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Vrettos I, Voukelatou P, Kyvetos A, Makrilakis K, Sfikakis PP, Raptis A, Niakas D. The role of frailty among the predictors of depression on informal caregivers of older adults: a mediation analysis. Psychogeriatrics 2023; 23:973-984. [PMID: 37704194 DOI: 10.1111/psyg.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Providing care for older adults has been associated with the presence of depressive symptoms among their informal caregivers. Numerous caregivers and older adults' characteristics have been mentioned as predictors of caregivers' depression. However, studies dealing with the impact of older adults' frailty status on caregivers' depression are scarce. This study was conducted to clarify the precise relationship between caregivers' depression, caregivers' burden, caregivers' characteristics and patients' characteristics, including frailty, among the variables that may have an impact on caregivers' depression. METHODS In this cross-sectional study, patients and caregivers' characteristics were recorded for 311 patient-caregiver dyads, when the patient was admitted to the hospital. For the purpose of the study, a mediation analysis was used with patients and caregiver characteristics considered to be predictors, subjective caregivers' burden as the mediator, and caregivers' depression as the outcome variable. RESULTS Only patients' frailty and caregivers' subjective burden had a direct effect on caregivers' depression. Moreover, caregivers' gender, patients' frailty status and comorbidity, duration of caregiving, and the relationship with the patient, had an indirect effect through caregivers' burden that acted as mediator. Regarding total effects, caregivers burden followed by patients' frailty status had the greater impact on caregivers' depression. CONCLUSIONS By organising interventions to reduce caregivers' depression, patients' frailty status could be among the targets of those interventions considering that frailty might be delayed or reversed.
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Affiliation(s)
- Ioannis Vrettos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece
| | - Panagiota Voukelatou
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece
| | - Andreas Kyvetos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia 'Agioi Anargyroi', Athens, Greece
| | - Konstantinos Makrilakis
- 1st Department of Propedeutic Internal Medicine, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- 1st Department of Propedeutic Internal Medicine-Rheumatology Unit, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Raptis
- 2nd Department of Propedeutic Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Niakas
- Department of Health Economics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
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Ma J, Yang H, Hu W, Khan HTA. Spousal Care Intensity, Socioeconomic Status, and Depression among the Older Caregivers in China: A Study on 2011–2018 CHARLS Panel Data. Healthcare (Basel) 2022; 10:healthcare10020239. [PMID: 35206854 PMCID: PMC8872002 DOI: 10.3390/healthcare10020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 02/04/2023] Open
Abstract
Using the stress process model and data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS), this study examined the effect of spousal caregiving intensity on the depression level of older caregivers in China. The moderating role that socioeconomic status plays in the relationship between spouses was explored by constructing multilevel growth models (MGMs). The care intensity for a spouse was found to relate to significantly increased depression levels in older caregivers, while the degree of disability of the spouse being cared for (B = 0.200, p < 0.001) having a greater effect on depression than the duration of care (B = 0.007, p < 0.01). There was a threshold effect where the provision of more than 10 h of care per week for a spouse (B = 0.931, p < 0.001; B = 0.970; p < 0.01) or caring for a disabled spouse with limited ADLs (B = 0.709, p < 0.01; B = 1.326; p < 0.001; B = 1.469, p < 0.01) increased depression in older caregivers. There were moderating influences, including higher professional prestige before retirement (B = −0.006, p < 0.05) and higher annual family income (B = −0.037, p < 0.10), that increased depression related to the spouse’s degree of disability. It was considered that active familism measures should be formulated for older spousal caregivers, especially those with lower socioeconomic status.
