PDF(Pubmed)
Abstract：
Family caregivers of children diagnosed with cancer often experience periods of significant stress. We provide an in-depth examination of the impacts of structural (health care and leave policies) and meso-level (organizations and communities/social networks) factors on caregiver coping during childhood cancer treatment. We conducted a secondary analysis of a comprehensive qualitative dataset examining the impacts of structural and meso-level factors on caregiver coping from in-depth, semi-structured interviews with 49 caregivers representing 38 unique cases of childhood cancer. Using a modified grounded theory approach, transcripts were analyzed using inductive thematic analysis. Caregivers experienced multiple and often intersecting structural and meso-level factors, both facilitating and impeding their ability to cope during their child\'s cancer treatment. Our analysis revealed the following themes: having few out-of-pocket medical expenses, access to paid time off from employment, and support from one\'s health system, organizations, or community/social networks fostered caregiver coping. Significant financial burdens due to cancer treatment, having to take unpaid leave from employment, remaining employed regardless of one\'s circumstances, and lack of support from one\'s health system, organizations, or community/social networks hindered caregiver coping. Our findings point to several policies that may ease caregiver burden and facilitate caregiver coping during childhood cancer treatment.
摘要：
被诊断患有癌症的儿童的家庭照顾者经常经历巨大的压力时期。我们对结构性（医疗保健和休假政策）和中观水平（组织和社区/社交网络）因素对儿童癌症治疗期间护理人员应对的影响进行了深入的研究。我们对一个全面的定性数据集进行了二次分析，研究了结构和中观水平因素对护理人员应对的影响，对49名护理人员的半结构化访谈，代表38例儿童癌症独特病例。使用改进的接地理论方法，使用归纳主题分析对转录本进行分析。照顾者经历了多重且经常相交的结构和中观水平因素，在孩子的癌症治疗过程中，既能促进又能阻碍他们的应对能力。我们的分析揭示了以下主题：自付医疗费用很少，获得带薪休假，和卫生系统的支持，组织,或社区/社交网络促进护理人员应对。癌症治疗带来的巨大经济负担，不得不休无薪假，不管一个人的情况如何，缺乏卫生系统的支持，组织,或社区/社交网络阻碍了护理人员的应对。我们的发现指出了一些可以减轻照顾者负担并促进儿童癌症治疗期间照顾者应对的政策。
