Objective: So as to provide a theoretical basis for the future development of intervention measures to reduce the negative psychological mood of caregivers. To investigate the psychological status of the main caregivers for patients who were transferred out of ICU after craniocerebral tumor surgery and analyze their factors. Methods: 112 patients with cerebral tumor surgery were reviewed from sun yat-sen university cancer hospital. The research object is caregivers. The general data questionnaire, hospital anxiety depression scale and migration of ICU patients’ family members stress questionnaire scale investigation are collected. Multiple linear regression analysis in cerebral tumor patients with postoperative ICU transition out main factors influencing the psychological condition of the caregivers. Results: The anxiety and depression scores were (15.60 ± 5.83) and (38.73 ± 3.23) respectively. The results of multiple regression analysis showed that the gender, education level, relationship with the patient and family monthly income of the primary caregivers of the patients were the influencing factors of anxiety, depression and migration stress psychological state (P < 0.05). Conclusion: The main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery had relatively severe anxiety, depression and migration stress. Medical staff should pay attention to the psychological status of caregivers and take effective measures to promote their physical and mental health.
Brain cancer and other nervous system accounted for only 1% of all new cancer cases—4%, about 3% of cancer deaths [
The main family caregivers of 112 craniocerebral tumor patients hospitalized in the department of Neurosurgery of a third-grade A tumor hospital in Guangzhou from April to July 2020 were selected as the research objects by adopting the convenience sampling method. Inclusion criteria for patients: they were pathologically diagnosed as craniocerebral tumor and admitted to ICU after surgery, ≥72 h. The inclusion criteria of the main caregivers are: 1) the spouse, parents, children and other relatives of the patient; Undertake the primary care of patients in their daily life, with continuous care exceeding 72 hours, and designated by the patient as the primary caregiver; Older than 18 years; 2) Normal cognitive function, can complete the questionnaire; Informed consent, voluntary participation. Exclusion criteria: caregivers with mental disorders or cognitive communication disorders.
1) General information questionnaire: The researcher designed the questionnaire by himself by referring to the literature, including gender, age, religious belief, educational level, family monthly income, place of residence, relationship with the patient, marital status, degree of knowledge of the patient’s condition, payment method of the patient’s treatment, length of stay in ICU, etc.
2) The Hospital Anxiety and Depression Scale (HADS) was compiled by Zigmond and Snaith [
3) The Family Relocation Stress Scale (FRSS) was developed by Hyun et al. [
On-site investigation was conducted on the subjects meeting the inclusion criteria by the researcher himself. On the day after surgery, a questionnaire was sent to the family members of the selected patients before they were transferred out of the ICU from the operating room. Unified guidance was used to introduce the purpose and significance of the survey to the research subjects, and the research subjects filled in the questionnaire by themselves. For those who could not complete the questionnaire by themselves, the researcher stated one by one, and the researcher filled in the questionnaire on their behalf after the research subjects chose the answers. The questionnaire will be issued on the spot and recalled on the spot. Check whether the questionnaire is complete. If there is any omission, complete it on the spot. In this study, 120 questionnaires were distributed and 112 were collected, with an effective recovery rate of 93.33%.
SPSS 21 software was used for statistical analysis of data. Measurement data were expressed as mean ± standard deviation. Counting data are described by frequency and composition ratio. Independent sample T test and one-way an OVA were used for the comparison between groups. Pearson correlation analysis was used for the normal distribution data of continuous variables, and multiple linear regression analysis was used for multi-factor analysis. The test level was in = 0.05 and out = 0.10.P & lt; A difference of 0.05 was statistically significant.