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Affiliation(s)
- Jun Ma
- Center for Social Security Studies, Wuhan University, Wuhan 430072, China;
| | - Hongyan Yang
- Center for Social Security Studies, Wuhan University, Wuhan 430072, China;
- Correspondence:
| | - Wenxiu Hu
- Center for Population and Development Policy Studies, Fudan University, Shanghai 200433, China;
- Postdoctoral Research Workstation, China Everbright Group, Beijing 100033, China
| | - Hafiz T. A. Khan
- Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, Brentford, London TW8 9GB, UK;
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Psychometric Evaluation of the Caring Ability of Family Caregivers of Patients With Cancer Scale-Mothers' Version for the Mothers of Children With Cancer. Cancer Nurs 2020; 45:E179-E186. [PMID: 33136613 DOI: 10.1097/ncc.0000000000000902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The experience of caring for cancer patients has adverse outcomes for family caregivers. The ability to care for a sick child is affected by the mother's health; to empower mothers, it will be necessary to examine their caring ability. OBJECTIVE The aim of this study was to carry out a psychometric evaluation of the Caring Ability of Family Caregivers of Patients With Cancer Scale-Mothers' Version (CAFCPCS-Mothers' Version). METHODS The present study is a psychometric evaluation of the CAFCPCS-Mothers' Version. The sample consisted of 196 mothers of children in treatment for cancer selected through convenience sampling. The face, content and construct validity, internal consistency, and stability of the scale were measured. Data were analyzed using the software SPSS 19 and LISREL 8.8. RESULTS After removing 2 items during confirmatory factor analysis, the values of root-mean-square error of approximation, comparative fit index, and nonnormed fit index were reported to be 0.066, 0.92, and 0.91, respectively. The Cronbach's α was calculated to be 0.71 and the stability correlation coefficient was 0.75. The final tested scale included 29 items in 5 dimensions: effective role play, fatigue and surrender, trust, uncertainty, and caring ignorance for mothers of children with cancer. CONCLUSION The CAFCPCS-Mothers' Version has satisfactory content, face, and construct validity and adequate reliability in terms of internal consistency and stability in a sample of mothers of children receiving treatment for cancer. IMPLICATION FOR PRACTICE The CAFCPCS-Mothers' Version can be used to assess the caring ability of Iranian mothers of children with cancer and to determine maternal care needs.
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Stajduhar KI. Examining the Perspectives of Family Members Involved in the Delivery of Palliative Care at Home. J Palliat Care 2019. [DOI: 10.1177/082585970301900106] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This ethnographic study examined the social context of home-based palliative caregiving. Data were composed of observation field notes, interviews, and textual documents, and were analyzed using constant comparative methods. Findings show that home-based palliative caregiving resulted in life-enriching experiences for many caregivers. However, assumptions about dying at home and health care reforms resulted in some caregivers feeling “pressured” to provide home care, and consequently, left them feeling their obligations to care were exploited by the health care system. Shifts toward providing care closer to home not only changed caregivers, but also changed the home setting where palliative care was provided. Findings indicate a need for interventions designed to improve support for caregivers at home, and to explore how assumptions influence and sometimes drive the provision of home health care.
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Affiliation(s)
- Kelli I. Stajduhar
- Centre on Aging, University of Victoria, and Vancouver Island Health Authority, Victoria, British Columbia, Canada
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Demiris G, Oliver DRP, Courtney KL, Porock D. Use of Technology as a Support Mechanism for Caregivers of Hospice Patients. J Palliat Care 2019. [DOI: 10.1177/082585970502100411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- George Demiris
- School of Medicine, University of Missouri-Columbia, Columbia, Missouri, USA
| | | | - Karen L Courtney
- School of Medicine, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Davina Porock
- School of Nursing, University of Nottingham, Nottingham, UK
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Fineberg IC. Social work perspectives on family communication and family conferences in palliative care. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/096992610x12624290277105] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Currow DC, Easterbrook S, Mattes R. Improving choices for community palliative care: a prospective 2-year pilot of a live-in support person. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/096992605x75877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Devlin M, McIlfatrick S. Providing palliative and end-of-life care in the community: the role of the home-care worker. Int J Palliat Nurs 2010; 16:195-203. [DOI: 10.12968/ijpn.2010.16.4.47786] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Margaret Devlin
- Northern Health and Social Care Trust, Diamond Medical Centre, Magherafelt
| | - Sonja McIlfatrick
- Northern Health and Social Care Trust/Reader, Institute of Nursing Research, University of Ulster, Shore Road, Newtownabbey, Northen Ireland
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Devlin M, McIlfatrick S. The role of the home-care worker in palliative and end-of-life care in the community setting: a literature review. Int J Palliat Nurs 2009; 15:526-32. [DOI: 10.12968/ijpn.2009.15.11.45491] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Margaret Devlin
- Northern Health and Social Care Trust Diamond Medical Centre, Magherafelt, Belfast
| | - Sonja McIlfatrick
- Northern Health and Social Care Trust
- University of Ulster, Shore Road, Newtownabbey, University of Ulster, Northern Ireland
