title: Impact of caregivers' unmet needs for supportive care on quality of terminal cancer care delivered and caregiver's workforce performance.
abstract: OBJECTIVE
  Family caregivers play an important role in caring for cancer patients, but the impact of caregivers' unmet needs on the quality of end-of-life (EOL) care they deliver and on their workplace performance are less understood.
  
  
  METHODS
  We identified 1,662 family caregivers of cancer patients who had died at any of 17 hospitals in Korea during 2004. The caregivers answered a telephone questionnaire about needs that were not met when they delivered terminal cancer care and how those unmet their needs affected their workplace performance; they also answered the Quality Care Questionnaire-End of Life (QCQ-EOL).
  
  
  RESULTS
  Compared with caregivers who did not have unmet needs, caregivers who had unmet needs for symptom management, financial support, or community support showed poorer QCQ-EOL scores (P < 0.01). Caregivers who had unmet needs for financial support (adjusted odds ratio (aOR) = 7.55; 95% confidential interval (CI) 3.80-15.00), psychosocial support (aOR = 6.24; 95% CI 2.95-13.05), symptom management (aOR = 3.21; 95% CI 2.26-4.54), community support (aOR = 3.82; 95% CI 2.38-6.11), or religious support (aOR = 4.55; 95% CI 1.84-11.26) were more likely to experience work limitations. Caregivers of patients receiving conventional hospital care were more likely to have unmet needs for symptom management (aOR = 1.21; 95% CI 1.00-1.47), psychosocial support (aOR = 1.99; 95% CI 1.37-2.88), and religious support (aOR = 1.73; 95% CI 1.08-2.78) than those of patients receiving palliative hospice care.
  
  
  CONCLUSIONS
  Caregivers' unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.
authors.affiliation: National Cancer Control Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Samyong
authors.initials: S
authors.lastname: Kim
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Choi
authors.forename: Ho-Yeong
authors.initials: HY
authors.lastname: Lim
authors.forename: Youn Seon
authors.initials: YS
authors.lastname: Choi
authors.forename: Young Seon
authors.initials: YS
authors.lastname: Hong
authors.forename: Si-Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Dae Seog
authors.initials: DS
authors.lastname: Heo
authors.forename: Ki Moon
authors.initials: KM
authors.lastname: Kang
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Jeong
authors.forename: Chang Geol
authors.initials: CG
authors.lastname: Lee
authors.forename: Do Ho
authors.initials: DH
authors.lastname: Moon
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Choi
authors.forename: In Sik
authors.initials: IS
authors.lastname: Kong
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Yun
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D005260:Female; D017051:Hospice Care; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D007723:Korea; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care; D011787:Quality of Health Care; D012944:Social Support; D013727:Terminal Care