Issues involved in the accrual of respondents.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to P M Koop.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Care-giving research has predominantly focused on the care-givers of those with long-term illness and the elderly. Little attention has been given to examining care-giving from the perspective of the person receiving the care, differentiating how the sex or age of the person may influence the care received, or examining care-giving in the context of shorter term situations where the patient is expected to recover. The purpose of this study was to examine the characteristics of the informal care-givers of cardiac surgery patients from three hospitals in one Canadian province and the effect of patient characteristics (sex, age) on their experience of receiving that care. A prospective, non-randomized design, was used to examine the short-term recovery from cardiac surgery of 120 subjects (60 men, 60 women). Patients were interviewed preoperatively and then at monthly intervals through the third postoperative month. The findings from this study suggest that the patterns of informal care-giving noted in the chronic care literature are also present in the short-term care of post-surgical cardiac patients. The burden of care-giving continues to rest predominantly on women. Female patients relied on their spouses for help less frequently than did male patients and their care-givers were more frequently employed outside the home and in lower status jobs than were the care-givers of male patients. 30% of care-givers were reported to have a health problem of their own to manage while caring for the recovering patient. Patients who were male or who were < 65 years of age had higher social support scores than did patients who were female or who were > or = 65 years of age. These findings suggest that the cardiac patient's sex affects the availability of home-based care. In addition, care-givers may themselves be patients in need of care. Further research is needed to examine the receipt of home-based care-giving, particularly for female patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Psychometric properties of assessment tools designed for use with English-speaking family members of advanced cancer patients in different care settings and different geographic locations were evaluated in this study. The robustness of the theoretical framework guiding the study and the factors identified with care satisfaction were also tested. Seventy-two family members drawn equally from medical hospital units, palliative care units, and home care programs in Alberta, Saskatchewan, and Manitoba participated. Instruments used included the F-Care Expectations Scale, F-Care Perceptions Scale, FAMCARE Scale, and the General Functioning Scale of the Family Assessment Device. All four tools yielded acceptable reliability estimates. Discrepancy theory predicted family care satisfaction in a highly significant manner (p < 0.0001). Family members of patients who had been diagnosed for longer than two years had more positive perceptions of palliative care than did family members of patients diagnosed for less than two years (p = 0.05). Older family members reported better family functioning than younger family members (p < 0.001). Spouses reported less discrepancy between care expectations and perceptions than did other relatives (p < 0.05).
The purpose of this paper is to review the literature on predictors of bereavement outcomes in family caregivers of persons who have died of cancer. The literature has been divided into common themes of predictors: characteristics of the deceased person, characteristics of the bereaved person, comparisons of bereaved and non-bereaved persons, well-being of the bereaved person prior to the death, prior interpersonal relationships, characteristics of the illness, characteristics of the caregiving experience, and characteristics of terminal care. A number of recurring patterns point the way to identifying persons who may be at increased risk for poor adjustment during bereavement. It is apparent that men and women express their grief somewhat differently. Whether men or women are at greater risk for poor adjustment, however, remains to be determined. There is some empirical evidence to suggest that lower socioeconomic status and linguistic barriers interfere with adjustment during bereavement. There is a dearth of culturally relevant services to help palliative-care patients and their family members make the required adjustments. The literature makes apparent the need for open awareness of the impending death and for careful and thoughtful planning for where and how the death ought to occur. The regular and frequent presence of professional caregivers contributes to family caregivers' satisfaction with care. Discrepant findings point to the need to explore the issues that underline them. Older bereaved caregivers appear to have some advantages over younger ones, but this finding is not universally found in the results of these studies. Methodological problems include small sample sizes and large variations in the particular bereavement outcomes studied.
This article reviews the published literature related to families of palliative care patients with cancer within the context of the Cancer Control Framework of the National Cancer Institute of Canada. Three themes emerged: 1) the impact of terminal cancer on the family; 2) family functioning--responses to terminal cancer; and 3) quality of palliative care from the family perspective. The most substantial body of research describes family needs, family caregiving burdens, caregiving costs and the impact of the patient's terminal cancer on the health of family members. Small samples, high nonresponse rates, selection biases and a lack of standardized outcome measures have impeded the advancement of knowledge. Method development studies are warranted, including the development of instruments to measure family care constructs. Longitudinal studies to examine the long-term impact of the patient's functional status, mood, symptom distress and quality of life on family members are needed. Research should also explore the effects of family composition, socioeconomic factors, culture and spirituality on families' experiences with terminal illness. Identification of families at risk as well as development and rigorous testing of appropriate interventions should become priorities.
Explore the source record for details and available documents.