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Lapa L, Cardoso M, Rego F. Informal Caregiver Burden in Palliative Care and the Role of the Family Doctor: A Scoping Review. Healthcare (Basel) 2025; 13:939. [PMID: 40281888 PMCID: PMC12027401 DOI: 10.3390/healthcare13080939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2025] [Revised: 03/24/2025] [Accepted: 04/10/2025] [Indexed: 04/29/2025] Open
Abstract
Background/Objectives: Caregivers play a central role in supporting patients in palliative care but often face significant challenges to their physical, emotional, social, and financial well-being. Family doctors are uniquely positioned to help alleviate this burden through early identification, targeted interventions, and coordinated care. This scoping review analyzed existing literature on caregiver burden in palliative care to explore the specific role of family doctors in identifying, preventing, and reducing this burden. Methods: A scoping review was carried out following the methodology set out by the Joanna Briggs Institute. The following databases were searched: PubMed, the Cochrane Library, Scopus, the National Institute for Health and Care Excellence, and the British Medical Journal. The search strategy was based on the use of the following keywords and Medical Subject Headings: "caregiver burden" AND "palliative care" AND ("family physician" OR "general practitioners" OR "primary care physicians"). The search was performed on 10 March 2024, with a time horizon between 2013 and 2023. Results: From 259 identified articles, 8 met the inclusion criteria. Key themes included factors influencing caregiver burden, strategies used by family doctors to mitigate it, and challenges in providing support. Family doctors play a crucial role in offering psychological support, educating caregivers on disease progression, and coordinating multidisciplinary care. Conclusions: The active involvement of family doctors significantly reduces caregiver burden by addressing emotional distress, improving communication, and ensuring care coordination. Key interventions include early distress screening, tailored education, and access to multidisciplinary networks. Strengthening their integration in palliative care teams is essential for optimizing patient and caregiver outcomes.
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Affiliation(s)
- Laura Lapa
- Unidade de Saúde Familiar Nova Mateus, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, 5000-577 Vila Real, Portugal
| | - Marta Cardoso
- Unidade de Saúde Familiar Régua, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, 5050-275 Peso da Régua, Portugal;
| | - Francisca Rego
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
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Deng XM, Hounsri K, Lopez V, Tam WWS. Caring Through the Final Phase: A Meta-Synthesis of Family Experiences, Needs and Perceptions in Home-Based Hospice Care for Terminal Cancer Patients. JMIR Cancer 2025. [PMID: 40301008 DOI: 10.2196/71596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2025] Open
Abstract
BACKGROUND Home-based hospice care offers terminal cancer patients the comfort of receiving care in a familiar environment while enabling family members to provide personalised support. Despite the critical role families play, the literature remains underexplored in terms of their experiences, needs, and perceptions. A robust qualitative synthesis is needed to inform improvements in palliative care services. OBJECTIVE This meta-synthesis aims to systematically review and synthesise qualitative evidence regarding the experiences, needs, and perceptions of family caregivers in home-based hospice care for terminal cancer patients. The goal is identifying key themes that can improve caregiver support and service delivery. METHODS A systematic search was conducted across MEDLINE, EMBASE, SCOPUS, PsycINFO, CINAHL, Google Scholar and relevant grey literature sources up to 14 March 2025. Studies were included if they focused on family caregivers' experiences in home-based hospice care settings, excluding those that addressed only patients or healthcare providers. Two independent reviewers performed study selection, data extraction, and quality assessment using the Critical Appraisal Skills Programme (CASP) checklist. Data were synthesised using a three-step thematic synthesis approach, and the confidence in the findings was assessed via the GRADE-CERQual framework. RESULTS Five studies published between 1989 and 2022 from diverse geographical regions (including Asia and Western settings) met the inclusion criteria. Two major themes emerged: (1) Being Physically and Emotionally Present-where caregivers expressed a strong commitment to remain with their loved ones, providing emotional support and maintaining a sense of control; and (2) Sharing Responsibilities-which underscored the importance of both formal support from palliative care teams and informal support from family and friends in mitigating caregiver burden. These findings directly address the study's aims by illustrating how caregivers balance emotional commitment with the practical challenges of providing home-based care. CONCLUSIONS While family caregivers are dedicated to delivering high-quality, personalised care, they encounter significant emotional and logistical challenges. Variability in study settings, potential recall bias from retrospective interviews, and limited grey literature access may affect the generalisability of the findings. This meta-synthesis underscores the essential role of family involvement in home-based hospice care for terminal cancer patients. The combined reliance on emotional commitment and shared responsibilities-with support from professional care teams-is vital for optimal care delivery. Future interventions should enhance formal and informal support systems to meet family caregivers' diverse needs better. CLINICALTRIAL Prospero: CRD42023486012.
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Affiliation(s)
- Xin Ming Deng
- National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore, SG
| | - Kanokwan Hounsri
- National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore, SG
| | - Violeta Lopez
- Central Queensland University, Rockhampton, AU
- School of Nursing and Allied Medical Sciences, Holy Angel University, Angeles City, PH
| | - Wilson Wai-San Tam
- National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore, SG
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Ghorbani A, Salami M, Rajabi MM. The relationship between caregiver burden and hope in leukemia patients: a cross-sectional study in selected referral hospitals in Tehran, Iran. BMC Palliat Care 2025; 24:95. [PMID: 40189527 PMCID: PMC11974149 DOI: 10.1186/s12904-025-01731-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Accepted: 03/21/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND Leukemia is a life-threatening condition that imposes significant challenges not only on patients but also on their caregivers. Caregiver burden, a multidimensional concept encompassing physical, psychological, and emotional strain, often impacts the quality of care provided to patients. Conversely, hope, a critical psychological resource, plays a pivotal role in patient well-being and coping. Understanding the relationship between caregiver burden and patient hope is essential for improving holistic cancer care. METHODS This descriptive correlational study was conducted at the Cancer Institute and Valiasr Hospital, affiliated with Tehran University of Medical Sciences, between May and November 2024. A total of 400 participants, including 200 leukemia patients and their 200 primary caregivers, were recruited using convenience sampling. Data were collected using the Zarit Caregiver Burden Interview (ZBI) and Snyder's Adult Hope Scale (AHS). Descriptive statistics and Pearson's correlation coefficient were used to analyze the data in SPSS version 16, with a significance level of P < 0.05. RESULTS The mean caregiver burden score was 37.69 ± 7.12, indicating a moderate level of burden, while the mean hope score among leukemia patients was 32.19 ± 1.88, reflecting relatively high levels of hope. A weak but statistically significant negative correlation was found between caregiver burden and overall hope scores (r= -0.164, P = 0.02). However, no significant correlations were observed between caregiver burden and the subscales of hope, namely Pathway Thinking (r=-0.127, P = 0.073) and Agency Thinking (r=-0.126, P = 0.076). CONCLUSION The study highlights a significant inverse relationship between caregiver burden and patient hope, underscoring the interconnected dynamics between caregiver well-being and patient psychological resilience. Interventions aimed at reducing caregiver burden and fostering hope in patients are essential for enhancing the overall quality of care in leukemia. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Azam Ghorbani
- Department of Medical Surgical Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Salami
- Department of Medical Surgical Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Mehdi Rajabi
- Department of Pediatric Nursing and Neonatal Intensive Care, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Grilo Gonçalves J, Teixeira Verissimo M, Figueiredo D. [Perception of Health-Related Quality of Life in Stroke Patients in a Continuing Care Unit: A Follow-Up Study]. ACTA MEDICA PORT 2025; 38:245-249. [PMID: 40185142 DOI: 10.20344/amp.22181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/16/2024] [Indexed: 04/07/2025]
Abstract
Stroke continues to be one of the main causes of death in Portugal, with a prevalence rate of 8% in individuals aged 50 or over. The objectives of this study were to evaluate the perception of quality of life (QoL) related to health in patients with stroke, after discharge from the Integrated Continuing Care Unit (UCCI), and to evaluate the factors that influence health-related QoL. An observational, longitudinal and descJá agora riptive study was carried out with patients aged 65 years or older with a history of stroke and hospital discharge in central Portugal. They were observed in two time points: six and 12 months after discharge from the UCCI. Data was collected using self-completion questionnaires, namely the Portuguese version of the Stroke Scale Quality of Life (SS-QoL). Considering follow-up losses, a total of 128 individuals were included. All SS-QoL dimensions showed improvements from six to 12 months post-discharge. The variables "personality" and "mental capacity" showed the best evolution. The present study allows us to understand the evolution of the QoL of these users, including the most affected factors over time and that influence post-stroke rehabilitation.
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Affiliation(s)
- José Grilo Gonçalves
- Departamento de Educação e Psicologia. Universidade de Aveiro. Aveiro. Portugal; Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Portugal
| | | | - Daniela Figueiredo
- CINTESIS@RISE. Escola Superior de Saúde da Universidade de Aveiro (ESSUA). Universidade de Aveiro. Aveiro. Portugal
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Kes D, Özcan A, Adahan D. Factors affecting the caregiver burden of family members to palliative care patients: A descriptive and cross-sectional study. Chronic Illn 2025:17423953251322261. [PMID: 39989211 DOI: 10.1177/17423953251322261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2025]
Abstract
OBJECTIVES Many factors affect caregiver burden. Limited studies exist on the effect of social support and fatigue on family caregivers. This study aims to explore the impact of fatigue and social support on the burden experienced by family caregivers of palliative care patients. METHODS The study was conducted with 80 family caregivers. Data were collected using the Piper Fatigue Scale, the Burden Interview, and the Multidimensional Scale of Perceived Social Support. Regression analysis was used to evaluate the data. RESULTS The regression analysis revealed that higher scores on the MSPSS were significantly associated with lower Burden Interview scores (p < 0.05). Conversely, higher PFS scores were significantly correlated with increased Burden Interview scores (p < 0.05). DISCUSSION Both fatigue and social support play a critical role in shaping the caregiving burden experienced by family caregivers. Interventions aimed at reducing caregiver fatigue and enhancing social support may help alleviate this burden.
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Affiliation(s)
- Duygu Kes
- Nursing Department, Faculty of Health Sciences, Karabuk University, Demir-Celik Campus, Karabuk, Turkey
| | - Aynur Özcan
- Karabük Training and Research Hospital, Palliative Care Clinic, Karabuk, Turkey
| | - Didem Adahan
- Faculty of Medicine, Department of Family Medicine Karabuk University, Demir-Celik Campus, Karabuk, Turkey
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Blütgen S, Pralong A, Wilharm C, Eisenmann Y, Voltz R, Simon ST. BreathCarer: Informal carers of patients with chronic breathlessness: a mixed-methods systematic review of burden, needs, coping, and support interventions. BMC Palliat Care 2025; 24:33. [PMID: 39893453 PMCID: PMC11786361 DOI: 10.1186/s12904-025-01670-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 01/24/2025] [Indexed: 02/04/2025] Open
Abstract
BACKGROUND Breathlessness is a common symptom in chronic and advanced diseases, and it poses a significant burden to patients and to their informal carers. They play a crucial role in sustainable care for patients living with breathlessness, but their challenges and needs are often neglected. OBJECTIVE To provide a systematic overview of the literature on the burden, needs, coping and use of healthcare and social services by carers of patients suffering from chronic breathlessness due to any life-limiting disease. DESIGN A mixed-methods systematic review (PROSPERO CRD42022312989). DATA SOURCES Medline, CENTRAL, PsycINFO, and CINAHL were searched and complemented with forward and backward searches and expert consultation. REVIEW METHODS The mixed-methods review included any study on burden, needs and coping among carers of patients with breathlessness published from the inception of the databases until July 2023. A narrative analysis of the quantitative results and a pragmatic meta-aggregation of the qualitative findings were performed, followed by a mixed-methods convergent segregated approach. FINDINGS A total of 53 studies with 4,849 carers were included. Breathlessness is highly burdensome for carers who live with and care for patients or for those who do not live with the patients and care for them. Breathlessness is a significant risk factor for high carers' burden, contributing to deteriorating physical and mental health among carers and creating an urgent need for external support. A major challenge is the sense of being trapped in a state of constant alertness and anxiety, centred around managing the patient's breathlessness. Carers bear substantial emotional burden due to uncertainty, sleep disturbances, and social isolation, which leads to severe psychological distress. Their unmet needs for professional guidance, self-management strategies, and social interaction are high. While supportive interventions, such as specialized services and multidisciplinary approaches, can alleviate some of the burden, there remains a lack of targeted interventions specifically designed for carers. CONCLUSIONS This review highlights the substantial burden associated with caring for patients with chronic breathlessness, the unmet needs of carers and the lack of supportive care structures, leaving them with little option but to accept the situation.
