| Objectives:To investigate the status of caregiving experience in family caregivers of inpatients with gastrointestinal cancer, and to explore the effect of adult attachment and social support on it. The mediation effect of social support in the relationship between adult attachment and caregiving experience in family caregivers was also explored. This study can provide a new sight to alleviate caregivers’negative experience and increase their positive experience, which might be helpful to take related intervention to keep caregivers health and caregiving quality.Methods:A cross-sectional survey was made. Participants were 207 family caregivers of post-operative gastrointestinal cancer inpatients from a Class 3-A comprehensive hospital in Jinan, between August 2014 and August 2015.237 caregivers were recruited and the final sample comprised 207 caregivers who completed the questionnaires. Caregivers were evaluated by general characteristics questionnaire, Experiences in Close Relationships Questionnaire-Revised (ECR-R), Social Support Rating Scale (SSRS) and Caregiver Reaction Assessment Scale (CRA). SPSS22.0 and AMOS17.0 was used to input and analyze data. Descriptive statistical analysis, univariate analysis. Pearson correction analysis, stepwise multiple regression analysis and the mediation model analysis were used to analyze the data.Results:(1) The mean score of caregivers’ negative experience was (10.40±0.78), and the scores on Health Problem, Disrupted Schedule, Impact on Finances and Lack of Family Support were (2.25±0.70), (3.50±0.67), (2.80±0.92) and (1.86±0.54), respectively. The mean score of caregivers’positive experience was (4.38±0.41)。(2) Results of the univariate analysis showed that there remained significant differences in negative experience on caregivers’ age, family economic status, kinship and the emotion of patients(P<0.05). Also, positive experience has significant difference in caregivers’ age, gender, education, occupation, family economic status, kinship, live with patients, the motivation of caregiving, the emotion of patients and patients’ gender(P<0.05).(3) Correlation analyses suggested negative experience was positively correlated to attachment avoidance and attachment anxiety(r=0.268, r=0.343, P<0.01), and negatively correlated to objective support, subjective support and the use of social support (r=-0.256, r=-0.354, r=-0.411, P<0.01). Positive experience was negatively correlated to attachment avoidance(r=-0.269, P<0.01), and positively correlated to objective support, subjective support and the use of social support (r=0.197, r=0.225, r=0.256, P<0.01). In addition, attachment avoidance was negatively correlated to objective support, subjective support and the use of social support(r=-0.162, r=-0.149, r=-0.260, P<0.05), and attachment anxiety was negatively correlated to objective support and the use of social support(r=-0.215, r=-0.354, P<0.01).(4) Multiple stepwise regression analysis found that caregivers’ age, the emotion of patients, ill severity, family economic status, education, attachment avoidance, attachment anxiety, subjective support and the use of social support were predicted caregivers’ negative experience(P<0.05). While, caregivers’ occupation, kinship, motivation of caregiving, education, patients’ gender, attachment figure, attachment avoidance, objective support and the use of support were predicted caregivers positive experience(P<0.05).(5) Structural equation model found that social support meditated the relationship between adult attachment and caregiving experience. Model fit indictors of the negative model were CMIN/DF=1.173, GFI= 0.935, AGFI=0.894, RMSEA=0.059, CFI=0.925, IFI=0.928. Social support mediated the relation between attachment avoidance and negative experience, and the mediator effect was 0.209. Also, social support mediated the relation between attachment anxiety and negative experience, and the mediator effect was 0.238(P<0.05). Model fit indictors of the positive model were CMIN/DF=1.343, GFI= 0.928, AGFI=0.895, RMSEA=0.041, CFI=0.956, IFI=0.958. Mediator effect of social support in the relationship between attachment avoidance and positive experience was-0.088. Mediator effect of social support in the relationship between attachment anxiety and positive experience was-0.105(P<0.05).Conclusions:(1) Family caregivers of inpatients with gastrointestinal cancer experienced both negative and positive aspects.(2) There were various factors impacted caregivers’caregiving experience, and the factors which influenced negative and positive experience were different. Adult attachment and social support have significantly effect on caregiving experience, and social support completely meditated the relationship between adult attachment and caregiving experience.(3) This study indicated medical staff should give more attention to caregivers who have high scores in attachment avoidance or attachment anxiety. Targeted measures should be taken to help caregivers to keep their health and caregiving quality, which might promote their quality of life. |
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