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Bektas HA, Ozer ZC. Reliability and validity of the caregiver quality of life index-cancer (CQOLC) scale in Turkish cancer caregivers. J Clin Nurs 2009; 18:3003-12. [DOI: 10.1111/j.1365-2702.2009.02915.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A conceptual framework of outcomes for caregivers of assistive technology users. Am J Phys Med Rehabil 2009; 88:645-55; quiz 656-8, 691. [PMID: 19620830 DOI: 10.1097/phm.0b013e3181ae0e70] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To develop and validate the content of a conceptual framework concerning outcomes for caregivers whose recipients are assistive technology users. DESIGN The study was designed in four stages. First, a list of potential key variables relevant to the caregivers of assistive technology users was generated from a review of the existing literature and semistructured interviews with caregivers. Second, the variables were analyzed, regrouped, and partitioned, using a conceptual mapping approach. Third, the key areas were anchored in a general stress model of caregiving. Finally, the judgments of rehabilitation experts were used to evaluate the conceptual framework. RESULTS An important result of this study is the identification of a complex set of variables that need to be considered when examining the experience of caregivers of assistive technology users. Stressors, such as types of assistance, number of tasks, and physical effort, are predominant contributors to caregiver outcomes along with caregivers' personal resources acting as mediating factors (intervening variables) and assistive technology acting as a key moderating factor (effect modifier variable). CONCLUSIONS Recipients' use of assistive technology can enhance caregivers' well being because of its potential for alleviating a number of stressors associated with caregiving. Viewed as a whole, this work demonstrates that the assistive technology experience of caregivers has many facets that merit the attention of outcomes researchers.
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Demiris G, Oliver DP, Wittenberg-Lyles E. Assessing caregivers for team interventions (ACT): a new paradigm for comprehensive hospice quality care. Am J Hosp Palliat Care 2008; 26:128-34. [PMID: 19116302 DOI: 10.1177/1049909108328697] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article provides a framework labeled ACT that aims to successfully integrate family caregivers and patients into one unit of care, as dictated by the hospice philosophy. ACT (assessing caregivers for team interventions) is based on the ongoing assessment of the caregiver background context, primary, secondary, and intrapsychic stressors as well as outcomes of the caregiving experience and subsequently, the design and delivery of appropriate interventions to be delivered by the hospice interdisciplinary team. Interventions have to be tailored to a caregiver's individual needs; such a comprehensive needs assessment allows teams to customize interventions recognizing that most needs and challenges cannot be met by only one health care professional or only one discipline. The proposed model ensures a holistic approach to address the multifaceted challenges of the caregiving experience.
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Affiliation(s)
- George Demiris
- School of Nursing, University of Washington, Seattle, WA 98195, USA.
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Distress and quality of life concerns of family caregivers of patients undergoing palliative surgery. Cancer Nurs 2008; 31:2-10. [PMID: 18176125 DOI: 10.1097/01.ncc.0000305682.13766.c2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There has been limited research in the field of palliative care and even far less focus on the area of palliative surgery. Although patient needs are paramount, family caregivers require information and support at the time surrounding surgery for advanced disease. The aim of this prospective cohort study of family caregivers of patients with advanced malignancies was to measure the impact of palliative surgery on dimensions of quality of life (QOL) for these family members. Family caregivers completed assessment tools preoperatively and at approximately 3 weeks and 2 and 3 months postoperatively. Parameters of physical, psychological, social, and spiritual QOL were measured on a scale of 0 (poor) to 10 (good) using the City of Hope QOL-Family instrument. Caregivers recorded their general distress on the Distress Thermometer using a scale of 0 (none) to 10 (severe). Analysis of the data revealed that family caregivers had disruptions similar to patients in physical, psychological, social, and spiritual dimensions of QOL. Findings suggest that caregivers should be assessed for distress and QOL concerns both before and after surgery for patients with advanced malignancies. Although caregiver concerns cannot always be eradicated, resources and interventions to support family caregivers are vital to improving QOL.
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Doorenbos AZ, Given B, Given CW, Wyatt G, Gift A, Rahbar M, Jeon S. The influence of end-of-life cancer care on caregivers. Res Nurs Health 2007; 30:270-81. [PMID: 17514724 DOI: 10.1002/nur.20217] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The purpose of this secondary analysis was to glean from prospective data whether those caring for elderly family members recently diagnosed with cancer who ultimately died reported different caregiver depressive symptomatology and burden than caregivers of those who survived. Findings from interviews with 618 caregivers revealed that caregiver depressive symptomatology differed based on family members' survival status, and spousal caregivers experienced greater burden when a family member was near death than did non-spousal caregivers. Family member symptoms and limitations in daily living, as well as caregiver health status, age, and employment, were associated with caregiver depressive symptomatology and burden; however, these associations had no interaction with family member survival status.