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Affiliation(s)
- Saskia Blütgen
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Centre for Integrated Oncology, University of Cologne, Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Cologne, Germany
| | - Anne Pralong
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Centre for Integrated Oncology, University of Cologne, Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Cologne, Germany
| | - Carolin Wilharm
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Centre for Integrated Oncology, University of Cologne, Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Cologne, Germany
| | - Yvonne Eisenmann
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Centre for Integrated Oncology, University of Cologne, Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Faculty of Medicine and University Hospital, Centre for Integrated Oncology, University of Cologne, Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Cologne, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Street 62, 50937, Cologne, Germany.
- Faculty of Medicine and University Hospital, Centre for Integrated Oncology, University of Cologne, Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Cologne, Germany.
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Lee JH, Lee YJ, Park SJ, Park YM, Lee CW, Hwang SW, Seo MS, Kim SH, Ahn HY, Hwang IC. Patient Acceptance of Death and Symptom Control/Quality of Care Among Terminal Cancer Patients Under Inpatient Hospice Care: A Multicenter Cross-Sectional Study. Am J Hosp Palliat Care 2025:10499091251318738. [PMID: 39888879 DOI: 10.1177/10499091251318738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2025] Open
Abstract
INTRODUCTION Patient attitude to death is associated with outcomes in hospice care settings. This Korean study investigated the association between terminal cancer patient death acceptance and symptom control and quality of care (QoC) as perceived by family caregivers (FCs). METHODS A multicenter cross-sectional survey was conducted in nine inpatient hospice care units, and the data of 108 dyads (terminal cancer patients who responded to the revised Death Attitude Profile and their primary FCs) were analyzed. Dyads were dichotomized into high and low groups by death-acceptance level. Multivariate regression models were used to examine the association between death acceptance and symptom severity/QoC as perceived by FCs. RESULTS Patients in the high acceptance group were younger, educated to a higher level, more religious, and had better-functioning families. Patients with severe shortness of breath were less likely to accept the inevitability of death. FCs of patients with high acceptance of death were more satisfied with QoC, particularly in domains of individualized care and family relationships. In addition, the positive association between patient acceptance and FC satisfaction with care was significant in dyads of young or female patients, patients with a low education level, and patients not cared for by a spouse. CONCLUSION Terminal cancer patient death acceptance is associated with symptom control and FC perceived QoC.
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Affiliation(s)
- Jae Hyuck Lee
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yoo Jeong Lee
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea
| | - So Jung Park
- Department of Family Medicine, National Cancer Center, Goyang, Korea
| | - Young Min Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Chung Woo Lee
- Department of Family Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Sun Wook Hwang
- Department of Family Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Min Seok Seo
- Department of Family Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Sun Hyun Kim
- Department of Family Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Chow AYM, Zhang AY, Chan IKN, Fordjour GA, Lui JNM, Lou VWQ, Chan CLW. Caregiving Strain Mediates the Relationship Between Terminally Ill Patient's Physical Symptoms and Their Family Caregivers' Wellbeing: A Multicentered Longitudinal Study. J Palliat Care 2025; 40:18-27. [PMID: 38018131 DOI: 10.1177/08258597231215137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Objectives: Research considered patient outcomes primarily over caregivers in end-of-life care settings. The importance of family caregivers (FCs) in end-of-life care draws growing awareness, evidenced by an increasing number of evaluations of caregiver-targeted interventions. Little is known of FCs' collateral benefits in patient-oriented home-based end-of-life care. The study aims to investigate FC outcomes and change mechanisms in patient-oriented care. Methods: A pre-post-test study. We recruited FCs whose patients with a life expectancy ≤ 6 months enrolled in home-based end-of-life care provided by service organizations in Hong Kong. Patients' symptoms, dimensions of caregiving strain (ie, perception of caregiving, empathetic strain, adjustment demands), and aspects of FCs' wellbeing (ie, perceived health, positive mood, life satisfaction, spiritual well-being) were measured at baseline (T0) and 3 months later (T1). Results: Of the 345 FCs at T0, 113 provided T1 measures. Three months after the service commenced, FCs' caregiving strain significantly reduced, and their positive mood improved. Alleviation of the patient's physical symptoms predicted FC better outcomes, including the perception of caregiving, empathetic strain, and wellbeing. Changes in perception of caregiving mediated the effects of changes in patients' physical symptoms on FCs' changes in life satisfaction and spiritual wellbeing. Changes in empathetic strain mediated the changes between patient's physical symptoms and FCs' positive mood. Conclusions: Collateral benefits of patient-oriented home-based end-of-life care were encouraging for FCs. Patient's physical symptom management matters to FCs' caregiving strain and wellbeing. The active ingredients modifying FCs' perception of caregiving and addressing empathetic strain may amplify their benefits in wellbeing.
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Affiliation(s)
- Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Anna Y Zhang
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Iris K N Chan
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Genevieve A Fordjour
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Julianna N M Lui
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong SAR, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Jockey Club End-of-life Community Care Project, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
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Gonçalves F, Gaudêncio M, Paiva I, Semedo VA, Rego F, Nunes R. Impact of Symptom Distress on the Quality of Life of Oncology Palliative Care Patients: A Portuguese Cross-Sectional Study. Healthcare (Basel) 2024; 12:2487. [PMID: 39685109 DOI: 10.3390/healthcare12232487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Revised: 11/24/2024] [Accepted: 12/05/2024] [Indexed: 12/18/2024] Open
Abstract
INTRODUCTION Uncontrolled symptoms are widely recognized as one of the main challenges in oncology palliative care patients. The central aim of palliative care is to improve the patient's quality of life. In recent years, there has been a growing use of patient-reported outcome measures in palliative care, particularly to evaluate symptoms, quality of care, and well-being. AIM To evaluate the sociodemographic and clinical profile, symptom distress, and perceived quality of life in oncology palliative care patients admitted to a specialized palliative care unit in Portugal. METHODS This study was cross-sectional, descriptive, and correlational, carried out in the inpatient setting of the palliative care unit at a tertiary oncology hospital (at admission). The evaluated protocol included a sociodemographic and clinical questionnaire, as well as two measurement instruments: the Edmonton Symptom Assessment Scale (ESAS) and the Palliative Care Outcome Scale (POS), both filled out by the patients. Data analysis was conducted using IBM SPSS® Statistics version 25.0, with a significance level set at 5% (p < 0.05). RESULTS The majority of participants in this sample were male (61.7%), with a mean age of around 72 years. More than half of the patients admitted (n = 34; 56.7%) were being monitored in outpatient care. Digestive and head and neck cancers were the most commonly found in the sample (41.7% and 20%, respectively). A significant correlation was found between high symptom intensity and poorer quality of life and care (p < 0.01). This association was particularly pronounced for symptoms such as pain, weakness, depression, anxiety, and anorexia. CONCLUSIONS This study revealed a positive correlation between overall symptom severity and a perceived deterioration in quality of life, well-being, and quality of care. Future studies should consider utilizing alternative assessment tools for evaluating symptoms and quality of care. Additionally, including non-cancer palliative patients in similar studies may provide further valuable insights.
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Affiliation(s)
- Florbela Gonçalves
- Portuguese Institute of Oncology Francisco Gentil Coimbra, 3000-075 Coimbra, Portugal
- Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal
| | - Margarida Gaudêncio
- Portuguese Institute of Oncology Francisco Gentil Coimbra, 3000-075 Coimbra, Portugal
| | - Ivo Paiva
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3000-232 Coimbra, Portugal
| | | | - Francisca Rego
- Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal
| | - Rui Nunes
- Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal
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10
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Martinsson L, Brännström M, Andersson S. Symptom assessment in the dying: family members versus healthcare professionals. BMJ Support Palliat Care 2024; 14:428-433. [PMID: 37973205 PMCID: PMC11671987 DOI: 10.1136/spcare-2023-004382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Symptom management and support of the family members (FMs) are considered essential aspects of palliative care. During end of life, patients are often not able to self-report symptoms. There is little knowledge in the literature of how healthcare professionals (HCPs) assess symptoms compared with FMs. The objective was to compare the assessment of symptoms and symptom relief during the final week of life between what was reported by FMs and what was reported by HCPs. METHODS Data from the Swedish Register of Palliative Care from 2021 and 2022 were used to compare congruity of the assessments by the FMs and by HCPs regarding occurrence and relief of three symptoms (pain, anxiety and confusion), using Cohen's kappa. RESULTS A total of 1131 patients were included. The agreement between FMs and HCPs was poor for occurrence of pain and confusion (kappa 0.25 and 0.16), but fair for occurrence of anxiety (kappa 0.30). When agreeing on a symptom being present, agreement on relief of that symptom was poor (kappa 0.04 for pain, 0.10 for anxiety and 0.01 for confusion). The trend was that HCPs more often rated occurrence of pain and anxiety, less often occurrence of confusion and more often complete symptom relief compared with the FMs. CONCLUSIONS The views of FMs and HCPs of the patients' symptoms differ in the end-of-life context, but both report important information and their symptom assessments should be considered both together and individually. More communication between HCPs and FMs could probably bridge some of these differences.
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Affiliation(s)
- Lisa Martinsson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | | | - Sofia Andersson
- Department of Nursing, Campus Skellefteå, Umeå University, Umeå, Sweden
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11
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Kondeti AK, Adavikolanu KR, Kaliyath SB, Marimuthu Y, Nannepaga HM, Shyam GK, Varthya SB. Factors Influencing the Quality of Life (QOL) of Advanced Cancer Patients in Home-based Palliative Care (HBPC): A Systematic Review. Asian Pac J Cancer Prev 2024; 25:3789-3797. [PMID: 39611901 PMCID: PMC11996095 DOI: 10.31557/apjcp.2024.25.11.3789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 11/13/2024] [Indexed: 11/30/2024] Open
Abstract
CONTEXT Despite the widespread recognition of the need for new palliative care models to better serve advanced cancer patients at the end of life, little importance is given to assessing the effectiveness of homecare models. OBJECTIVE This systematic review aims to summarize factors influencing the quality of life (QOL) of advanced cancer patients in home-based palliative care (HBPC) being adopted worldwide. METHODS Following the PRISMA guidelines, electronic databases such as MEDLINE, Cochrane, EMBASE, and Scopus databases from 2000 to February 2024 were systematically searched using predetermined search terms of "quality of life", "home-based palliative care" as well as "advanced cancer". Studies with less than ten subjects, scoping reviews, conference abstracts, and that adopted poorly validated QOL questionnaires were excluded. RESULTS Twenty-two (22) studies from both developed and developing countries were included in the narrative synthesis. 45.4% were cross-sectional, 27.2% were prospective cohort studies, 13.6% were retrospective cohort studies, and 18.1% were RCTs or quasi-experimental studies. Around 33 QOL factors were studied with 16 different types of QOL instruments. Advanced cancer patients who practiced spirituality, female gender, were married, had satisfaction with care, and preferred home as a place of death showed higher QOL scores. Older patients, aware of cancer diagnosis, poor performance status, high pain score, symptom distress, and psychological distress were associated with a poor QOL. CONCLUSION Various factors affect QOL among cancer patients in HBPC. Hence it shows the importance of interventions to improve QOL and their rigorous implementation. With the widespread adoption of multi-disciplinary home care palliative programs, palliative care services to advanced cancer patients can be delivered readily which may be cost-effective.
