Abstract
BackgroundFamily 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.MethodsPalliative 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.ResultsOne 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 %).ConclusionsPatients’ 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 registrationCurrent Controlled Trials ISRCTN78021852, assigned on 04/04/2007
Highlights
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
The study was part of a larger project which primarily evaluated palliative continuing medical education (CME) courses for general practitioners (GPs) [15]. In this prospective observational cohort study, palliative patients cared for at home at the end of life and their family caregivers were asked to fill in short questionnaires at monthly intervals for a period of six months or until death of the patient
Ninety GPs consented to participate of which 47 GPs cared for eligible patients within the observation period
Summary
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. Caregivers support patients by giving them practical help, providing personal care, supporting them psychologically, and often taking care of medication administration [4, 5] These caring tasks in addition to having a relative at the end of life, influence caregivers physically, emotionally, and socially. Trustful and reliable relationships within their familiar and social systems are important resources for patients in palliative situations [10]. If these sources of support are exhausted palliative care at home is only possible to a limited extent
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
