,heavy burdens,etc.During the care period,their own time is not regular;It is suggested that clinicians should use professional knowledge to relieve the pain and discomfort of patients as much as possible,and the dignity should be given to the death;on the other hand,by actively encouraging other family members to support the system,appropriately applying social,network,religious and other support,the spouse’ care burden could be possibly relieved to enhance their positiveness.The stress reaction of the spouses of the young and middle-aged cancer patients in the dying period is at a high level,which is related to the care burden and positive feelings.The heavier the burden of care as for the spouses,the less positive the care is,and the higher the level of stress reaction thereafter.Qualitative research interviews also showed that a series of physiological discomfort,grief,helplessness,anxiety and other negative emotions and social problems such as how to well confront the dying patients suggest that the medical staff should properly give psychological relief to the spouses and the patients according to the actual situation of the spouses.Health education,carry out pre-death education should be carried out by using the WeChat network platform to provide sufficient information to help the spouses to successfully pass the grief period.