Impact of caregivers' unmet needs for supportive care on quality of terminal cancer care delivered and caregiver's workforce performance.
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.
Park
Sang Min
SM
National Cancer Control Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea.
Kim
Young Jin
YJ
Kim
Samyong
S
Choi
Jong Soo
JS
Lim
Ho-Yeong
HY
Choi
Youn Seon
YS
Hong
Young Seon
YS
Kim
Si-Young
SY
Heo
Dae Seog
DS
Kang
Ki Moon
KM
Jeong
Hyun Sik
HS
Lee
Chang Geol
CG
Moon
Do Ho
DH
Choi
Jin-Young
JY
Kong
In Sik
IS
Yun
Young Ho
YH
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