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Affiliation(s)
- Ajay Kumar Kondeti
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
| | | | - Soorej Balan Kaliyath
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
| | - Yamini Marimuthu
- Department of Community and Family Medicine (CFM), All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
| | - Haveela Mary Nannepaga
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
| | - Gopi Krishna Shyam
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
| | - Shobhan Babu Varthya
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
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Marx Y, Bauer A, Frese T, Unverzagt S. The challenge of identifying family carers in general practice at an early stage and measuring their burden: A scoping review of possible tools and their actual use. J Family Med Prim Care 2024; 13:3518-3528. [PMID: 39464897 PMCID: PMC11504783 DOI: 10.4103/jfmpc.jfmpc_551_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 10/29/2024] Open
Abstract
Informal care, provided unpaid by family members or friends is a crucial source for providing care at home due to chronic illnesses, disability, or long-lasting health issues. An increasing burden on informal carers largely determines the already proven negative mental and physical health effects. General practitioners are usually responsible for recognizing the effects of persistent burdens on informal carers at an early stage to maintain a functional caring relationship by providing individual support. A scoping review was conducted in four databases (PubMed, LIVIVO, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature [CINAHL]) until July 31, 2023, to identify studies describing the actual use of tools to identify informal care and measure the burden due to informal care. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were followed to select studies. A total of 5.686 references were identified, and 59 potentially eligible articles were assessed for inclusion, resulting in the inclusion of five studies published between 2009 and 2019. Instruments were primarily used to measure burden after an intervention; only one study focused on instruments to identify carers in general practice. This review highlights the need for a tool to identify informal carers in general practice, but it is important to consider practice-specific processes and settings. Future research should take a proactive approach to testing, modifying, and implementing an assessment and optimizing framework conditions. A follow-up project should be initiated to evaluate the effectiveness of an adapted identification tool on the burden and health of family carers.
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Affiliation(s)
- Yvonne Marx
- Center of Health Sciences, Medical Faculty, Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Alexander Bauer
- Center of Health Sciences, Medical Faculty, Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Thomas Frese
- Center of Health Sciences, Medical Faculty, Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Susanne Unverzagt
- Center of Health Sciences, Medical Faculty, Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
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Sa'ari CZ, Chik H, Syed Muhsin SB, Zainuddin SI, Abdul Aziz NA, Mohammad Jodi KH, Saari CZ, Muhamad Shukri AS, Karman S, Surip AG. Needs Analysis for The Development of a Manual in Palliative Care for Malaysia: An Islamic Psychospiritual Approach. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02073-w. [PMID: 38874714 DOI: 10.1007/s10943-024-02073-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/15/2024]
Abstract
This study explicates an Islamic approach to palliative care based on the results of a needs analysis regarding the development of an Islamic psychospiritual manual of palliative care alongside related elements. This article represents the first phase of a three-phase study using the design and development research (DDR) approach developed by Richey and Klein to study for design and development of manual either needed or otherwise. This project is a quantitative study that uses purposive sampling through a questionnaire instrument to investigate 210 participants from the general population in Malaysia that have experience in taking care of terminally ill patients. The findings of the study indicated that the majority of participants agreed with the development of an Islamic psychospiritual manual with mean values (x̅) of 4.57 and 4.66. Concurrently, the findings showed that the hierarchy of emphasis in terms of the elements to be included in the manual starts with emotional support, which exhibited the highest mean rate (x̅), followed by faith in God, spiritual and religious support, self and physical management, trauma management and social support. The correlations indicated that all the elements to be included in the manual were significant.
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Affiliation(s)
- Che Zarrina Sa'ari
- Department of Akidah and Islamic Thought, Academy of Islamic Studies, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Hasimah Chik
- Department of Akidah and Islamic Thought, Academy of Islamic Studies, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Sharifah Basirah Syed Muhsin
- Department of Akidah and Islamic Thought, Academy of Islamic Studies, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Sheriza Izwa Zainuddin
- Department of Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nor Azah Abdul Aziz
- Faculty of Art, Computing and Creative Industries, Universiti Pendidikan Sultan Idris (UPSI), 35900, Tanjung Malim, Perak, Malaysia
| | | | - Che Zuhaida Saari
- Faculty of Syariah and Law, Universiti Sains Islam Malaysia, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Abdul Salam Muhamad Shukri
- Kulliyyah Of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia (IIUM), 50728, Kuala Lumpur, Malaysia
| | - Salmah Karman
- Department of Biomedical Engineering Faculty of Engineering, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Abdul Ghafar Surip
- Division of Research, Department of Islamic Development Malaysia (JAKIM), Kompleks Islam Putrajaya, Presint 3, 62100, Putrajaya, Malaysia
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Wang C, Bi S, Lu Y, Li Y, Han B, Xu M, Meng G, Zhou Q. Availability and stability of palliative care for family members of terminally ill patients in an integrated model of health and social care. BMC Palliat Care 2024; 23:140. [PMID: 38840255 PMCID: PMC11151625 DOI: 10.1186/s12904-024-01475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/28/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Palliative care and the integration of health and social care have gradually become the key direction of development to address the aging of the population and the growing burden of multimorbidity at the end of life in the elderly. AIMS To explore the benefits/effectiveness of the availability and stability of palliative care for family members of terminally ill patients in an integrated institution for health and social care. METHODS This prospective observational study was conducted at an integrated institution for health and social care. 230 patients with terminal illness who received palliative care and their family members were included. Questionnaires and scales were administered to the family members of patients during the palliative care process, including quality-of-life (SF-8), family burden (FBSD, CBI), anxiety (HAMA), and distress (DT). We used paired t-tests and correlation analyses to analyze the data pertaining to our research questions. RESULTS In the integrated institution for health and social care, palliative care can effectively improve quality of life, reduce the family's burden and relieve psychological impact for family members of terminally ill patients. Palliative care was an independent influencing factor on the quality of life, family burden, and psychosocial status. Independently of patient-related and family-related factors, the results are stable and widely applicable. CONCLUSION The findings underline the availability and stability of palliative care and the popularization of an integrated service model of health and social care for elder adults.
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Affiliation(s)
- Chunyan Wang
- Department of Geriatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China
| | - Shaojie Bi
- Department of Cardiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China
| | - Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Bing Han
- Department of Geriatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China
| | - Min Xu
- Department of Geriatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China
| | - Guiyue Meng
- Department of Geriatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China
| | - Qingbo Zhou
- Department of Geriatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China.
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Domeisen Benedetti F, Hechinger M, Fringer A. Self-Assessment Instruments for Supporting Family Caregivers: An Integrative Review. Healthcare (Basel) 2024; 12:1016. [PMID: 38786426 PMCID: PMC11120749 DOI: 10.3390/healthcare12101016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/21/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Family caregivers take on a variety of tasks when caring for relatives in need of care. Depending on the situation and the intensity of care, they may experience multidimensional burdens, such as physical, psychological, social, or financial stress. The aim of the present study was to identify and appraise self-assessment instruments (SAIs) that capture the dimensions of family caregivers' burdens and that support family caregivers in easily identifying their caregiving role, activities, burden, and needs. We performed an integrative review with a broad-based strategy. A literature search was conducted on PubMed, Google Scholar, Google, and mobile app stores in March 2020. After screening the records based on the eligibility criteria, we appraised the tools we found for their usefulness for family care and nursing practice. From a total of 2654 hits, 45 suitable SAIs from 274 records were identified and analyzed in this way. Finally, nine SAIs were identified and analyzed in detail based on further criteria such as their psychometric properties, advantages, and disadvantages. They are presented in multi-page vignettes with additional information for healthcare professionals. These SAIs have proven useful in assessing the dimensions of caregiver burden and can be recommended for application in family care and nursing practice.
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Affiliation(s)
- Franzisca Domeisen Benedetti
- School of Health Professions, Institute of Nursing, ZHAW—Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401 Winterthur, Switzerland (A.F.)
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Zhang Y, Li J, Zhang Y, Chen C, Guan C, Zhou L, Zhang S, Chen X, Hu X. Mediating effect of social support between caregiver burden and quality of life among family caregivers of cancer patients in palliative care units. Eur J Oncol Nurs 2024; 68:102509. [PMID: 38310666 DOI: 10.1016/j.ejon.2024.102509] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/29/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE To identify factors influencing the quality of life of family caregivers with terminal cancer in Chinese palliative wards and to test whether social support mediates the relationship between caregiver burden and caregiver quality of life. METHODS A cross-sectional study design was used. Sociodemographic data were collected and the Quality of Life Scale, the Caregiver Burden Scale, and the Social Support Rating Scale were administered to Chinese family caregivers from December 2021 to December 2022. The factors influencing quality of life and caregiver burden were examined using the Mann‒Whitney U test and the Kruskal‒Wallis H test. The mediating role of social support was assessed using the bootstrap method. RESULTS Family caregivers' quality of life in Chinese terminal cancer palliative units was related to caregivers' daily care time, the caregiver-patient relationship, and patient age. Caregiver quality of life was negatively associated with caregiver burden and positively associated with social support. In addition, social support mediated the relationship between caregiver burden and caregiver quality of life. CONCLUSION Social support mediated the impact of caregiver burden on caregiver quality of life. Family, society, and palliative care institutions should be integrated to take actions to reduce family caregiver burden, increase social support, and transfer the positive aspects of specific cultural contexts to the culture of palliative care in general to collaboratively cope with various problems related to end-stage cancer.
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Affiliation(s)
- Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Chongcheng Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chendu, Sichuan, PR China
| | - Chang Guan
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, PR China.
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Narayanan SP, Mohanty S, Mohanti BK, Rath H, Atreya S, Rout A, Mahapatra S. Comparative effectiveness of verbal instruction versus video-based education (VIVid) among family caregivers for improving the quality of life in advanced head and neck cancer patients receiving palliative care in Eastern India: a randomized controlled trial. Qual Life Res 2023; 32:3495-3506. [PMID: 37530959 DOI: 10.1007/s11136-023-03484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE To determine if video-based educational intervention compared to the standard verbal guidelines, provided to caregivers on home-based palliative care could enhance the quality of life (QoL) in advanced head and neck cancer (HNC) patients. METHODS The study employed a prospective, two-arm parallel-group, randomized controlled trial design. Investigators prepared a real-world demonstrational video of ten minutes duration regarding home-based care for family caregivers, with voice-over in Odia language (Eastern India). The contents of the video addressed the management of common problems in palliative care among HNC patients. This study included 180 participants, 90 patient & caregiver dyads randomized to interventional (video-based education) or control (verbal instruction) groups. Patients' QoL was measured at baseline and 3 weeks follow-up using EORTC QLQ C30. Data were analyzed descriptively, and the Chi-square, Mann-Whitney U, T-test, spearman correlation, and multiple hierarchical regression analyses were employed for statistical analysis, with a significance level of p < 0.05. RESULTS Seventy participant dyads completed the planned two assessments: baseline and at the end of 3rd week (Intervention = 37; Control = 33). The intervention group showed a significant improvement in the patient's health-related QoL, physical, emotional, and social functioning. Symptom burden reduction was observed for pain, nausea, and fatigue. A significant increase in the change in QoL with the video-based education group (VBE) compared to the verbal instruction (VI) group after adjusting for age, gender, physical functioning, and pain symptomology (adjusted R2 = 0.402) was noted. CONCLUSION VBE intervention using smart-phone may offer caregivers a viable means of enhancing self-management while improving patients' QoL within the socio-cultural challenges for home-based palliative care in India. Further research on training caregivers using digital interventions and home-based visits is recommended. TRIAL REGISTRATION NUMBER CTRI/2021/06/034473 [Registered on: 30/06/2021].
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Affiliation(s)
- Sri Priya Narayanan
- Department of Public Health Dentistry, S.C.B. Dental College & Hospital, Cuttack, Odisha, 753007, India.
