Knowledge and attitudes of family members of cancer patients towards immunotherapy toxicity and health management

Family members play a critical role in the care and decision-making processes of cancer patients. This study aimed to examine the knowledge and attitudes of cancer patients’ family members regarding the toxicity and health management of immunotherapy. A cross-sectional study was conducted at People’s Hospital of Quzhou City in Zhejiang Province, from January to March 2024. Questionnaires were administered to collect demographic data, as well as knowledge and attitude scores, from family members of cancer patients.: The study enrolled 382 participants. Among them, 132 (34.6%) were aged between 41 and 50 years, 192 (50.3%) were male, 211 (55.2%) were retired, and 158 (41.4%) were spouses of the patients. Correlation analysis showed that there was significant positive correlation between knowledge and attitude (r = 0.259, P < .001). Multivariate logistic regression showed that with junior high school education (OR = 0.194, 95% CI:[0.073, 0.514], P = .001) and with high school/vocational school education (OR = 0.250, 95% CI:[0.099, 0.632], P = .003) were independently associated with poor knowledge. Concurrently, aged 41–50 years old (OR = 10.147, 95% CI: [1.912, 53.844], P = .007) and retired (OR = 0.026, 95% CI: [0.005, 0.144], P < .001) were independently associated with attitude. Structural equation modeling (SEM) indicated a positive association between knowledge and attitude. Overall, educational attainment was a strong predictor of knowledge, whereas attitudes were more strongly shaped by age and occupational status. Family members demonstrated insufficient knowledge and mixed attitudes regarding immunotherapy toxicity. Educational level was strongly associated with knowledge, whereas attitudes appeared to be influenced by age and occupational status, as well as emotional and socioeconomic factors. These findings highlight the potential value of stratified family education, standardized caregiver support, and targeted assistance for vulnerable groups.

家属在癌症患者的照护与决策流程中发挥着至关重要的作用。本研究旨在探究癌症患者家属对免疫治疗（immunotherapy）相关毒性及健康管理的认知与态度。本研究于2024年1月至3月在浙江省衢州市人民医院开展横断面研究（cross-sectional study），通过问卷收集癌症患者家属的人口学资料、认知得分与态度得分，共纳入382名研究对象。其中，132名（34.6%）年龄介于41至50岁，192名（50.3%）为男性，211名（55.2%）为退休人员，158名（41.4%）为患者配偶。相关性分析结果显示，认知与态度之间存在显著正相关（r=0.259，P<0.001）。多因素logistic回归（multivariate logistic regression）分析显示，初中学历（OR=0.194，95%CI[0.073, 0.514]，P=0.001）与高中学历/中专学历（OR=0.250，95%CI[0.099, 0.632]，P=0.003）均与较差的认知水平独立相关。同时，年龄41至50岁（OR=10.147，95%CI[1.912, 53.844]，P=0.007）与退休状态（OR=0.026，95%CI[0.005, 0.144]，P<0.001）均与态度得分独立相关。结构方程模型（Structural Equation Modeling, SEM）结果显示，认知与态度之间存在正向关联。总体而言，学历是认知水平的强预测因子，而态度则更多受年龄与职业状态影响。家属对免疫治疗相关毒性的认知不足，且态度呈现分化态势。学历与认知水平密切相关，而态度则受年龄、职业状态以及情绪与社会经济因素的影响。本研究结果凸显了针对脆弱群体开展分层家属教育、标准化照护者支持及精准援助的潜在应用价值。