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Impact of caregivers’ unmet needs for supportive care on quality of terminal cancer care delivered and caregiver’s workforce performance

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Abstract

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).

Results

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.

Conclusions

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.

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Acknowledgment

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

None disclosed.

Author information

Author notes

  1. Sang Min Park

    Present address: Department of Family Medicine, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea

Authors and Affiliations

  1. National Cancer Control Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea

    Sang Min Park, Young Jin Kim, Jin-Young Choi & Young Ho Yun

  2. Department of Population and International Health, Harvard School of Public Health, Boston, MA, USA

    Sang Min Park

  3. Department of Internal Medicine, Chungnam University Hospital, Daejeon, South Korea

    Samyong Kim

  4. Department of Internal Medicine, College of Medicine, Ulsan University, Ulsan, South Korea

    Jong Soo Choi

  5. Division of Hematology/Oncology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea

    Ho-Yeong Lim

  6. Department of Family Medicine, College of Medicine, Korea University, Seoul, South Korea

    Youn Seon Choi

  7. Department of Medicine, Kangnam St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Young Seon Hong

  8. Department of Internal Medicine, Kyunghee University Hospital, Seoul, South Korea

    Si-Young Kim

  9. Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea

    Dae Seog Heo

  10. Department of Internal Medicine, Gyeong Sang National University Hospital, Jinju, Gyeongsangnam-do, South Korea

    Ki Moon Kang

  11. Department of Internal Medicine, Sunlin Hospital, Handong University, Pohang, South Korea

    Hyun Sik Jeong

  12. Department of Radiation Oncology, College of Medicine, Yonsei University, Seoul, South Korea

    Chang Geol Lee

  13. Department of Internal Medicine, Sam Anyang Hospital, Anyang, South Korea

    Do Ho Moon

  14. Ministry of Health and Welfare, Seoul, South Korea

    In Sik Kong

  15. Division of Cancer Control, National Cancer Control Research Institute, National Cancer Center, 809 Madu-dong, Ilsan-gu, Goyang-si, Gyeonggi-do, 411-769, South Korea

    Young Ho Yun

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  1. Sang Min Park
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Correspondence to Young Ho Yun.

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Park, S.M., Kim, Y.J., Kim, S. et al. Impact of caregivers’ unmet needs for supportive care on quality of terminal cancer care delivered and caregiver’s workforce performance. Support Care Cancer 18, 699–706 (2010). https://doi.org/10.1007/s00520-009-0668-5

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