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Affiliation(s)
- Ardith Z Doorenbos
- Department of Behavioral Nursing and Health System, School of Nursing, University of Washington, Seattle, WA 98195, USA
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Milberg A, Strang P. What to do when ‘there is nothing more to do’? A study within a salutogenic framework of family members' experience of palliative home care staff. Psychooncology 2007; 16:741-51. [PMID: 17106866 DOI: 10.1002/pon.1124] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of this study was to develop a theoretical framework of family members' experience of palliative home care staff based on a secondary analysis of four previous studies. A salutogenic framework was used, i.e. with the origin of health in focus. Data had been collected (semi-structured tape-recorded interviews and postal questionnaires with open-ended questions) from 469 family members of mainly cancer patients referred to advanced palliative home care. Walker and Avant's strategies for theory construction were used. The secondary analysis generated three theoretical blocks: (1) general components of staff input (including five generalized resistance resources (GRRs): competence, support, spectrum of services, continuity, and accessibility); (2) specific interactions with staff (including two GRRs: being in the centre and sharing caring); (3) emotional and existential consequences of staff support (including six health-disease continuums: security-insecurity, hope-hopelessness, congruent inner reality-chaos, togetherness-isolation, self-transcendence-feelings of insufficiency and retained everyday life-disrupted everyday life). It seems important that all three aspects of family members' experience of palliative care staff are to be considered in evaluations of palliative care, in goal-setting and in teaching role models. The study is specific to the Swedish model of palliative home care and replication of the work in other countries is recommended.
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Affiliation(s)
- A Milberg
- Department of Society and Welfare Studies, Linköping University and Unit of Advanced Palliative Home Care, University Hospital, Linköping, Sweden.
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Cooper B, Kinsella GJ, Picton C. Development and initial validation of a family appraisal of caregiving questionnaire for palliative care. Psychooncology 2006; 15:613-22. [PMID: 16287207 DOI: 10.1002/pon.1001] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This article describes the derivation and initial psychometric validation of a multi-dimensional Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). The 25-item measure consists of four theoretically derived subscales: (i) caregiver strain, (ii) positive caregiving appraisals, (iii) caregiver distress, and (iv) family well-being. Based on a sample of 160 family caregivers of a relative with cancer receiving palliative care, reliability analyses demonstrated the subscale scores to be internally consistent and factor analysis revealed evidence of factorial validity. Correlations of the four subscales with measures of family functioning, positive and negative affect, and subjective burden provided evidence of convergent and discriminant validity. The FACQ-PC provides a measure of the family's appraisal of caregiving that can be used in clinical assessment, and has potential utility for evaluating the effectiveness of palliative care interventions.
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Hudson P. A conceptual model and key variables for guiding supportive interventions for family caregivers of people receiving palliative care. Palliat Support Care 2006; 1:353-65. [PMID: 16594225 DOI: 10.1017/s1478951503030426] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
According to the World Health Organization, the patient and family should be viewed as the "unit of care" when palliative care is required. Therefore family caregivers should receive optimal supportive care from health professionals. However, the impact of supporting a dying relative is frequently described as having negative physical and psychosocial sequalae. Furthermore, family caregivers consistently report unmet needs and there has been a dearth of rigorous supportive interventions published. In addition, comprehensive conceptual frameworks to navigate the family caregiver experience and guide intervention development are lacking. This article draws on Lazarus and Folkman's seminal work on the transactional stress and coping framework to present a conceptual model specific to family caregivers of patients receiving palliative care. A comprehensive account of key variables to aid understanding of the family caregiver experience and intervention design is provided.
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Affiliation(s)
- Peter Hudson
- School of Nursing and Centre for Palliative Care, University of Melbourne, Carlton, Victoria, Australia.