- Pain and Palliative Unit, Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, 753007, India.
| | - Sumita Mohanty
- Pain and Palliative Unit, Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, 753007, India
| | - Bidhu Kalyan Mohanti
- Bagchi Sri Shankara Cancer Centre, Infovalley, Bhubaneswar, Odisha, 751024, India
| | - Hemamalini Rath
- Department of Public Health Dentistry, S.C.B. Dental College & Hospital, Cuttack, Odisha, 753007, India
| | - Shrikant Atreya
- Department of Palliative Care and Psychooncology, Tata Medical Center, Kolkata, West Bengal, 700160, India
| | - Archana Rout
- Pain and Palliative Unit, Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, 753007, India
| | - Shilpa Mahapatra
- Department of Public Health Dentistry, S.C.B. Dental College & Hospital, Cuttack, Odisha, 753007, India
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Kurtgöz A, Koç Z. Effects of Nursing Care Provided to the Relatives of Palliative Care Patients on Caregivers' Spiritual Well-Being and Hope: A Randomized Controlled Trial. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:318-332. [PMID: 36036673 DOI: 10.1177/00302228221124643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study is to determine the effects of nursing care, based on Watson's Theory of Human Caring, given to the relatives of palliative care patients on caregivers' spiritual well-being and hope. This research was planned as a randomized controlled trial and conducted among 60 patient relatives (intervention group: 30, control group: 30) taking care of their patients in five palliative care units in Turkey. Data were collected via the Introductory Information Form on Patient Relatives, the Beck Hopelessness Scale, and the Spiritual Well-Being Scale. Although administered nursing care caused a significant difference in the Beck Hopelessness Scale scores of the intervention group (U= 235.5, p = 0.001); no change was measured in scores from the Spiritual Well-Being Scale (U=385.0, p = 0.336). The findings of the study evidenced that nursing care based on Theory of Human Caring diminished the hopelessness levels of patient relatives while causing no effect on their spiritual well-being.
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Affiliation(s)
- Aslı Kurtgöz
- Department of Therapy and Rehabilitation, Amasya University, Amasya, Turkey
| | - Zeliha Koç
- Health Science Faculty, Ondokuz Mayıs University, Samsun, Turkey
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Prajitha KC, Subbaraman MR, Siddharth Raman SR, Sharahudeen A, Chandran D, Sawyer J, Kumar S, Anish TS. Need of community-based palliative care in rural India and factors that influence its sustainability: a comprehensive exploration using qualitative methodology in rural Puducherry, India. Palliat Care Soc Pract 2023; 17:26323524231196315. [PMID: 37692560 PMCID: PMC10486217 DOI: 10.1177/26323524231196315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023] Open
Abstract
Background The existing palliative care services in India are concentrated in urban areas, attached to tertiary care hospitals. This poses issues relating to access and equity for people in rural locations and with low socioeconomic status. A Community-Based Palliative Care (CBPC) service named Sanjeevan has been initiated in Puducherry, a union territory of India to provide physical, social, psychological, and emotional support to incurably ill people, including older adults living in rural areas. Objectives To understand the social mechanisms that underpin the implementation of CBPC in rural parts of India and the challenges to its sustainability. Design Qualitative research using focus group discussions (FGDs) and key informant interviews (KIIs). Methods Community-based participatory research (CBPR) approach was used in this study, and descriptive analysis was done. Through CBPR it was possible to document and interpret local knowledge on the community concerns and assets along with the experiences of the community members. Purposive sampling was used to identify vocal participants involved in patient care and areas of the Sanjeevan program such as financial management, administration, and community mobilization. Seven KIIs and four FGDs were conducted, with 7-8 participants in each. Results The analysis indicated the need for a CBPC and the factors enabling its establishment. The findings revealed capacity building, resources for palliative care services, and the existing social structure of the community being the main challenges that need to be overcome for better penetration of CBPC services into society. Demand generation through sensitization and administration of services based on the need and regular follow-up remains the key strategies for the sustainability of the program. Conclusion The CBPC program like 'Sanjeevan' adopted in the rural area of Puducherry can be cited as an example and can be replicated in other rural settings with similar sociocultural characteristics to support people living with end-stage diseases.
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Affiliation(s)
| | | | | | - Anisha Sharahudeen
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Dhanusha Chandran
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Joseph Sawyer
- Academic Clinical Fellow in Palliative Medicine, UCL Division of Psychiatry, MCPCRD, London, UK
| | - Suresh Kumar
- WHO Collaborating Centre for Community Participation in Palliative Care and Long Term Care, Calicut, Kerala, India Director Sanjeevan, Puducherry India
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Ray S, McLorie EV, Downie J. Healthcare Professionals' Attitudes towards and Knowledge and Understanding of Paediatric Palliative Medicine (PPM) and Its Meaning within the Paediatric Intensive Care Unit (PICU): A Summative Content Analysis in a Tertiary Children's Hospital in Scotland-"An In Vitro Study". Healthcare (Basel) 2023; 11:2438. [PMID: 37685471 PMCID: PMC10487473 DOI: 10.3390/healthcare11172438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Background: Paediatric palliative medicine (PPM) is a holistic approach to care for children and their families. Services are growing and developing worldwide but significant disparity in service provision remains. The Paediatric Supportive and Palliative Care Team (PSPCT) at the Royal Hospital for Children in Glasgow was established in 2019, but there is still no clear integrated role within the paediatric intensive care unit (PICU) at present. Through analysing the attitudes, meaning, knowledge and understanding of PPM in the PICU environment, we hoped to explore the experiences of those providing paediatric palliative care and to identify any barriers to or facilitators of integrated working to gain a better understanding of providing this care. Methods: This qualitative study used a survey composed of five open-ended and five closed questions. Sixteen out of a possible thirty-two responses (50%) were accrued from PICU healthcare professionals, including consultants (n = 19), advanced nurse practitioners (n = 4) and band-seven nurses (n = 9). The data were comprehensively studied and analysed by two coders using summative content analysis with assistance from data management software. Codes were further developed to form categories and subcategories. Results: Two categories were found: (1) the role of palliative care and (2) experiences of providing palliative care. A total of five subcategories were found, demonstrating that the PSPCT can enhance care in PICU through collaborative working. Barriers identified included staffing, funding and stigma around palliative care. Conclusions: This study shows that PICU professionals have a good understanding of the concepts of PPM and view it as an essential part of PICU work. Barriers related to resources and misperceptions of palliative care can be overcome through improved education, funding and staff retention, but this would require buy-in from policymakers. The perspective from our relatively small team increases generalizability to growing teams across the country.
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Affiliation(s)
- Satyajit Ray
- Royal Hospital for Children, Glasgow G51 4TF, UK;
| | - Emma Victoria McLorie
- The Paediatric Palliative Care Research Group, Health Sciences, University of York, York YO10 5DD, UK
| | - Jonathan Downie
- Royal Hospital for Children, Glasgow G51 4TF, UK;
- Children’s Hospices Across Scotland (CHAS), Edinburgh EH14 1LT, UK
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Ribeiro AF, Pereira SM, Nunes R, Hernández-Marrero P. What do we know about experiencing end-of-life in burn intensive care units? A scoping review. Palliat Support Care 2023; 21:741-757. [PMID: 36254708 DOI: 10.1017/s1478951522001389] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this article is to review and synthesize the evidence on end-of-life in burn intensive care units. METHODS Systematic scoping review: Preferred Reporting Items for Systemic Reviews extension for Scoping Reviews was used as a reporting guideline. Searches were performed in 3 databases, with no time restriction and up to September 2021. RESULTS A total of 16,287 documents were identified; 18 were selected for analysis and synthesis. Three key themes emerged: (i) characteristics of the end-of-life in burn intensive care units, including end-of-life decisions, decision-making processes, causes, and trajectories of death; (ii) symptom control at the end-of-life in burn intensive care units focusing on patients' comfort; and (iii) concepts, models, and designs of the care provided to burned patients at the end-of-life, mainly care approaches, provision of care, and palliative care. SIGNIFICANCE OF RESULTS End-of-life care is a major step in the care provided to critically ill burned patients. Dying and death in burn intensive care units are often preceded by end-of-life decisions, namely forgoing treatment and do-not-attempt to resuscitate. Different dying trajectories were described, suggesting the possibility to develop further studies to identify triggers for palliative care referral. Symptom control was not described in detail. Palliative care was rarely involved in end-of-life care for these patients. This review highlights the need for early and high-quality palliative and end-of-life care in the trajectories of critically ill burned patients, leading to an improved perception of end-of-life in burn intensive care units. Further research is needed to study the best way to provide optimal end-of-life care and foster integrated palliative care in burn intensive care units.
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Affiliation(s)
- André Filipe Ribeiro
- MEDCIDS: Medicina da Comunidade, Informação e Decisão em Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Sandra Martins Pereira
- Research Department, CEGE - Research Center in Management and Economics, Universidade Católica Portuguesa, Porto, Portugal
- Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal
| | - Rui Nunes
- MEDCIDS: Medicina da Comunidade, Informação e Decisão em Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- MEDCIDS: Medicina da Comunidade, Informação e Decisão em Saúde, International Network UNESCO Chair in Bioethics, Porto, Portugal
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Lee J, Kim E, Chung M, Yeom I. Validity and reliability of the Korean caregiver contribution to self-care chronic illness inventory. Sci Rep 2023; 13:7808. [PMID: 37183194 PMCID: PMC10183459 DOI: 10.1038/s41598-023-35084-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 05/12/2023] [Indexed: 05/16/2023] Open
Abstract
The contribution of caregivers to self-care for chronically ill patients is important for improving patient outcomes. The Caregiver Contribution to Self-Care Chronic Illness Inventory (CC-SC-CII) has been used to assess caregivers' contributions to three distinct aspects of self-care (maintenance, monitoring, and management) globally. This study aimed to examine the psychometrics of the Korean version of the CC-SC-CII with 230 family caregivers (mean age = 49.8 years, 70% women) of patients with chronic illness. We demonstrated that the CC-SC-CII-Korean has good reliability with acceptable internal consistency and construct validity for all three factors using confirmatory factor analysis. The CC-SC-CII-Korean is a reliable and valid instrument to measure the contributions of Korean caregivers to the self-care of patients with chronic illnesses.
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Affiliation(s)
- Juhee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, College of Nursing, Yonsei University, Seoul, Republic of Korea
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Eunyoung Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Misook Chung
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Insun Yeom
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea.
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Knop J, Dust G, Kasdorf A, Schippel N, Rietz C, Strupp J, Voltz R. Unsolved problems and unwanted decision-making in the last year of life: A qualitative analysis of comments from bereaved caregivers. Palliat Support Care 2023; 21:261-269. [PMID: 35264274 DOI: 10.1017/s1478951522000165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Patients in their last year of life, as well as their relatives, often feel that existent care structures of the healthcare system do not adequately address their individual needs and challenges. This study analyzes unmet needs in terms of unsolved problems and unwanted decision-making in the health and social care of patients in their last year of life from the perspective of bereaved caregivers. METHODS This qualitative study is based on free-text comments from informal caregivers of deceased patients collected as part of the Last-Year-of-Life-Study-Cologne (LYOL-C) using a postal survey. With qualitative content analysis, a category system with main and subcategories was developed in a multi-step process. RESULTS Free-text commentaries and demographic data were collected from 240 bereaved caregivers. Particularly outside of hospice and palliative care services, study participants addressed the following unsolved problems: poor communication with medical and nursing staff, insufficient professional support for informal caregivers, inadequate psycho-social support for patients, and poor management of pain and other symptoms. Respondents often stated that their relative had to be cared for and die outside their own home, which the relative did not want. SIGNIFICANCE OF RESULTS Our findings suggest the necessity for greater awareness of patients' and their relatives' needs in the last year of life. Addressing individual needs, integrating palliative and hospice care in acute hospitals and other healthcare structures, and identifying patients in their last year of life and their caregivers could help to achieve more targeted interventions and optimization of care.
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Affiliation(s)
- Jannis Knop
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gloria Dust
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Alina Kasdorf
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nicolas Schippel
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Christian Rietz
- Department of Educational Science, Faculty of Educational and Social Sciences, University of Education Heidelberg, Heidelberg, Germany
| | - Julia Strupp
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Clinical Trials Center (ZKS), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Center for Health Services Research, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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Sotiria K, Athina S, Maria N, Efi P, Eleni T, Alexandra M, Kyriaki M. Greek Caregivers of Chronically Ill Patients Struggling in Everyday Life. Curr Aging Sci 2023; 16:40-48. [PMID: 35331102 DOI: 10.2174/1874609815666220324161856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/14/2021] [Accepted: 12/30/2021] [Indexed: 04/13/2023]
Abstract
BACKGROUND Caregivers of chronically ill geriatric patients face several problems throughout the disease progression of the patients under their care. This is a prospective crosssectional study conducted from September 2017 to September 2018, including 130 caregivers of geriatric patients from Attica, Greece. OBJECTIVES This study investigates caregivers' anxiety, perception of changes in their lives, and quality of life. METHODS The questionnaires administered were the revised Bakas Caregiving Outcomes Scale (rBCOS), the State-Trait Anxiety Inventory (STAI), and the Linear Analogue Scale Assessment (LASA). RESULTS Influencing factors associated with rBCOS, STAI and LASA were care timespan and energy levels. Only the State Anxiety Scale and the Patient-caregiver Relationship rBCOS questionnaire seemed to be affected by a cancer diagnosis. CONCLUSION Our findings revealed that anxiety, low quality of life, and perception of changes in the lives of caregivers are the underlying factors. Significant factors were time spent caring for the patient, the status of their relationship, the diagnosis, especially in life-threatening and life-limiting diseases, and the caregivers' energy levels. These results are important in order to comprehend the lives of caregivers and assess by what means could the healthcare system and society further assist them.
