肺癌化疗患者照护者经济毒性现状及影响因素研究  

Financial toxicity and its influencing factors of caregivers of lung cancer patients undergoing chemotherapy

作　　者：徐晨 张静[1] 张雅思 施冰梓 XU Chen;ZHANG Jing;ZHANG Yasi;SHI Bingzi(The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang,China)

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001

出　　处：《护士进修杂志》2025年第8期831-837,共7页Journal of Nurses Training

摘　　要：目的了解肺癌化疗患者照护者经济毒性(financial toxicity,FT)现状,分析肺癌化疗患者照护者FT与其自我效能、家庭关怀、社会支持、患者FT的相关性,并探讨照护者FT的影响因素。方法采用方便抽样法,于2023年9—12月选取收治于哈尔滨市某三级甲等肿瘤专科医院呼吸内科病房的肺癌化疗患者照护者287名为研究对象,采用一般资料调查表、癌症患者报告结局的经济毒性量表、一般自我效能感量表、家庭关怀度指数量表、社会支持评定量表进行调查。结果肺癌化疗患者照护者癌症患者报告结局的经济毒性量表得分为[15.00(10.00,22.00)]分。相关性分析结果显示:肺癌化疗患者照护者较低的FT与其较高的自我效能、较高的家庭关怀呈正相关(r=0.291、0.346,均P<0.01);其较低的FT与其较高的社会支持呈正相关(r=0.293,P<0.01);其较低的FT与较低的患者FT呈正相关(r=0.530,P<0.01)。多元线性回归分析结果显示:与患者关系(其他)、文化程度(本科及以上)、每日照护时长(≥8~12 h和≥12 h)、自我效能、家庭关怀、患者化疗次数(>6次)、患者FT是肺癌化疗患者照护者FT的影响因素(P<0.05),解释总变异的52.8%。结论肺癌化疗患者照护者FT较高,完善肺癌化疗患者照护者的家庭关怀系统,鼓励其采用自信积极的态度去应对经济挑战,同时给予肺癌化疗患者有效的财务导航支持,可有效减轻其FT。Objective To understand the current status of financial toxicity(FT)among caregivers of lung cancer patients undergoing chemotherapy and analyze the correlations between caregivers'FT and their self-efficacy,family functioning,social support,as well as patients'FT,and to explore influencing factors of caregivers'FT.Methods Using convenience sampling method,287 caregivers of lung cancer chemotherapy patients admitted to the respiratory ward of a tertiary cancer hospital in Harbin from September to December 2023 were selected,and were surveyed by the general information questionnaire,comprehensive scores for FT based on the patient-reported outcome measures(COSTPROM),general self-efficacy scale(GSES),family APGAR index,and social support rate scale(SSRS).Results The FT score of caregivers of lung cancer chemotherapy patients was 15.00(10.00,22.00)points.The result of correlation analysis showed that lower FT in caregivers of lung cancer chemotherapy patients was positively correlated with higher self-efficacy and better family functioning(r=0.291,0.346;P<0.01),while also showing positive correlations with greater social support(r=0.293,P<0.01).Lower caregiver FT was positively associated with lower patient FT(r=0.530,P<0.01).The result of multiple linear regression analysis identified relationship to patient(others),education level(bachelor's degree or higher),daily caregiving duration(≥8-12 h and≥12 h),selfefficacy,family functioning,number of chemotherapy cycles(>6 times),and patient FT were the significant influencing factors of caregivers'FT(P<0.05),which explaining 52.9%of the total variance.Conclusion Caregivers of lung cancer chemotherapy patients experience substantial FT,and their FT could be effectively mitigated by enhancing family support systems,encouraging proactive coping strategies for financial challenges,and providing effective financial navigation support for patients.

关 键 词：肺肿瘤 照顾者 经济毒性 影响因素 护理 

分 类 号：R473.73[医药卫生—护理学] R734.2[医药卫生—临床医学]