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Fineberg IC. Preparing professionals for family conferences in palliative care: evaluation results of an interdisciplinary approach. J Palliat Med 2005; 8:857-66. [PMID: 16128661 DOI: 10.1089/jpm.2005.8.857] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Patients, families, and health care professionals recognize the need for better communication in palliative and end-of-life care. Family conferences are a powerful clinical tool for communicating with patients and family members. Although family conferences are often used in medical care, few clinicians are prepared to conduct them effectively. An innovative palliative care educational model that included specific attention to family conferences was developed and evaluated. To intervene early in the process of professional socialization, the interactive and interdisciplinary training included medical and social work students. METHOD A quasi-experimental longitudinal design was employed to evaluate the educational intervention. Survey measures were administered before, immediately after, and three months after training. Questions addressed experience, education, and attitudes about family conferences. A standardized scale was used to measure change in students' confidence in their ability to lead family conferences. RESULTS For both professions, the intervention group demonstrated a significant increase in confidence in the ability to lead family conferences compared with the control group. Three-month follow-up data suggested that subjects in the intervention group maintained these gains. CONCLUSION This pilot intervention showed that an interdisciplinary educational approach improves confidence in the ability to lead family conferences when students are exposed early in the process of professional socialization. Early intervention increases the propensity and skills needed to conduct family conferences and advances communication in palliative care. Future research on interdisciplinary education should evaluate effects on clinical practice behaviors, satisfaction with communication and collaboration, and patients' and families' perceptions of quality of care.
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Affiliation(s)
- Iris Cohen Fineberg
- Division of General Internal Medicine and Health Services Research, University of California-Los Angeles, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA.
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Hudson PL, Aranda S, Hayman-White K. A psycho-educational intervention for family caregivers of patients receiving palliative care: a randomized controlled trial. J Pain Symptom Manage 2005; 30:329-41. [PMID: 16256897 DOI: 10.1016/j.jpainsymman.2005.04.006] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2005] [Indexed: 11/19/2022]
Abstract
This study describes an evaluation of a psycho-educational intervention for family caregivers of patients dying of cancer at home. In a randomized controlled trial, participants (n = 106) received standard home-based palliative care services (n = 52) or these services plus the new intervention (n = 54). Data were collected at three time points: upon commencement of home-based palliative care (Time 1), five weeks later (Time 2), and then eight weeks following patient death (Time 3). No intervention effects were identified with respect to preparedness to care, self-efficacy, competence, and anxiety. However, participants who received the intervention reported a significantly more positive caregiver experience than those who received standard care at both Times 2 and 3. The findings indicate that it is possible to increase caregiver rewards despite being immersed in challenging circumstances that often yield considerable negative psychosocial sequelae. Furthermore, it is feasible for health professionals to discuss emotive topics, such as impending death, with caregivers without adverse effects.
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Affiliation(s)
- Peter L Hudson
- Center for Palliative Care, School of Nursing, University of Melbourne, Australia
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Brandsen CK. Social work and end-of-life care: reviewing the past and moving forward. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2005; 1:45-70. [PMID: 17387063 DOI: 10.1300/j457v01n02_05] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This paper reviews the professional literature with respect to the social work profession's involvement in end-of-life care. The search process was conducted by entering key words in various combinations to electronic databases. Eligible articles were required to address one of the following: roles and activities of social workers in providing end-of-life care; core principles valued by social workers in the provision of end-of-life care; and barriers to provision of effective end-of-life care. The literature from 1990 through July 2004 was searched most rigorously. Based on this review, suggestions for where the profession of social work should focus its energies are offered. These key areas include focusing on generating empirically-based knowledge for practice and policy analysis and developing a system of social work education that addresses the unique knowledge and skills needed to participate in end-of-life practice as competent and informed professional practitioners. Current initiatives with regard to critical areas are summarized.
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Affiliation(s)
- Cheryl K Brandsen
- Department of Sociology and Social Work, Calvin College, 3201 Burton SE, Grand Rapids, MI, USA
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Hudson PL, Aranda S, Kristjanson LJ. Meeting the supportive needs of family caregivers in palliative care: challenges for health professionals. J Palliat Med 2004; 7:19-25. [PMID: 15008126 DOI: 10.1089/109662104322737214] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Caring for a dying relative is demanding, and family caregivers have acknowledged many unmet needs associated with their caregiver role. Consistently, caregivers of dying patients with cancer have reported that they need more support and information from health care professionals. Moreover, a number of palliative care clinicians and researchers have called for interventions to enhance the support offered to family caregivers. However, before researchers can develop and test palliative care interventions directed to families, it is important to identify barriers that may confront health care professionals with regard to the provision of supportive family care. For new interventions to be feasible they must be applicable within the constraints of current palliative care service delivery environments. This paper provides an account of issues that may impinge on optimal transference of supportive strategies from health care professionals to family caregivers of patients receiving palliative care. By acknowledging these barriers to supportive care, researchers and health care professionals can begin to design and implement interventions that are clinically relevant and more likely to be effective.
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Affiliation(s)
- Peter L Hudson
- School of Nursing and Centre for Palliative Care, University of Melbourne, Victoria, Australia.
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