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Affiliation(s)
- Kostopoulou Sotiria
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
| | - Sakellariou Athina
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
| | - Nikoloudi Maria
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
| | - Parpa Efi
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
| | - Tsilika Eleni
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
| | - Mantoudi Alexandra
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
| | - Mystakidou Kyriaki
- Palliative Medicine, Pain Relief and Palliative Care Unit, Aretaieion Hospital, National & Kapodistrian University of Athens, School of Medicine, 27 Korinthias St, Athens 115 26, Greece
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Gagnon MC, Hébert J. Gaining a better understanding of the needs of rural cancer patients requiring in-home palliative and end-of-life care and nursing care and services. Can Oncol Nurs J 2023; 33:46-60. [PMID: 36789213 PMCID: PMC9894362 DOI: 10.5737/2368807633146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Issue Access to in-home palliative and end-of-life care (PELC), qualified professionals, and high-quality nursing care and services in rural areas is limited and unequal, thus leading to an increase in unmet needs across the care trajectory of cancer patients. Objectives and methodology A qualitative descriptive study was carried out to gain a better understanding of the needs of rural cancer patients receiving in-home PELC and to describe the nursing care and services available to them. Results Five rural cancer patients requiring PELC reported a variety of needs, especially those arising from limited information resources and multiple time- and energy-consuming back-and-forth trips to urban centres. Seven nurses who provide in-home care and services to rural inhabitants outlined the challenges they face in addressing these needs. These are related primarily to the long distances they are called upon to travel, the limited number of specialized professional resources available, transfers to emergency departments, the dearth of PELC training and the lack of a dedicated PELC team. Conclusion These findings helped gain a better understanding of the specific needs of rural cancer patients requiring in-home PELC, as well as the challenges that nurses must confront to help their patients remain in their own homes.
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Affiliation(s)
- Marie-Carmen Gagnon
- Department of Health Sciences, Université du Québec à Rimouski, Lévis Campus, Quebec, Canada G6V 0A6,
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Gagnon MC, Hébert J. Mieux comprendre les besoins des personnes atteintes de cancer nécessitant des soins palliatifs et de fin de vie à domicile et les soins et services infirmiers offerts en milieu rural. Can Oncol Nurs J 2023; 33:31-45. [PMID: 36789220 PMCID: PMC9894361 DOI: 10.5737/2368807633131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Problématique L’accès limité et inégal aux soins palliatifs et de fin de vie (SPFV) à domicile de même qu’à des professionnels qualifiés et à des soins et services infirmiers de qualité en milieu rural augmente les besoins non répondus dans l’ensemble de la trajectoire de soins des personnes atteintes de cancer. Objectifs et méthodologie L’étude propose un devis qualitatif descriptif afin de mieux comprendre les besoins des personnes atteintes de cancer recevant des SPFV à domicile en milieu rural et d’avoir un portrait des soins et services infirmiers qui leur sont offerts. Résultats Cinq personnes atteintes de cancer nécessitant des SPFV en milieu rural ont rapporté de nombreux besoins, notamment en termes de ressources informationnelles restreintes et des nombreux déplacements vers les milieux urbains qui nécessitent de l’organisation et du temps. Pour répondre à ces besoins, sept infirmières offrant des soins et services à domicile en milieu rural décrivent plusieurs défis, notamment les grandes distances à parcourir, les ressources professionnelles spécialisées limitées, les transferts aux urgences, le manque de formation en SPFV et l’absence d’équipe dédiée. Conclusion Ces résultats permettent de mieux comprendre des besoins spécifiques des personnes atteintes de cancer nécessitant des SPFV à domicile en milieu rural ainsi que les divers défis auxquels les infirmières font face afin de favoriser le maintien à domicile.
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Moldón-Ballesteros E, Llamas-Ramos I, Calvo-Arenillas JI, Cusi-Idigoras O, Llamas-Ramos R. Validation of the Spanish Versions of FACIT-PAL and FACIT-PAL-14 in Palliative Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10731. [PMID: 36078446 PMCID: PMC9518596 DOI: 10.3390/ijerph191710731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Palliative patients require several types of care to improve their quality of life as much as possible, and valid and reliable assessment instruments are essential. The objective of this study is the Spanish validation of the Functional Assessment Chronic Illness Therapy-Palliative Care (FACIT-PAL) and its abbreviated version, FACIT-PAL-14, in palliative care patients. FACIT-PAL and FACIT-PAL-14 were translated into Spanish and administered to 131 terminal oncology patients in home palliative care units, hospital palliative care units, health center teams, and social health centers. The European Organization for Research and Treatment of Cancer questionnaire, EORTC-QLQ-C15-PAL version, was used to evaluate the criterion validity. The EORTC-QLQ-C15-PAL was employed as a "gold standard", and it obtained significant results with FACIT scales. FACIT-PAL-14, FACIT-PAL, and its subscales reported high internal consistency, from 0.640 to 0.816. The exploratory factor analysis for FACIT-PAL-14 found a structure in three factors that explained the 70.10% variance, and the FACIT-PAL scale found a structure of five factors. Physical wellbeing from FACIT-PAL highly correlated to the EORTC-QLQ-C15-PAL (r = 0.700), but social and family wellbeing was correlated to a lesser extent (r = -0.323). FACIT-PAL and the TOI (Toi Outcome Index) were also highly correlated with the EORTC-QLQ-C15-PAL, with values of r = -0.708 and r = -0.709, respectively. The Spanish versions of FACIT-PAL and FACIT-PAL-14 were demonstrated to be valid and reliable scales in palliative care patients.
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Affiliation(s)
- Estefanía Moldón-Ballesteros
- Nursing School of Zamora, University of Salamanca, Av. de Requejo, 33, 49022 Zamora, Spain
- Virgen de la Concha Hospital of Zamora, Av. de Requejo, 35, 49022 Zamora, Spain
| | - Inés Llamas-Ramos
- Nursing and Physiotherapy Faculty, University of Salamanca, Avda./Donantes de Sangre s/n, 37007 Salamanca, Spain
- University Hospital of Salamanca, Paseo de San Vicente, n 182, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Jose Ignacio Calvo-Arenillas
- Nursing and Physiotherapy Faculty, University of Salamanca, Avda./Donantes de Sangre s/n, 37007 Salamanca, Spain
| | - Olaia Cusi-Idigoras
- Social Psychology Department, University of País Vasco, Barrio Sarriena s/n, 48940 Lejona, Vizcaya, Spain
| | - Rocío Llamas-Ramos
- Nursing and Physiotherapy Faculty, University of Salamanca, Avda./Donantes de Sangre s/n, 37007 Salamanca, Spain
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Assessment of symptom intensity and psychological well-being of patients with advanced cancer undergoing palliative care in a Brazilian public hospital: A cross-sectional study. Palliat Support Care 2022:1-7. [PMID: 35920303 DOI: 10.1017/s1478951522000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The characterization of clinical-emotional aspects of advanced cancer patients is essential for palliative care. To date, there is scarce information regarding the socio-demographic and clinical profiles, as well as the quality of care given to hospitalized patients under this condition, particularly in South American countries. The objectives of this study were to analyze the socio-demographic profile, symptoms (including psychological well-being), and the quality of life of advanced cancer patients admitted to the oncology ward of the General Hospital of the University of Campinas, Brazil. METHODS In this cross-sectional study, patients were invited to fill the selected questionnaires such as Edmonton Symptom Assessment Scale (ESAS) and Palliative Care Outcome Scale (POS). Descriptive analyses were performed, regarding socio-demographic profile, symptoms, level of information over treatment aims, and quality-of-life scores. RESULTS Fifty-nine patients were included, of whom 29 were male and 30 female, with a mean age of 58 years. Overall, 31.9% presented pain at the time of the interview, 52.5% depression, and 76.3% anxiety. The median individual scores for ESAS and POS (and interquartile range) were, respectively, 27 (17-41) and 14 (9-19). Patients with previous knowledge of treatment objectives reported worse depression scores in the ESAS (median 2 vs. 0, p 0.02), even when correcting for possible confounders. SIGNIFICANCE OF RESULTS In contrast to current literature, in which pain is a prevalent report, depression and anxiety were more evident in this specific population of hospitalized patients. This framework reflects the need for valuing not only physical but also emotional symptoms to achieve the integrality of care.
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Silveira A, Sequeira T, Gonçalves J, Lopes Ferreira P. Patient reported outcomes in oncology: changing perspectives-a systematic review. Health Qual Life Outcomes 2022; 20:82. [PMID: 35597948 PMCID: PMC9124403 DOI: 10.1186/s12955-022-01987-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
In public health context, oncology is associated with severe negative impact on patients and on their relatives’ quality of life. Over the last decades, survival has remained at 50% worldwide for some tumor locations. Patient reported outcomes (PROs) assessment and, the corresponding use in clinical practice, help establishing patient individualized profiling involving caregivers. The purpose of this systematic review was to examine critical success factors for PROs assessment in daily clinical oncology practice. Additionally, we investigated how PROs collection can change oncology perspectives for patients and caregivers. According to PRISMA guidelines, 83 studies were included in this systematic review, whether related with implementation in daily clinical practice or associated with its use in oncology. PROs assessment gathers multi-professional teams, biomedical and clinical expertise, patients, families and caregivers. Institutional involvement, first line for caregiver’s adherence, team continuous formation, encompassing training and support, design of clear workflows, continuous monitoring, and data analysis are crucial for implementation. PROs measures are decisive in oncology. Several items were improved, including caregiver–patient–physician communication, patient risk groups identification, unmet problems and needs detection, disease course and treatment tracking, prognostic markers, cost-effectiveness measurement and comfort/support provision for both patients and caregivers. Routine assessment and implementation of PROs in clinical practice are a major challenge and a paradigm transformation for future.
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Affiliation(s)
- Augusta Silveira
- Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.,Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal
| | - Teresa Sequeira
- Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.,Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal
| | - Joaquim Gonçalves
- 2Ai - Applied Artificial Intelligence Laboratory, School of Technology of Polytechnic Institute of Cávado and Ave, R. de São Martinho, 4750-810, Vila Frescainha, Barcelos, Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal. .,Faculty of Economics, University of Coimbra, Av. Dr. Dias da Silva, 165, 3004-512, Coimbra, Portugal.
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See F, Teo I, Malhotra C. Longitudinal trajectories of caregiving experiences among primary informal caregivers of patients with metastatic solid cancer (Stage IV). Psychooncology 2022; 31:1161-1168. [PMID: 35199404 DOI: 10.1002/pon.5904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/14/2021] [Accepted: 02/11/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Cancer is a significant cause of mortality worldwide. The diagnosis of advanced cancer affects both patients and their family caregivers. Understanding the course of both negative and positive experiences of caregiving provides a more comprehensive understanding of the caregiving experience. The study aims to identify joint trajectories of burden and esteem among family caregivers of patients with solid metastatic cancer, and to identify caregiver characteristics that predict membership for each delineated trajectory. METHODS A prospective longitudinal study of 346 informal family caregivers of patients with solid metastatic cancer were recruited between July 2016 and December 2019. Surveys were conducted every 3 months for 2 years. We assessed caregiver burden and positive aspects of caregiving using the modified Caregiver Reaction Assessment. We estimated the joint trajectories for these outcomes using group-based multi-trajectory modelling. RESULTS We identified 4 trajectories describing caregivers with 1) low burden, moderate esteem (38.3%), 2) low burden, high esteem (20.3%), 3) high burden, low esteem (16.4%), 4) high burden, high esteem (24.9%). Compared to the "low burden, high esteem" trajectory, male and non-spousal caregivers were more likely to experience high burden and esteem while caregivers from low socioeconomic status were more likely to belong to trajectories with a high burden. CONCLUSION Recognising caregivers at high risk of belonging to trajectories with high burden or low esteem may enable healthcare professionals to anticipate and provide appropriate support to mitigate the impact of negative outcomes.
