Family carer support in home and hospital: a cross-sectional survey of specialised palliative care

Support given by health professionals before and after a patient's death to relatives involved in general palliative care at home in Sweden: Findings from the Swedish Register of Palliative Care

OBJECTIVES

General palliative care (PC) is provided more at home, leading to increased involvement of relatives. Although support for relatives is a fundamental component of PC, there are deficiencies in the support provided to relatives when general PC is provided at home. This study aimed to describe the support provided by health professionals before and after a patient's death to relatives involved in general PC at home.

METHODS

A cross-sectional register study was implemented, with data from the Swedish Register of Palliative care. The sample consisted of 160 completed surveys from relatives who had been involved in general PC at home, with 160 related surveys answered by health professionals. Only the questions about support to relatives were used from the surveys.

RESULTS

The findings showed that although many relatives appear to receive support in general PC at home, not all relatives receive optimal support before or after a patient's death. The findings also indicated differences in whether relatives received some support before and after a patient's death depending on the type of relative. There were also differences in responses between health professionals and relatives regarding if relatives received counseling from a doctor about whether the patient was dying.

SIGNIFICANCE OF RESULTS

There is potential for improvements regarding support for relatives, especially after a patient's death, which has been confirmed in previous studies. The differences in whether relatives received support before and after a patient's death depending on the type of relative highlight the need for future research on how to support different types of relatives before and after a patient's death when general PC is provided at home.

Support from healthcare professionals in empowering family carers to discuss advance care planning: A population-based survey

BACKGROUND

Family carers have a prominent role in end-of-life care for seriously ill persons. However, most of the Advance Care Planning literature is focused on the role of healthcare professionals.

AIMS

To investigate (1) what proportion of family carers discussed advance care planning with their relative and associated socio-demographic and clinical characteristics (2) what proportion received support from healthcare professionals for these conversations, (3) what type of support they received and (4) to what extent the type of support received was considered sufficient.

DESIGN/PARTICIPANTS

Population-based cross-sectional survey in Belgium of bereaved family carers of persons with a serious chronic illness (N = 3000) who died 2-6 months before the sample was drawn, identified through three sickness funds. The survey explored support from healthcare professionals for family carers during the last 3 months of the patient's life.

RESULTS

Response rate was 55%. The proportion of family carers that engaged in an advance care planning conversation with their relative was 46.9%. Of these family carers, 78.1% received support from a healthcare professional, mostly by doing the advance care planning conversation together (53.8%). Of family carers receiving support from a healthcare professional, 57.4% deemed the support sufficient.

CONCLUSION

Many family carers engage in advance care planning conversations with their dying relative. Healthcare professionals often support them by performing the advance care planning conversations together. More insight into how family carers can be supported to conduct these advance care planning conversations, both with and without involvement of healthcare professionals, is necessary.

Caregivers' satisfaction with cervical cancer care in Ethiopia

BACKGROUND AND PURPOSE

Cervical cancer is the second most common cancer among African women, following breast cancer. Palliative care is among the standards of care in cancer management. While caregivers play key roles in palliative care, their satisfaction with the care influences treatment outcomes and patients' quality of life. This study evaluated caregivers' satisfaction with the care provided to patients with advanced cervical cancer.

METHOD

A cross-sectional evaluation of caregivers' satisfaction with patient care was conducted at a tertiary hospital in Ethiopia. The study tool included the 20-item family satisfaction with advanced cancer care (FAMCARE) and caregiver stress index (CSI). Using binary logistic regression, we identified factors associated with caregivers' satisfaction.

RESULT

A total of 360 caregivers were interviewed. Most of the caregivers were male (58.1%), below the age of 35 years (60.8%), and educated to the high school level or less (64.4%). The average FAMCARE score was 77.7 out of the maximum 100. High satisfaction was observed among subscales "availability of treatment and care" and "psychosocial care," while low satisfaction was observed with "physical patient care" and "provision of information." Caregivers' stress and time dedicated to the caregiving were associated with caregivers' satisfaction.

CONCLUSION

Overall, high satisfaction with advanced care at the tertiary hospital was documented. However, the caregivers also bore high burden of strain. Management of caregivers' strain, prompt treatment of patients' symptoms, and provision of adequate information to the caregivers could further improve caregivers' satisfaction.

Educational needs in palliative care of Primary Health Care nurses

ABSTRACT Objectives: to understand the experience of Primary Health Care nurses with palliative care and their educational needs on the topic. Methods: an exploratory study, with a qualitative approach. The data was collected through 19 focus groups involving 181 nurses. In interpreting the results, the thematic analysis was used. Results: the knowledge presented by nurses in palliative care proved to be limited. Gaps were identified in the definition of palliative care and in the philosophical principles that guide it. The experiences described highlighted the need for continuing education regarding the definition and philosophy of palliative care, patient eligibility, integral care to the patient and the family, interpersonal communication and difficult news, performance in a multi-professional team, and end-of-life care. Final Considerations: the analysis of the perceptions of Primary Health Care nurses about palliative care can help identify the obstacles to improving the provision of this care modality.