Psychological Distress And Positive Aspects Of Caregiving And Their Related Factors In Caregivers Of Cancer Patients

Objective:This study aimed to investigate the status of psychological distress(PD)and positive aspects of caregiving(PAC)in caregivers of cancer patients and their related factors.Second,based on the stress and coping theory,this study explored the relationship among family function,different dimensions of hope(pathways thinking and agency thinking),different dimensions of coping,PD and PAC,to provide a research basis for formulating targeted interventionsMethods:Totally 417 caregivers of cancer patients from two grade-A tertiary hospitals in Jinan were selected as the research subjects using a convenient sampling method.The study instruments included a general information questionnaire,Adult Dispositional Hope Scale,Simplified Coping Style Questionnaire,Positive Aspects of Caregiving Scale,the 10-item Kessler Psychological Distress Scale and Family Adaptation,Partnership,Growth,Affection,Resolve Questionnaire.The SPSS 26.0 and AMOS 24.0 software were used to analyze data.Statistical methods included ANOVA,multiple linear regression analysis,structural equation model and.Results:1.Status of psychological distress and positive aspects of caregiving in caregivers of cancer patientsThe psychological distress mean score in caregivers was 26.40(SD=10.30),among which,48.4%of the caregivers have high or very high psychological distress.The positive aspects of caregiving mean score in caregivers was 33.07(SD=9.38),which was at a medium level.The self-affirmation and outlook on life dimensions scored 21.66(SD=6.45)and 11.41(SD=3.39)respectively.2.Analysis of psychological distress and positive aspects of caregiving scores of caregivers of cancer patients in terms of general characteristics of patients and caregivers.(1)The psychological distress scores of caregivers showed significant differences in their occupational status,education level,residence and personal monthly income,as well as patientrelated information(including cancer type,tumor stage,cancer diagnosis time,current treatment,and previously received cancer treatment or not).(2)The positive aspects of caregiving scores of caregivers showed significant differences in their chronic disease status and duration of caregiving,as well as patient disease information(including cancer type,tumor stage,cancer diagnosis time,current treatment,and previously received cancer treatment or not).PAC was positively associated with the age of cancer patients and caregiving hours per day of caregivers.3.Multiple linear regression analysis of psychological distress or positive aspects of caregiving in caregivers of cancer patients(1)The results of multiple linear regression analysis with PD as the dependent variable showed that tumor stage(β=0.147,P<0.001),cancer type(β=0.091,P<0.05),monthly personal income(β=0.070,P<0.05),education level(β=-0.082,P<0.05),negative coping(β=0.400,P<0.001),positive coping(β=-0.217,P<0.001),family function(β=-0.169,P<0.001)and pathways thinking(β=-0.106,P<0.05)were significantly associated with PD.(2)The results of multiple linear regression analysis with PAC as the dependent variable showed that cancer diagnosis time(β=-0.082,P<0.05),chronic disease status(β=0.098,P<0.01),pathways thinking(β=0.321,P<0.001),positive coping(β=0.206,P<0.001),family function(β=0.158,P<0.001)and agency thinking(β=0.123,P<0.05)were significantly associated with PAC.4.Analysis of the mediating role of hope and coping strategies between family function and psychological distress or positive aspects of caregiving in caregivers of cancer patients(1)Structural equation model 1 was constructed with PD and PAC as dependent variables,family function as an independent variable,and pathways thinking,positive coping and negative coping as mediator variables.The results showed that family function had direct and significant effects on PAC(β=0.194,P<0.01),PD(β=-0.208,P<0.01),and indirect effects on PAC(β=0.342,P<0.001),PD(β=-0.336,P<0.001).Family function indirectly affected the PD mainly through four paths,including the mediator role of positive coping or negative coping,the chain mediator role of pathways thinking and positive coping and the chain mediator role of pathways thinking and negative coping.In addition,in model 1,family function indirectly affected the PAC through three paths:the mediator role of positive coping or pathways thinking,and the chain mediator role of pathways thinking and positive coping.(2)Structural equation model 2 was constructed with PD and PAC as dependent variables,family function as an independent variable,and agency thinking,positive coping and negative coping as mediator variables.The results showed that family function had direct effects on PAC(β=0.267,P<0.001),PD(β=-0.202,P<0.01),and indirect effects on PAC(β=0.273,P<0.001),PD(β=-0.344,P<0.001).Family function indirectly affected the PD mainly through three paths,including the mediator role of positive coping or negative coping and the chain mediator role of agency thinking and positive coping.In addition,in model 2,family function indirectly affected PAC through three paths:the mediator role of positive coping or agency thinking,and the chain mediator role of agency thinking and positive coping.Conclusion:1.The psychological distress of caregivers of cancer patients was serious and cannot be ignored.The level of positive aspects of caregiving was moderate and needed to be improved.2.Negative coping was a risk factor for the psychological distress.Positive coping,family function,and pathways thinking were protective factors for psychological distress.Pathways thinking,positive coping,family function,and agency thinking were protective factors for positive aspects of caregiving.3.Positive coping or negative coping played a mediator role between family function and psychological distress.Pathways thinking,agency thinking or positive coping played a mediator role between family function and the positive aspects of caregiving.4.Pathways thinking and positive coping,pathways thinking and negative coping or agency thinking and positive coping played a chain mediator role between family function and psychological distress.Pathways thinking and positive coping or agency thinking and positive coping played a chain mediator role between family function and positive aspects of caregiving.