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Affiliation(s)
- Faith See
- Lien Center for Palliative Care, Duke-NUS Medical School, Blk 541 Pasir Ris St 51 #04-14, Singapore, 169857
| | - Irene Teo
- Lien Center for Palliative Care, Duke-NUS Medical School, 8 College Rd, Singapore
| | - Chetna Malhotra
- Lien Center for Palliative Care, Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore National Cancer Center, 8 College Road, Level 4, Singapore
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Pop RS, Payne S, Tint D, Pop CP, Mosoiu D. Instruments to assess the burden of care for family caregivers of adult palliative care patients. Int J Palliat Nurs 2022; 28:80-99. [PMID: 35446673 DOI: 10.12968/ijpn.2022.28.2.80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND A primary caregiver shares the illness experience of the patient and undertakes vital care work, alongside managing the patient's emotions, and is actively involved in care process without being paid. When faced with the palliative care patient's needs, caregivers are affected on multiple levels (physical, psychological and socio-economic), thereby experiencing a moderate or severe burden of care. AIM To identify assessment instruments for the burden of care for family caregivers that are suitable to be used in clinical practice. METHOD A narrative review was conducted using an electronic search in Pubmed, PsychINFO, CINAHL of articles published in English between 2009-2019, using the search terms: 'caregiver/family, caregiver/carer and burden and palliative care/hospice/end of life'. An assessment grid was developed to appraise the clinical use of identified instruments. RESULTS Of the 568 articles identified, 40 quantitative studies were selected using 31 instruments to measure the caregiver burden of cancer, noncancer and terminally ill patients. Most instruments 23 (74.11%) evaluate the psycho-emotional and, 22 (70.96%) the social domain, 12 instruments (38.7%) focused on the physical domain, three (9.67%) on the spiritual field and six instruments (19.35%) on economic aspects. For the multidimensional instruments, the assessment grid scored highest for the Burden Scale for Family Caregiver (BSFC). CONCLUSION The BSFC is the tool that seems to meet the most requirements, being potentially the most useful tool in clinical practice.
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Affiliation(s)
- Rodica Sorina Pop
- Assistant Professor, Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Medicine, Cluj-Napoca, Romania
| | - Sheila Payne
- Professor, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Diana Tint
- Professor, Transilvania University, Faculty of Medicine, Brasov, Romania
| | | | - Daniela Mosoiu
- Associate Professor, Transilvania University, Faculty of Medicine, Brasov, Romania
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Nguyen HQ, Haupt EC, Duan L, Hou AC, Wang SE, Mariano JD, Lee JA, McMullen C. Hospital utilisation in home palliative care: caregiver health, preparedness and burden associations. BMJ Support Palliat Care 2022:bmjspcare-2021-003455. [PMID: 35078873 DOI: 10.1136/bmjspcare-2021-003455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/06/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Prior studies show that family caregiver factors influence patient outcomes. The purpose of this analysis was to determine the association between family caregiver self-rated health, perception of preparedness and burden at the time of patient admission to home palliative care (HomePal) with downstream patient hospital utilisation and time to hospice enrolment and death. METHODS Data for this cohort study (n=441) were drawn from a trial testing two models of HomePal. Caregiver self-rated health, preparedness (Preparedness for Caregiving Scale, CPS) and burden (Zarit-12) were measured at admission to HomePal. Caregivers were categorised as having good/very good/excellent or fair/poor health, scoring above or below the CPS median score (23), or having no/mild (0-10), moderate (11-20) or high (>20) burden. Proportional hazard competing risk models assessed the association between caregiver factors with hospital utilisation (emergency department visits, observation and inpatient stays). RESULTS Patients whose caregivers reported poor health and low preparedness received more visits by home health aides and social workers, respectively (both, p<0.05). Adjusted models showed that worse caregiver health (HR: 0.69 (95% CI 0.52 to 0.92), p=0.01), low preparedness (HR: 0.73 (95% CI 0.57 to 0.94), p=0.01) and high burden (HR: 0.77 (95% CI 0.56 to 1.06), p=0.10) were associated with lower risk for hospital utilisation. There were no significant associations between caregiver factors with time to patient enrolment in hospice or death in adjusted models (both, p>0.05). CONCLUSION Prospective studies are needed to understand how greater in-home supports for family caregivers with poor health could help achieve quality palliative care that aligns with families' priorities. TRIAL REGISTRATION NUMBER NCT03694431; ClinicalTrials.gov.
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Affiliation(s)
- Huong Q Nguyen
- Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Eric C Haupt
- Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Lewei Duan
- Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Anthony C Hou
- Geriatrics, Palliative and Continuing Care, Kaiser Permanente Southern California, Los Angeles Medical Center, Los Angeles, California, USA
| | - Susan E Wang
- Geriatrics, Palliative and Continuing Care, Kaiser Permanente Southern California, West Los Angeles Medical Center, Los Angeles, California, USA
| | - Jeffrey D Mariano
- Geriatrics, Palliative and Continuing Care, Kaiser Permanente Southern California, West Los Angeles Medical Center, Los Angeles, California, USA
| | - Jung-Ah Lee
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, California, USA
| | - Carmit McMullen
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
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Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review. Support Care Cancer 2022; 30:3691-3700. [PMID: 34993653 DOI: 10.1007/s00520-021-06793-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This review summarizes and synthesizes the available empirical literature on the experiences concerned with the problems and challenges faced by caregivers of patients with pancreatic cancer. METHODS An integrative review method was used, and a literature search was conducted using five databases. We searched the terms "pancreatic cancer," "caregiver," and "experience," and used the Boolean operators OR and AND to combine them. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of the included studies. RESULTS Four qualitative studies, one mixed method, and three quantitative studies met the selection criteria and were included in the review. Informal family caregivers of patients with pancreatic cancer experienced multifaceted roles, lack of information, difficulties in maintaining emotional well-being, and positive coping. The factors associated with their caring experience included the caregivers' demographics, patients' psychological status, and clinical characteristics. CONCLUSION Caregivers of patients with pancreatic cancer have various experiences while providing care. Health care providers should offer opportunities for caregivers to recognize their feelings, provide sufficient information and psychological support, and foster coping strategies to maintain the physical and psychosocial well-being of caregivers.
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Rahayuwati L, Pahria T, Ibrahim K, Nurhidayah I, Agustina H. Social support and quality of life in cancer patients: A study of palliative shelters in West Java. MATRIX SCIENCE MEDICA 2022. [DOI: 10.4103/mtsm.mtsm_58_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sousa MS, Davis W, Blanchard M, Razmovski-Naumovski V, Agar M, Daveson B, Hsm D, Currow DC. Appetite-Related Distress Is Burdensome in the Last Sixty Days of Life of People Receiving Palliative Care: A National Longitudinal Consecutive Cohort Study. J Palliat Med 2021; 25:636-642. [PMID: 34978898 DOI: 10.1089/jpm.2021.0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: People with life-limiting illnesses experience a range of distressing symptoms. Appetite-related symptoms are common, but studies have found varied prevalence and the distress caused has had limited quantification. Objectives: To examine the clinicodemographic factors and trajectory of appetite-related distress in the last 60 days of life. Design/Setting/Subjects: Consecutive cohort of 109,385 patients (359,038 data points) using specialist palliative care services in the Australian Palliative Care Outcomes Collaboration (PCOC). Measurements: Patient-reported appetite-related distress using the PCOC Symptom Assessment Scale. Results: Diagnoses included cancer (75%), end-stage organ failure (11%), neurodegenerative disease (4%), dementia (3%), and other noncancer (7%). Fifty-eight percent reported some degree of appetite-related distress at least once in the last 60 days of life. Daily mean distress scores did not vary greatly by diagnosis and the distributions of symptom severity were not linked with performance status. There was a sharp decline in mean distress for all diagnostic groups around 7-10 days before death. Moderate to severe distress was associated with nausea-, bowel-, pain-, and breathing-related distress, controlling for key baseline factors. Conclusion: Appetite-related distress is prevalent and burdensome in the 60 days before death and is strongly associated with distress from other cardinal symptoms.
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Affiliation(s)
- Mariana S Sousa
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Walter Davis
- Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Megan Blanchard
- Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Valentina Razmovski-Naumovski
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Meera Agar
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | | | - Dip Hsm
- Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - David C Currow
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.,Wolfson Palliative Care Research Centre, University of Hull, Hull, England
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Muñoz Camargo JC, Hernández-Martínez A, Rodríguez-Almagro J, Parra-Fernández ML, Prado-Laguna MDC, Martín M. Perceptions of Patients and Their Families Regarding Limitation of Therapeutic Effort in the Intensive Care Unit. J Clin Med 2021; 10:4900. [PMID: 34768420 PMCID: PMC8584556 DOI: 10.3390/jcm10214900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/17/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Our objective was to determine and describe the opinion and attitudes of patients and their families regarding the limitation of therapeutic effort and advanced directives in critical patients and whether end-of-life planning occurs. Religious affiliation, education level, and pre-admission quality of life were also evaluated to determine whether they may influence decisions regarding appropriate therapeutic effort. METHODS A prospective, observational and descriptive study, approved by the center's ethical committee, was carried out with 257 participants (94 patients and 163 family members) in the intensive care unit (ICU). A questionnaire regarding the opinions of patients and relatives about situations of therapeutic appropriateness in case of poor prognosis or poor quality of life was used. The questionnaire had three sections. In the first section, sociodemographic features were investigated. In the second section, information was collected on the quality of life and functional situation before ICU admission (taking as a reference the situation one month before admission) assessed by the Karnofsky scale, Barthel index, and the PAEEC scale (Project for the Epidemiological Analysis of Critical Care Patients). The third section aimed to determine whether the family knew the patient's opinion regarding his/her end of life. RESULTS Of those interviewed, 62.2% would agree to limit treatment in case of poor prognosis or poor quality of future life. In contrast, 37.7% considered that they should fight for life, even if it is irretrievable. Only 1.6% had advanced directives registered, 43.9% of the participants admitted deterioration in their quality of life before ICU admission, 18.2% with moderate-severe deterioration. Our study shows that the higher the educational level, the lower the desire to fight for life when it is irretrievable and the greater the agreement to limit treatment. Besides, those participants not affiliated with a religion were significantly less likely to fight for life, including when irretrievable, than Catholics and were more likely to agree to limit treatment. CONCLUSIONS More than half of the participants would agree to limit treatment in the case of a poor prognosis. Our results indicate that patients do not prepare for the dying process well in advance. Religion and educational level were determining factors for the choice of procedures at the end of life, both for patients and their families.
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Affiliation(s)
- Juan Carlos Muñoz Camargo
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.C.M.C.); (A.H.-M.); (J.R.-A.); (M.L.P.-F.); (M.d.C.P.-L.)
