Caregiving at the end of life: Perceptions of health care quality and quality of life among patients and caregivers

被引:76
作者
Fleming, David A.
Sheppard, Vanessa B.
Mangan, Patricia A.
Taylor, Kathryn L.
Tallarico, Michelle
Adams, Inez
Ingham, Jane
机构
[1] Georgetown Univ, Ctr Clin Bioeth, Washington, DC USA
[2] Georgetown Univ, Dept Internal Med, Washington, DC USA
[3] Georgetown Univ, Dept Oncol, Lombardi Canc Ctr, Canc Control Program, Washington, DC USA
[4] Georgetown Univ, Lombardi Canc Ctr Palliat Care Program, Washington, DC USA
关键词
end of life; health care quality; caregiver burden; cancer; trust;
D O I
10.1016/j.jpainsymman.2005.09.002
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
This studs explored the association between, perceptions of health care quality and quality of life in patients with advanced metastatic cancer and their informal caregivers (n = 39). Patients' and caregivers' perceptions of health care quality, mental health, health-related quality of life, symptoms, and burden were measured. The hey findings included the following: 1) patients' mental health and depression scores correlated with those of caregivers, suggesting that the mental health of patients and their caregivers are associated; 2) patients and caregivers shared similar perceptions regarding health care quality; 3) the presence of depression in caregivers correlated with, caregivers being less satisfied with the health care being given to their patients (this correlation did not a exist for patients, a finding that may be due in part to the protective buffering effect that caregivers provide their patients as illness progresses); and 4) a modified Primary Care Assessment Survey, originally designed for primary care patients, was a useful measure of health care assessment for both patients and caregivers. These data suggest that patients with advanced disease and, their caregivers share similar perceptions and evolve as a. "unit of care," and caregivers, as unique and important members of the patient's health care team, are also in need of care. When depressed, caregivers may unilaterally lose trust by becoming less satisfied with the quality of health acre being provided to their patients. (C) 2006 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:407 / 420
页数:14
相关论文
共 63 条
[41]   NONABANDONMENT - AN OLD OBLIGATION REVISITED [J].
PELLEGRINO, ED .
ANNALS OF INTERNAL MEDICINE, 1995, 122 (05) :377-378
[42]  
Pellegrino EdmundD., 1988, For the Patient's Good: The Restoration of Beneficence in Health Care
[43]   MENTAL AND PHYSICAL HEALTH OF CAREGIVING SPOUSES - DEVELOPMENT OF A CAUSAL MODEL [J].
PRUCHNO, RA ;
KLEBAN, MH ;
MICHAELS, JE ;
DEMPSEY, NP .
JOURNALS OF GERONTOLOGY, 1990, 45 (05) :P192-P199
[44]   NONABANDONMENT - A CENTRAL OBLIGATION FOR PHYSICIANS [J].
QUILL, TE ;
CASSEL, CK .
ANNALS OF INTERNAL MEDICINE, 1995, 122 (05) :368-374
[45]  
RADLOFF L S, 1977, Applied Psychological Measurement, V1, P385, DOI 10.1177/014662167700100306
[46]   The primary care assessment surrey - Tests of data quality and measurement performance [J].
Safran, DG ;
Kosinski, M ;
Tarlov, AR ;
Rogers, WH ;
Taira, DA ;
Lieberman, N ;
Ware, JE .
MEDICAL CARE, 1998, 36 (05) :728-739
[47]  
Safran DG, 1998, J FAM PRACTICE, V47, P213
[48]  
Safran DG, 2001, J FAM PRACTICE, V50, P130
[49]   PSYCHIATRIC AND PHYSICAL MORBIDITY EFFECTS OF CAREGIVING [J].
SCHULZ, R ;
VISINTAINER, P ;
WILLIAMSON, GM .
JOURNALS OF GERONTOLOGY, 1990, 45 (05) :P181-P191
[50]   Involvement in caregiving and adjustment to death of a spouse - Findings from the caregiver health effects study [J].
Schulz, R ;
Beach, SR ;
Lind, B ;
Martire, LM ;
Zdaniuk, B ;
Hirsch, C ;
Jackson, S ;
Burton, L .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (24) :3123-3129