Caregivers of cancer patients can manage the end of life treatment decisions with the help of the support team -
Many caregivers of patients of terminal cancer suffer from depression and regret and guilt to report feeling they could have done more to eliminate the side effects and pain relief.
Thus, researchers from the School of Nursing at Case Western Reserve University designed and tested an intervention that rapidly integrates a cancer support team to guide caregivers and their patients through difficult treatment end of life decisions.
In the study, caregivers reported high levels of satisfaction to have a team consisting of an advanced practice nurse, a social worker, a spiritual counselor and the patient's oncologist explain what happening and why in the death process.
positive results to have a support team to inform and allow caregivers and patients the opportunity to think about what was important and that the measures that the disease has progressed are reported in the July issue of Oncology Nursing Forum . The National Nursing Research and the National Cancer Institute Institute (grant: NR018717) funded the study
The intervention support team are involved in end of life conversations with the patient and caregiver at the first diagnosis of. cancer at an advanced stage.
In the past, many of these conversations began late, days or weeks before the death of the patient, said Sara Douglass, PhD, RN, Associate Professor Frances Payne School Bolton Case Western Reserve Nursing and lead author.
"We owe it to patients and caregivers to start earlier and believe that through choice," said Douglas, who led the research with colleague and CWRU principal researcher, Barbara Daly, Ph.D. , RN, FAAN, professor of nursing.
The methodology
- their concept of intervention follows a larger study of 610 patients with advanced cancer and their caregivers at Case Medical Center- Cancer Seidman Center Cleveland, Ohio, between 08 and 2012.
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of this study, the researchers analyzed data from 106 caregivers with loved ones who have died of the lung, gastrointestinal or gynecological cancers . They were divided into two groups :. He that had received the support team cancer and one without additional support
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For those who have received cancer support team, a team member checked in with the monthly caregiver to answer questions and discuss the care and the patient's progress. At any time, the caregiver had concerns, the team was available.
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studied over 15 months, participants were asked about their mood and social support at enrollment, and again at three, nine and 15 months to assess whether intervention has made a difference in their moods, social support and satisfaction of end of life care. They were also interviewed after their loved died on patient care in the last week of life.
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Neither group showed changes in mood and feelings of social support. But caregivers with the cancer support team showed greater satisfaction with end of life care in five areas: pain relief, pain management, speed in processing symptoms, information on side effects and care coordination
measurable benefit to the bereaved families have had access to a comprehensive support before the death of their loved strengthens the need to include families in cancer care, Douglas said. The researchers argue support services targeting the psychosocial needs of patients and families should be incorporated as a routine adjuvant to cancer therapy directed, and that this type of team-based approach is an effective way to do it.
"The perception that loved one caregiver has been well maintained can have long term benefits in easing possible regrets that can occur after someone has died," said Douglas.
These results will be shared with the community clinical oncology.
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