The anxiety and depression scores (15.60 ± 5.83) of the main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery were measured in two dimensions: anxiety (8.72 ± 3.35) and depression (6.88 ± 3.01).The score of migration stress was (38.73 ± 3.23), and the order of the four
project | Number of entries | Range of points (points) | Equipartition of dimensions ( x ¯ ± s ) |
---|---|---|---|
anxiety | 7 | 0 - 21 | 8.72 ± 3.35 |
depression | 7 | 0 - 21 | 6.88 ± 3.01 |
Overall score for anxiety and depression | 14 | 0 - 42 | 15.60 ± 5.83 |
The dimension | Number of entries | The minimum value | The maximum | Divide entries ( x ¯ ± s ) |
---|---|---|---|---|
General ward environment and care | 6 | 13 | 23 | 2.53 ± 0.67 |
Awareness of the patient’s critical condition | 3 | 5 | 11 | 2.88 ± 0.72 |
Cognition of separation anxiety | 3 | 3 | 12 | 2.60 ± 0.75 |
Turn out cognition | 2 | 4 | 8 | 2.32 ± 0.68 |
Total migration stress score | 14 | 28 | 47 | 38.73 ± 3.23 |
dimensions from high to low was: the cognitive dimension of critical condition (2.88 ± 0.72), the cognitive dimension of separation anxiety (2.60 ± 0.75), the cognitive dimension of general ward environment and nursing (2.53 ± 0.67), and the cognitive dimension of transfer (2.32 ± 0.68). See
project | The number of cases | Anxiety and depression score ( x ¯ ± s ) | Migratory stress score ( x ¯ ± s ) | F/T value (anxiety depression/ migration stress) | P value (anxiety, depression/ migration stress) |
---|---|---|---|---|---|
gender | 1.932/1.092 | 0.05/0.042 | |||
male | 62 | 14.79 ± 5.58 | 22.83 ± 2.61 | ||
female | 50 | 18.36 ± 6.17 | 27.52 ± 2.57 | ||
age | 0.719/3.867 | 0.742/0.942 | |||
19 - 34 | 35 | 15.17 ± 5.42 | 25.40 ± 2.51 | ||
35 - 59 | 71 | 16.15 ± 5.97 | 24.93 ± 2.67 | ||
≥60 | 6 | 11.50 ± 5.32 | 26.17 ± 2.40 | ||
Marital status | 1.864/1.051 | 0.149/0.875 | |||
unmarried | 13 | 13.23 ± 4.65 | 24.61 ± 2.32 | ||
married | 94 | 15.97 ± 5.85 | 25.13 ± 2.63 | ||
Divorced/separated | 4 | 17 ± 6.68 | 26.00 ± 2.82 | ||
Death of a spouse | 1 | 6 | 29 | ||
Level of education | 10245/14.899 | 0.016/0.001 | |||
Primary school | 13 | 20.00 ± 5.55 | 26.65 ± 2.01 | ||
Junior high school | 22 | 16.82 ± 5.37 | 26.47 ± 1.91 | ||
High school or technical secondary school | 30 | 14.20 ± 6.17 | 25.16 ± 2.32 | ||
college | 21 | 13.86 ± 5.24 | 23.45 ± 2.50 | ||
Bachelor and above | 26 | 12.38 ± 5.41 | 22.76 ± 2.24 | ||
professional | 2.550/14.644 | 0.056/0.895 | |||
workers | 20 | 15.30 ± 4.52 | 23.55 ± 2.74 | ||
farmers | 21 | 18.62 ± 6.38 | 23.09 ± 1.51 | ||
clerk | 44 | 14.50 ± 6.13 | 26.11 ± 2.58 | ||
soho | 27 | 15.26 ± 5.20 | 26.33 ± 1.51 | ||
Relationship with patients | 3.785/6.082 | 0.042/0.001 | |||
spouse | 49 | 18.08 ± 5.90 | 27.66 ± 2.16 | ||
children | 55 | 15.58 ± 5.85 | 25.60 ± 2.51 |
Other relatives | 2 | 13.17 ± 5.77 | 24.20 ± 0.00 | ||
---|---|---|---|---|---|
parents | 6 | 15.50 ± 0.70 | 25.12 ± 2.16 | ||
To live | 3.888/0.098 | 0.023/0.907 | |||
city | 38 | 15.13 ± 5.36 | 25.13 ± 3.13 | ||
Cities and towns | 28 | 13.54 ± 5.97 | 25.32 ± 2.19 | ||
rural | 46 | 17.24 ± 5.75 | 25.04 ± 2.51 | ||
The extent to which farmers knew the disease of patients | 0.896/0.695 | 0.9870.907 | |||
All know | 61 | 14.93 ± 6.08 | 24.92 ± 2.56 | ||
Part of the unknown | 50 | 16.42 ± 5.51 | 25.24 ± 3.01 | ||
don’t know | 1 | 15 | 24 | ||
Monthly household income (yuan) | 1.199/14.910 | 0.041/0.000 | |||
<3000 | 25 | 17.08 ± 7.18 | 27.57 ± 1.95 | ||
3000 - 5000 | 38 | 16.32 ± 5.48 | 26.38 ± 2.41 | ||
5000 - 7000 | 19 | 14.42 ± 5.32 | 26.11 ± 1.76 | ||
7000 - 9000 | 16 | 13.94 ± 2.97 | 24.82 ± 2.41 | ||
>9000 | 14 | 12.50 ± 6.89 | 22.76 ± 1.78 | ||
How patients are paid for treatment | 1.897/6.73 | 0.873/0.546 | |||
At his own expense | 3 | 15.53 ± 2.34 | 23.35 ± 1.76 | ||
Residents of social security | 78 | 15.65 ± 3.47 | 25.34 ± 1.89 | ||
Commercial insurance | 31 | 14.75 ± 3.25 | 26.43 ± 3.67 | ||
Days in ICU | 5.674/4.788 | 0.897/0.032 | |||
2 - 4 | 82 | 16.25 ± 2.45 | 24.67 ± 3.65 | ||
4 - 7 | 25 | 17.23 ± 2.31 | 25.23 ± 4.32 | ||
>7 | 5 | 16.25 ± 3.45 | 27.24 ± 3.54 |
The total scores of psychological anxiety, depression and stress migration of the main caregivers of patients transferred out of ICU after craniocervical surgery were taken as dependent variables, and the variables with statistical significance in univariate analysis were taken as independent variables for multiple linear regression analysis. The values of independent variables were shown in
The independent variables | The assignment |
---|---|
gender | male = 1 female = 0 |