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.C.M.C.); (A.H.-M.); (J.R.-A.); (M.L.P.-F.); (M.d.C.P.-L.)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.C.M.C.); (A.H.-M.); (J.R.-A.); (M.L.P.-F.); (M.d.C.P.-L.)
| | - María Laura Parra-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.C.M.C.); (A.H.-M.); (J.R.-A.); (M.L.P.-F.); (M.d.C.P.-L.)
| | - María del Carmen Prado-Laguna
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.C.M.C.); (A.H.-M.); (J.R.-A.); (M.L.P.-F.); (M.d.C.P.-L.)
| | - Mairena Martín
- Department of Inorganic, Organic Chemistry and Biochemistry, Faculty of Nursing of Ciudad Real, Regional Center of Biomedical Research (CRIB), Universidad de Castilla-La Mancha, 13091 Ciudad Real, Spain
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Chen DD, Zhang H, Cui N, Tang L, Shao J, Wang X, Wang D, Liu N, Ye Z. Cross-cultural adaptation and validation of the caregiver contribution to self-care of chronic illness inventory in China: a cross-sectional study. BMJ Open 2021; 11:e048875. [PMID: 34493514 PMCID: PMC8424873 DOI: 10.1136/bmjopen-2021-048875] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Caregiver contribution (CC) is important for the self-care behaviors of chronic disease individuals, as it could enhance patient outcomes. Therefore, it is necessary to assess this CC by using a good validity and reliability instrument. The Caregiver Contribution to Self-Care Chronic Illness Inventory (CC-SC-CII) was designed to assess CC to self-care behaviors of patients with chronic illness in Italy. However, it was unclear whether this tool had sound psychometrics properties in the context of Chinese culture. Therefore, we performed the cross-cultural adaption of the CC-SC-CII and we tested its psychometric properties among Chinese caregivers of patients with chronic disease. DESIGN A cross-sectional observational design. SETTINGS Participants were recruited from communities and institutions in Pingdingshan, Henan Province, China. PARTICIPANTS 301 caregivers of care recipients with chronic disease completed the Chinese version of the CC-SC-CII (C-CC-SC-CII). PRIMARY AND SECONDARY OUTCOME MEASURES The content validity index of items (I-CVI), the scale content validity index-average (S-CVI/Ave), exploratory factor analysis, confirmatory factor analysis (CFA), internal consistency and item analysis were tested. RESULTS The range of I-CVI was between 0.833 and 1.00, and the score of S-CVI was 0.991. In CFA, the C-CC to self-care monitoring scale had satisfactory fit indices. However, the C-CC to self-care maintenance and management scales had unsupported fit indices. The reliability coefficients of C-CC-SC-CII were 0.792, 0.880 and 0.870 for its three scales. Item-total correlations were all over 0.590. Test-retest reliability showed that the range of intraclass correlation coefficients was from 0.728 to 0.783. CONCLUSION The C-CC-SC-CII has sound psychometrics characteristics and is a culturally appropriate and reliable instrument for assessing CC to the self-care behaviours of patients with chronic disease in China.
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Affiliation(s)
- Dan Dan Chen
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hui Zhang
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Nianqi Cui
- Nursing Department, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Leiwen Tang
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jing Shao
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Dan Wang
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Na Liu
- Thyroid&breast surgery, Chongqing Medical University Affiliated Second Hospital, Chongqing, China
| | - Zhihong Ye
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Abstract
A substantial number of neurological diseases lead to chronic impairment of activities of daily living (ADL) and physical or mental dependence. In Austria, homecare is provided mostly by female family members. Moreover, mainly female personnel, in the majority from southern and eastern European countries, contributes to care. Dependence and need for care vary between neurological diagnoses and accompanying diseases. Caregiver burden (CB) depends on patient- and caregiver-related and external factors, such as integrity of a family network, spatial resources, and socioeconomic factors. Depending on the neurological diagnosis, disease severity, and behavioral impairment and psychiatric symptoms, caregivers (CG) are at a significant risk of mental and somatic health problems because of limitations in personal needs, occupational and social obligations, financial burden, and restricted family life and leisure. Subjective and objective CB needs to be assessed in time and support should be provided on an individual basis. Recently, COVID-19 has caused additional multifactorial distress to dependent patients and informal and professional CG.
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Affiliation(s)
- Gerhard Ransmayr
- Department of Neurology II, MedCampus III, Kepler University Hospital, Johannes Kepler University, Medical Faculty, Krankenhausstraße 9, 4020, Linz, Austria.
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Clinical nutrition as part of the treatment pathway of pancreatic cancer patients: an expert consensus. Clin Transl Oncol 2021; 24:112-126. [PMID: 34363594 PMCID: PMC8732873 DOI: 10.1007/s12094-021-02674-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022]
Abstract
Purpose Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients. Methods A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients. Results The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment. Conclusions There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients.
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The Relationship between Practitioners and Caregivers during a Treatment of Palliative Care: A Grounded Theory of a Challenging Collaborative Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158081. [PMID: 34360374 PMCID: PMC8345580 DOI: 10.3390/ijerph18158081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022]
Abstract
The possibility of coming to a “good death” is a challenging issue that crosses ethical and religious beliefs, cultural assumptions, as well as medical expertise. The provision of palliative care for relieving patients’ pain is a practice that reshapes the path to the event of death and gives form to a particular context of awareness, recalling the notion proposed by Glaser and Strauss. This decision redesigns the relationships between patients, practitioners and caregivers and introduces a new pattern of collaboration between them. Our study focuses on the implications of the collaboration between practitioners and caregivers, starting from the assumption that the latter may provide support to their loved ones and to the practitioners, but need to be supported too. We provide a qualitative analysis of this collaboration based on an empirical research that took place in four different settings of provision of palliative care, reporting the contrast between the affective engagement of caregivers and the professional approach of practitioners. We claim that this ambivalent collaboration, while embedded in contingent and incommensurable experiences, brings to the fore the broader understanding of the path to a “good death,” outlining its societal representation as a collective challenge.
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Matsunuma R, Yamaguchi T, Mori M, Ikari T, Suzuki K, Matsuda Y, Matsumoto Y, Watanabe H, Amano K, Kamura R, Kizawa Y. Predictive Factors for the Development of Dyspnea Within 7 Days After Admission Among Terminally Ill Cancer Patients. Am J Hosp Palliat Care 2021; 39:413-420. [PMID: 34235973 DOI: 10.1177/10499091211028817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Predictive factors for the development of dyspnea have not been reported among terminally ill cancer patients. OBJECTIVE This current study aimed to identify the predictive factors attributed to the development of dyspnea within 7 days after admission among patients with cancer. METHODS This was a secondary analysis of a multicenter prospective observational study on the dying process among patients admitted in inpatient hospices/palliative care units. Patients were divided into 2 groups: those who developed dyspnea (development group) and those who did not (non-development group). To determine independent predictive factors, univariate and multivariate analyses using the logistic regression model were performed. RESULTS From January 2017 to December 2017, 1159 patients were included in this analysis. Univariate analysis showed that male participants, those with primary lung cancer, ascites, and Karnofsky Performance Status score (KPS) of ≤40, smokers, and benzodiazepine users were significantly higher in the development group. Multivariate analysis revealed that primary lung cancer (odds ratio [OR]: 2.80, 95% confidence interval [95% CI]: 1.47-5.31; p = 0.002), KPS score (≤40) (OR: 1.84, 95% CI: 1.02-3.31; p = 0.044), and presence of ascites (OR: 2.34, 95% CI: 1.36-4.02; p = 0.002) were independent predictive factors for the development of dyspnea. CONCLUSIONS Lung cancer, poor performance status, and ascites may be predictive factors for the development of dyspnea among terminally ill cancer patients. However, further studies should be performed to validate these findings.
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Affiliation(s)
- Ryo Matsunuma
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takashi Yamaguchi
- Division of Palliative Care, Department of Medicine, Konan Medical Center, Kobe, Japan
| | - Masanori Mori
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Tomoo Ikari
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Kozue Suzuki
- Department of Palliative Care, Tokyo Metropolitan Cancer, and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Koji Amano
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Department of Palliative and Supportive Medicine, Aichi Medical University, Graduate School of Medicine, Aichi, Japan
| | - Rena Kamura
- Yodogawa Christian Hospital, Hospice, Osaka, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Guirimand F, Bouleuc C, Sahut d'Izarn M, Martel-Samb P, Guy-Coichard C, Picard S, Devalois B, Ghadi V, Aegerter P. Development and Validation of the QUALI-PALLI-FAM Questionnaire for Assessing Relatives' Perception of Quality of Inpatient Palliative Care: A Prospective Cross-Sectional Survey. J Pain Symptom Manage 2021; 61:991-1001.e3. [PMID: 32979519 DOI: 10.1016/j.jpainsymman.2020.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 11/22/2022]
Abstract
CONTEXT Relatives of patients receiving palliative care are at risk for psychological and physical distress, and their perception of quality of care can influence patients' quality of life. OBJECTIVES The purpose of this study was to develop and validate the QUALI-PALLI-FAM questionnaire (QUAlity of PALLIative car from FAMilies' perspective) to measure families' perception of and satisfaction with palliative care. METHODS An exploratory factor analysis was conducted, and we evaluated the questionnaire's internal consistency using Cronbach's alpha, its stability across various strata, and the correlation between the QUALI-PALLI-FAM (factors, total score, and global satisfaction) and the total score of the FAMCARE (FAMily satisfaction with CARE) questionnaire. RESULTS This multicentric prospective cross-sectional survey was conducted in seven French hospitals, namely, three palliative care units and four standard medical units with a mobile palliative care team. The questionnaire was completed by 170 relatives of patients (more than 90% of patients had advanced cancer). The final questionnaire included 14 items across three domains: organization of care and availability of caregivers, medical information provision, and confidence and involvement of relatives. Internal consistency was good for all subscales (Cronbach's α = 0.74-0.86). Our questionnaire was stable across various strata: age and gender (patients and relatives), Palliative Performance Scale scores, and care settings. The QUALI-PALLI-FAM total score was correlated with the total FAMCARE score. CONCLUSION The QUALI-PALLI-FAM appears to be a valid, reliable, and well-accepted tool to explore relatives' perception of quality of inpatient palliative care and complements the QUALI-PALLI-PAT questionnaire. Further testing is required in various settings and countries.
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Affiliation(s)
- Frédéric Guirimand
- Pôle Recherche SPES 'Soins Palliatifs en Société' Maison Médicale Jeanne Garnier, Paris and Université Paris-Saclay, UVSQ, Versailles, France.
| | - Carole Bouleuc
- Institut Curie, Département interdisciplinaire des Soins de Support, Paris, France
| | - Marine Sahut d'Izarn
- AP-HP, Hôpital Ambroise Paré, Equipe Mobile de Soins Palliatifs, Boulogne, France
| | - Patricia Martel-Samb
- AP-HP, Unité de Recherche Clinique URC HU PIFO, Hôpital Ambroise Paré, Boulogne, France
| | | | - Stéphane Picard
- Groupe Hospitalier Diaconesses Croix Saint-Simon, Unité de Soins Palliatifs, Paris, France
| | - Bernard Devalois
- Centre de Recherche et d'Enseignement interprofessionnel Bientraitance et fin de vie and AGORA (EA7892) université CY Cergy Paris Université, Cergy, France
| | | | - Philippe Aegerter
- GIRCI-IDF, Cellule Méthodologie, Paris, France et Université Paris-Saclay, UVSQ, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP - Centre de recherche en Epidémiologie et Santé des Populations U1018 INSERM UPS UVSQ, 94807, Villejuif, France
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TİMUR Ö, GÜNDÜZ N, ALTAŞ H, TURAN H, KARAŞAHİN Ö, TOSUN TASAR P, BİNİCİ DN. Burden, quality of life and coping strategies of palliative care patients’ caregivers. EGE TIP DERGISI 2021. [DOI: 10.19161/etd.915677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Caregiver burden and related factors during active cancer treatment: A latent growth curve analysis. Eur J Oncol Nurs 2021; 52:101962. [PMID: 33962232 DOI: 10.1016/j.ejon.2021.101962] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/06/2021] [Accepted: 04/11/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Caregiver burden is frequently studied cross-sectionally, but longitudinal studies on family caregiver burden during active cancer treatment are lacking. The goals of this study were to characterize trajectories of caregivers' burden during a 6-month active treatment period, and to examine which predictors are associated with their burden. METHOD This study was a secondary analysis of data from a prospective study. A sample of 112 family caregivers of patients receiving cancer treatment were assessed at three time points (the initiation of new treatment regimen, 3-, and 6-month follow-up). Caregivers completed measures: Caregiver Reaction Assessment and Mutuality Scale of the Family Care Inventory. Data were analyzed using latent growth curve modeling. RESULTS The two highest burdens were subdomains related to disrupted schedule and financial problems. Models showed a decline in schedule burden over time, yet total burden and other subscales (financial problems, health problems, and lack of family support and self-esteem) remained relatively stable. In multivariate analysis, mutuality, the relationship quality between patients and caregivers was inversely related to burden at baseline. Being a spouse, a sole caregiver and lower income were related to higher burden over time. CONCLUSIONS Our findings confirmed significant determinants of caregiver burden over the course of active treatment. It is important for health care providers to be attentive to vulnerable caregivers who are at higher risk of elevated burden over time. Considering the multidimensional nature of caregiver burden, early assessment and tailored support programs may be effective by focusing on patient-caregiver relationships, caregiving roles, and income.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea; University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- National Institutes of Health, Clinical Center, Bethesda, MD, USA
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45
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Drageset S, Austrheim G, Ellingsen S. Quality of life of women living with metastatic breast cancer and receiving palliative care: A systematic review. Health Care Women Int 2021; 42:1044-1065. [PMID: 33798012 DOI: 10.1080/07399332.2021.1876063] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The quality of life (QoL) of women living with metastatic breast cancer and receiving palliative care needs more attention. We reviewed published studies (1992-2019) examining QoL of women receiving palliative care. The findings were interpreted according to the World Health Organization's (WHO) definition of palliative care. Four themes emerged: (1) the impact of medical treatment on pain relief; (2) the need for psychosocial attention and support; (3) the necessity of an interdisciplinary approach; (4) ambiguous understanding of the term palliative care. A common understanding of the term palliative care and more research is needed to enhance the QoL of women living with metastatic breast cancer.
