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Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study

BACKGROUND: Family caregivers play a key role in palliative care at home, and understanding the interdependencies in the constellation of patient, family caregivers and service providers is important. As few longitudinal studies have examined the influence of patient quality of life (QoL) in palliat...

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Autores principales: Krug, Katja, Miksch, Antje, Peters-Klimm, Frank, Engeser, Peter, Szecsenyi, Joachim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714452/
https://www.ncbi.nlm.nih.gov/pubmed/26767785
http://dx.doi.org/10.1186/s12904-016-0082-y
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author Krug, Katja
Miksch, Antje
Peters-Klimm, Frank
Engeser, Peter
Szecsenyi, Joachim
author_facet Krug, Katja
Miksch, Antje
Peters-Klimm, Frank
Engeser, Peter
Szecsenyi, Joachim
author_sort Krug, Katja
collection PubMed
description BACKGROUND: Family caregivers play a key role in palliative care at home, and understanding the interdependencies in the constellation of patient, family caregivers and service providers is important. As few longitudinal studies have examined the influence of patient quality of life (QoL) in palliative care on burden of family caregivers, the aim of this study was to identify correlations between changing patient QoL and changing burden of family caregivers that need consideration in patient management. METHODS: Palliative patients with cancer in primary care evaluated their QoL (Quality of Life Questionnaire Core 15 Palliative Care, QLQ-C15-PAL). They were assessed monthly for an interval of 6 months or until death of the patient. Family caregivers reported the burden they perceived while supporting the patient (Short form of the Burden Scale for Family Caregivers, BSFC). Longitudinal data were analysed for all patients with at least 3 available assessments, considering the most recent data for participants with more than 3 assessments. Changes in patient QoL were analysed using the Friedman test. In a stepwise regression analysis, influences of change in patient QoL on changing caregiver burden were investigated. RESULTS: One hundred patients (63 men, 37 women; average age: 68 years) were enrolled in the study. The most common primary diagnoses were colon, lung or breast cancer. In 58 cases, assessments were available from both patients and caregivers. Patients reported overall quality of life increasing towards end of life, although reporting that physical functioning deteriorated. Symptoms of pain and fatigue bothered patients most. Caregiver burden was moderate and on average did not change over time. In a stepwise regression model, the difference in emotional functioning and the difference in dyspnoea showed an influence on the development of caregiver burden (explained variance of 19.3 %). CONCLUSIONS: Patients’ dyspnoea, feelings of depression and anxiety impacted on the perceived burden of family caregivers, but are manageable symptoms. Our results corroborate the need of regular assessment of patients’ needs taking into account caregiver burden. In this way, general practice teams can intervene early and may more likely meet patients’ needs in the end of life care process. TRIAL REGISTRATION: Current Controlled Trials ISRCTN78021852, assigned on 04/04/2007
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spelling pubmed-47144522016-01-16 Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study Krug, Katja Miksch, Antje Peters-Klimm, Frank Engeser, Peter Szecsenyi, Joachim BMC Palliat Care Research Article BACKGROUND: Family caregivers play a key role in palliative care at home, and understanding the interdependencies in the constellation of patient, family caregivers and service providers is important. As few longitudinal studies have examined the influence of patient quality of life (QoL) in palliative care on burden of family caregivers, the aim of this study was to identify correlations between changing patient QoL and changing burden of family caregivers that need consideration in patient management. METHODS: Palliative patients with cancer in primary care evaluated their QoL (Quality of Life Questionnaire Core 15 Palliative Care, QLQ-C15-PAL). They were assessed monthly for an interval of 6 months or until death of the patient. Family caregivers reported the burden they perceived while supporting the patient (Short form of the Burden Scale for Family Caregivers, BSFC). Longitudinal data were analysed for all patients with at least 3 available assessments, considering the most recent data for participants with more than 3 assessments. Changes in patient QoL were analysed using the Friedman test. In a stepwise regression analysis, influences of change in patient QoL on changing caregiver burden were investigated. RESULTS: One hundred patients (63 men, 37 women; average age: 68 years) were enrolled in the study. The most common primary diagnoses were colon, lung or breast cancer. In 58 cases, assessments were available from both patients and caregivers. Patients reported overall quality of life increasing towards end of life, although reporting that physical functioning deteriorated. Symptoms of pain and fatigue bothered patients most. Caregiver burden was moderate and on average did not change over time. In a stepwise regression model, the difference in emotional functioning and the difference in dyspnoea showed an influence on the development of caregiver burden (explained variance of 19.3 %). CONCLUSIONS: Patients’ dyspnoea, feelings of depression and anxiety impacted on the perceived burden of family caregivers, but are manageable symptoms. Our results corroborate the need of regular assessment of patients’ needs taking into account caregiver burden. In this way, general practice teams can intervene early and may more likely meet patients’ needs in the end of life care process. TRIAL REGISTRATION: Current Controlled Trials ISRCTN78021852, assigned on 04/04/2007 BioMed Central 2016-01-15 /pmc/articles/PMC4714452/ /pubmed/26767785 http://dx.doi.org/10.1186/s12904-016-0082-y Text en © Krug et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Krug, Katja
Miksch, Antje
Peters-Klimm, Frank
Engeser, Peter
Szecsenyi, Joachim
Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
title Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
title_full Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
title_fullStr Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
title_full_unstemmed Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
title_short Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
title_sort correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714452/
https://www.ncbi.nlm.nih.gov/pubmed/26767785
http://dx.doi.org/10.1186/s12904-016-0082-y
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