Relationship with patient (with spouse as reference) | |
Relationship with the patient 1 | spouse = 0 children = 1 Other relatives = 0 parents = 0 |
Relationship with the patient 2 | spouse = 0 children = 0 Other relatives = 1 parents = 0 |
Relationship with the patient 3 | spouse = 0 children = 0 Other relatives = 0 parents = 1 |
Level of education | Primary schools and below = 1 Junior high school = 2 High school or technical secondary school = 3 college = 4 Bachelor and above = 5 |
Monthly household income(yuan) | <3000 = 1 3000 - 5000 = 2 5000 - 7000 = 3 7000 - 9000 = 4 >9000 = 5 |
variable | B value | SE values | β value | t value | P value |
---|---|---|---|---|---|
constant | 20.303 | 3.652 | 5.845 | 0.000 | |
gender | 1.654 | 2.330 | 0.056 | 2.281 | 0.001 |
Level of education | −3.353 | 1.262 | −0.759 | −2.659 | 0.009 |
Relationship with patient (with spouse as reference) | |||||
children | −0.355 | 1.934 | −0.031 | −0.184 | 0.005 |
Other relatives | −8.470 | 4.709 | −0.193 | −1.799 | 0.007 |
parents | −3.137 | 3.449 | −0.122 | −0.910 | 0.005 |
Monthly household income | −1.889 | −1.374 | 0.427 | −1.375 | 0.002 |
variable | B value | SE values | β value | t value | P value |
---|---|---|---|---|---|
constant | 40.396 | 1.277 | 31.786 | 0.000 | |
gender | 1.787 | 1.118 | 0.303 | 1.598 | 0.010 |
Level of education | −2.042 | 0.858 | −0.827 | −2.380 | 0.005 |
Relationship with patient (with spouse as reference) | |||||
children | −1.771 | 1.060 | −0.272 | −1.671 | 0.005 |
Other relatives | −2.311 | 2.286 | −0.133 | −1.011 | 0.006 |
parents | −3.562 | 2.223 | −0.282 | −1.586 | 0.011 |
Monthly household income | −2.459 | 0.810 | −1.001 | −3.034 | 0003 |
Note: R2 = 0.142, adjustment R2 = 0.093, F = 2.887, P < 0.001.
The results showed that patients with cerebral tumor postoperative ICU transition out main caregivers migration stress score (38.73 ± 3.23), in the average level, this has to do with Wang YH [
The scores of anxiety, depression and stress migration of female caregivers were higher than that of male caregivers
The scores of anxiety, depression and stress migration of female caregivers were higher than that of male caregivers, of our study results were consistent with Mali [
The lower the educational level of caregivers, the higher the scores of anxiety, depression and stress migration of caregivers
The lower the educational level of caregivers, the higher the scores of anxiety, depression and stress migration of caregivers, which is consistent with the research results of Brodsky et al. [
The scores of anxiety, depression and stress migration of spouses were significantly higher than those of other caregivers
This study showed that the scores of anxiety, depression and stress migration of spouses were significantly higher than that of other caregivers including children, which was similar to the results of Bernard et al. [
The lower the family monthly income, the higher the scores of anxiety, depression and stress migration of caregivers
The lower the monthly income of the family, the higher the scores of anxiety, depression and stress migration of the caregivers. The high medical expenses and care burden make the caregivers feel helpless, which aggravates the scores of anxiety, depression and stress migration of the caregivers. The research of Park scholar [
To sum up, the main caregivers in the transitional period of ICU after craniocerebral operation are more serious in psychological anxiety, depression and migration stress. Psychological anxiety, depression and migration stress are common among the primary caregivers of patients who are transferred out of ICU after craniocerebral operation. Many scholars [
This research still has certain limitation, only a convenience sampling survey of the Guangzhou three cancer hospital neurosurgery transfer 112 ICU patients’ families, sample representativeness, suggest a larger sample of multicenter study in the future, to make up for any deficiencies in this study, further explore the occurrence of stress transfer ICU patients’ families migration characteristics and preventive intervention strategy, prompting transition of ICU patients and family members to ordinary ward.
The authors declare no conflicts of interest regarding the publication of this paper.
Li, Y., Zou, D.L., Yang, Y., Li, Y.J., Zhao, Q.Q. and Zhou, Z.H. (2021) A Study on the Psychological Status of the Caregivers to Patients Out of ICU after Craniocerebral Tumor Surgery and Their Factors. Neuroscience & Medicine, 12, 1-11. https://doi.org/10.4236/nm.2021.121001