Impact of caregivers’ unmet needs for supportive care on quality of terminal cancer care delivered and caregiver’s workforce performance
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Goals of work
Family caregivers play an important role in caring for cancer patients, but the impact of caregivers’ unmet needs on the quality of end-of-life (EOL) care they deliver and on their workplace performance are less understood.
Patients and methods
We identified 1,662 family caregivers of cancer patients who had died at any of 17 hospitals in Korea during 2004. The caregivers answered a telephone questionnaire about needs that were not met when they delivered terminal cancer care and how those unmet their needs affected their workplace performance; they also answered the Quality Care Questionnaire-End of Life (QCQ-EOL).
Compared with caregivers who did not have unmet needs, caregivers who had unmet needs for symptom management, financial support, or community support showed poorer QCQ-EOL scores (P < 0.01). Caregivers who had unmet needs for financial support (adjusted odds ratio (aOR) = 7.55; 95% confidential interval (CI) 3.80–15.00), psychosocial support (aOR = 6.24; 95% CI 2.95–13.05), symptom management (aOR = 3.21; 95% CI 2.26–4.54), community support (aOR = 3.82; 95% CI 2.38–6.11), or religious support (aOR = 4.55; 95% CI 1.84–11.26) were more likely to experience work limitations. Caregivers of patients receiving conventional hospital care were more likely to have unmet needs for symptom management (aOR = 1.21; 95% CI 1.00–1.47), psychosocial support (aOR = 1.99; 95% CI 1.37–2.88), and religious support (aOR = 1.73; 95% CI 1.08–2.78) than those of patients receiving palliative hospice care.
Caregivers’ unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.
KeywordsCaregivers Terminal cancer care Workforce performance Unmet need
This work was supported partially by the 2005 Korean National Cancer Control Program by the Ministry of Health and Welfare, Korea, partially by Grant No. 0710730-1 from the National Cancer Center, Korea, and partially by Takemi program in international health at Harvard School of Public Health. We thank Michael R. Reich and Marc Mitchell for their cooperation and assistance.
Potential financial conflicts of interest
- 9.Deeken JF, Taylor KL, Mangan P, Yabroff KR, Ingham JM (2003) Care for the caregivers: a review of self-report instruments developed to measure the burden, needs, and quality of life of informal caregivers. J Pain Symptom Manage 26:922–953. doi: 10.1016/S0885-3924(03)00327-0 CrossRefPubMedGoogle Scholar
- 13.International Agency for Research on Cancer (2002) Cancer incidence in five continents. IARC, LyonsGoogle Scholar
- 14.National Cancer Institute Surveillance, epidemiology, and end results (SEER). http://www.seer.cancer.gov
- 15.National Statistical Office Korea (2005) 2004 Annual report on the cause of death statistics (based on vital registration). National Statistical Office, SeoulGoogle Scholar
- 17.Stommel M, Given CW, Given BA (1993) The cost of cancer home care to families. Cancer 71:1867–1874. doi: 10.1002/1097-0142(19930301)71:5<1867::AID-CNCR2820710525>3.0.CO;2-7 CrossRefPubMedGoogle Scholar
- 25.Yun YH, Rhee YS, Nam SY et al (2004) Public attitudes toward dying with dignity and hospice, palliative care. Korean Soc Hospice Palliat Care 7:17–28Google Scholar
- 26.Korea National Statistical Office (1992–2008) Annual report on the cause of death statistics. National Statistical Office, SeoulGoogle Scholar