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Affiliation(s)
- Sigrunn Drageset
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Faculty of Health Studies, VID Specialized University - Haraldsplass, Bergen, Norway
| | - Gunhild Austrheim
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sidsel Ellingsen
- Faculty of Health Studies, VID Specialized University - Haraldsplass, Bergen, Norway.,Faculty of Health Studies and Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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46
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Troschel FM, Ahndorf F, Wille LM, Brandt R, Jost J, Rekowski S, Eich HT, Stummer W, Wiewrodt R, Jetschke K, Wiewrodt D. Quality of Life in Brain Tumor Patients and Their Relatives Heavily Depends on Social Support Factors during the COVID-19 Pandemic. Cancers (Basel) 2021; 13:cancers13061276. [PMID: 33805663 PMCID: PMC7999211 DOI: 10.3390/cancers13061276] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 02/08/2023] Open
Abstract
Simple Summary The COVID-19 pandemic has been associated with increased mortality worldwide. Cancer patients are among those at enhanced risk while already suffering from decreased quality of life (QoL) due to their disease. In the present study, we investigated QoL in 100 brain tumor patients and relatives across a twelve-week timespan during the first COVID-related lockdown (04–07/2020) in detail. Compared to the general population, both patients and relatives showed significant distress, anxiety, and depression, with patients more at risk. QoL within a family—between patients and relatives—was correlated. While QoL did not change over time, acceptance of lockdown measures decreased towards the end of the study period. Finally, QoL was strongly associated with the number of weekly social contacts. These findings shed light on the psychosocial situation of a vulnerable cancer population during the COVID pandemic and indicate the need for targeted psychosocial interventions in these patients and their relatives. Abstract The COVID-19 pandemic is associated with significant morbidity, mortality, and restrictions on everyday life worldwide. This may be especially challenging for brain tumor patients given increased vulnerability due to their pre-existing condition. Here, we aimed to investigate the quality of life (QoL) in brain tumor patients and relatives in this setting. Over twelve weeks during the first wave of the pandemic (04–07/2020), brain tumor patients and their families from two large German tertiary care centers were asked to complete weekly questionnaires for anxiety, depression, distress, and well-being. Information regarding social support and living conditions was also collected. One hundred participants (63 patients, 37 relatives) completed 729 questionnaires over the course of the study. Compared to relatives, patients showed more depressive symptoms (p < 0.001) and reduced well-being (p = 0.013). While acceptance of lockdown measures decreased over time, QoL remained stable. QoL measures between patients and their families were weakly or moderately correlated. The number of social contacts was strongly associated with QoL. Age, living conditions, ongoing therapy, employment, and physical activity were other predictors. QoL is correlated between patients and their families and heavily depends on social support factors, indicating the need to focus on the entire family and their social situation for QoL interventions during the pandemic.
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Affiliation(s)
- Fabian M. Troschel
- Department of Radiation Oncology, Münster University Hospital, 48149 Münster, Germany;
- Correspondence: (F.M.T.); (D.W.)
| | - Franziska Ahndorf
- Department of Neurosurgery, Münster University Hospital, 48149 Münster, Germany; (F.A.); (L.-M.W.); (R.B.); (J.J.); (W.S.)
| | - Lisa-Marie Wille
- Department of Neurosurgery, Münster University Hospital, 48149 Münster, Germany; (F.A.); (L.-M.W.); (R.B.); (J.J.); (W.S.)
| | - Ralf Brandt
- Department of Neurosurgery, Münster University Hospital, 48149 Münster, Germany; (F.A.); (L.-M.W.); (R.B.); (J.J.); (W.S.)
| | - Johanna Jost
- Department of Neurosurgery, Münster University Hospital, 48149 Münster, Germany; (F.A.); (L.-M.W.); (R.B.); (J.J.); (W.S.)
| | - Sylvia Rekowski
- Department of Neurosurgery, University Hospital, Ruhr-Universität Bochum, 44892 Bochum, Germany; (S.R.); (K.J.)
| | - Hans Theodor Eich
- Department of Radiation Oncology, Münster University Hospital, 48149 Münster, Germany;
| | - Walter Stummer
- Department of Neurosurgery, Münster University Hospital, 48149 Münster, Germany; (F.A.); (L.-M.W.); (R.B.); (J.J.); (W.S.)
| | - Rainer Wiewrodt
- Pulmonary Division, Department of Medicine A, Münster University Hospital, 48149 Münster, Germany;
| | - Kathleen Jetschke
- Department of Neurosurgery, University Hospital, Ruhr-Universität Bochum, 44892 Bochum, Germany; (S.R.); (K.J.)
| | - Dorothee Wiewrodt
- Department of Neurosurgery, Münster University Hospital, 48149 Münster, Germany; (F.A.); (L.-M.W.); (R.B.); (J.J.); (W.S.)
- Correspondence: (F.M.T.); (D.W.)
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Barlund AS, André B, Sand K, Brenne AT. A qualitative study of bereaved family caregivers: feeling of security, facilitators and barriers for rural home care and death for persons with advanced cancer. BMC Palliat Care 2021; 20:7. [PMID: 33419428 PMCID: PMC7796575 DOI: 10.1186/s12904-020-00705-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/28/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND For cancer patients and their family, an important factor that determines the choice to die at home is the caregivers' feeling of security when caring for the patient at home. Support to caregivers from healthcare professionals is important for the feeling of security. In rural areas, long distances and variable infrastructure may influence on access to healthcare services. This study explored factors that determined the security of caregivers of patients with advanced cancer who cared for the patients at home at the end of life in the rural region of Sogn og Fjordane in Norway, and what factors that facilitated home death. METHODS A qualitative study using semi-structured in-depth interviews with bereaved with experience from caring for cancer patients at home at the end of life was performed. Meaning units were extracted from the transcribed interviews and divided into categories and subcategories using Kvale and Brinkmann's qualitative method for analysis. RESULTS Ten bereaved caregivers from nine families where recruited. Five had lived together with the deceased. Three main categories of factors contributing to security emerged from the analysis: "Personal factors", "Healthcare professionals" and "Organization" of healthcare. Healthcare professionals and the organization of healthcare services contributed most to the feeling of security. CONCLUSION Good competence in palliative care among healthcare professionals caring for patients with advanced cancer at home and well- organized palliative care services with defined responsibilities provided security to caregivers caring for advanced cancer patients at home in Sogn og Fjordane.
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Affiliation(s)
- Anne Sæle Barlund
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. .,Cancer Department, Førde Central Hospital, Førde, Norway.
| | - Beate André
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Sand
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | - Anne-Tove Brenne
- European Palliative Care Research Centre, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Bittencourt NCCDM, Santos KA, Mesquita MGDR, Silva VGD, Telles AC, Silva MMD. Sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar: uma revisão integrativa. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo identificar os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar. Método revisão integrativa nas bases LILACS, MEDLINE e CINAHL em janeiro de 2020. Perguntou-se: “Quais os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos destacados nos estudos abrangendo o contexto do domicílio?”. Foram descritores/termos: Sinais e Sintomas/Signs and Symptoms; Assistência Domiciliar/Home Care Services; Cuidados Paliativos/Palliative Care e Neoplasias/Neoplasms. Elencaram-se como critérios de elegibilidade: texto completo; entre 2015 e 2019; em inglês, português ou espanhol e idade adulta. Para o mapeamento dos dados, consideraram-se: título; país; ano; objetivo; método; sinais e sintomas. Os resultados foram categorizados em subgrupos, considerando a classificação conceitual predeterminada (sinal e sintoma). O elemento contagem facilitou a análise e a comparação de dados. Resultados foram selecionados 35 artigos, sendo identificados 25 sinais e 23 sintomas. Os mais frequentes foram: dor, náusea/vômito, dispneia, fadiga, depressão, ansiedade, constipação, perda de apetite, sonolência, bem-estar e insônia. A maioria (39) relacionou-se ao domínio físico. Conclusão a identificação dos principais sinais e sintomas, neste contexto, direciona a prática dos profissionais de saúde para as intervenções mais adequadas e o mais precocemente possível, contribuindo para viabilizar a assistência domiciliar, e alerta para a necessidade de educação permanente sobre este tema.
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Arias-Rojas M, Universidad de Antioquia, Carreño Moreno S, Sepúlveda García A, Romero Ballesteros I. Sobrecarga y calidad de vida de cuidadores de personas con cáncer en cuidados paliativos. REVISTA CUIDARTE 2021. [DOI: 10.15649/cuidarte.1248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción. El cuidador familiar experimenta en muchos casos sobrecarga relacionada con asumir el cuidado de una persona, esto a su vez puede tener implicaciones para su calidad de vida. El objetivo de este estudio fue describir las asociaciones entre el nivel de sobrecarga del cuidado y la calidad de vida de cuidadores de pacientes con cáncer en cuidados paliativos que asistían a una institución de IV nivel de la ciudad de Medellín, Colombia. Materiales y métodos. Estudio descriptivo correlacional de corte transversal desarrollado con 62 cuidadores familiares. Se aplicaron los cuestionarios de caracterización del participante, escala de sobrecarga del cuidador Zarit y calidad de vida del cuidador. Se realizaron pruebas de correlación por coeficiente de Pearson y modelo de regresión simple. Resultados. Se encontró un coeficiente de Pearson de r = -0.54 con una p < 0.0001 entre la sobrecarga y la calidad de vida; surgieron además correlaciones negativas entre todas dimensiones de calidad de vida y la sobrecarga del cuidado. Se estableció un modelo de regresión en el que la sobrecarga del cuidador (b = -0.556 IC 95% = -3.114 - -1.237) y el ser cuidador casado o en unión libre (b = 0.258 IC 95%= 0.907-52.99) son variables predictoras de la calidad de vida. Conclusiones. Existe una correlación inversa y fuerte entre la sobrecarga y la calidad de vida del cuidador familiar de la persona con cáncer en cuidados paliativos.
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50
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Cengiz Z, Turan M, Olmaz D, Erce Ç. Care Burden and Quality of Life in Family Caregivers of Palliative Care Patients. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2021; 17:50-63. [PMID: 33691608 DOI: 10.1080/15524256.2021.1888844] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This research was conducted for the purpose of examining the care burden and quality of life in family caregivers of palliative care patients. The research design was a descriptive correlational study conducted with the caregivers of 163 patients residing in palliative care units. Data were collected via a demographic survey, The Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life Assessment (WHOQOL). The results showed that there was a negative correlation between ZBI and WHOQOL scores. Further, there was a significant negative correlation between many subdimensions of the ZBI (general quality of life, general perception of health, being satisfied with daily life skills, home conditions, energy and self-satisfaction) and the WHOQOL. Quality of life thus appeared to be reduced in family members with a high level of care burden and that the quality of life of caregivers depends on the individual characteristics of the caregiver. Social workers, nurses and physicians should regularly assess the burden and quality of life of caregivers.
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Affiliation(s)
- Zeliha Cengiz
- Department of Fundamentals Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Mensure Turan
- SBU Gazi Yasargil Education And Research Hospital, Diyarbakır, Turkey
| | - Dilek Olmaz
- General Intensive Care Unit, Tunceli State Hospital, Tunceli, Turkey
| | - Çiğdem Erce
- Palliative Care Unit, Malatya Local Health Authority Malatya Training Research Hospital, Malatya, Turkey
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