title: Longitudinal changes and predictors of caregiving burden while providing end-of-life care for terminally ill cancer patients.
abstract: BACKGROUND
  The effect of caring for a dying cancer patient on caregiving burden has been explored primarily in Western-based studies with small samples or in studies that did not follow up until the patient's death, but has not yet been investigated in Taiwan.
  
  
  OBJECTIVE
  The study's goals were (1) to identify the trajectory of caregiving burden for family caregivers (FCs) of terminally ill cancer patients in Taiwan, and (2) to investigate the determinants of caregiving burden in a large sample and with longitudinal follow-ups, until the patient's death.
  
  
  METHODS
  A prospective, longitudinal study was conducted among 193 FCs. The trajectory and determinants of caregiving burden were identified by a generalized estimation equation approach.
  
  
  RESULTS
  Caregiving burden did not change as the patient's death approached. FCs experienced heavy caregiving burden when their relative suffered from greater symptom distress or if they were spousal caregivers; provided high intensity of assistance to the patient while spending fewer hours providing care; reported financial insufficiency; or had lower social support, fewer psychological resources, or less confidence in caregiving.
  
  
  CONCLUSIONS
  Taiwanese family caregivers' carry moderate caregiving burden which did not change significantly as the patients' death approached. The effects of caregiving burden while providing EOL care to terminally ill cancer patients may be tempered substantially by enhancing family caregivers caregiving confidence, social support, and psychological resources.
authors.affiliation: School of Nursing, China Medical University and China Medical University Hospital, Taichung, Taiwan.
authors.forename: Kwo C
authors.initials: KC
authors.lastname: Lee
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Chang
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chou
authors.forename: Po-Jung
authors.initials: PJ
authors.lastname: Su
authors.forename: Chia-Hsun
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Jen-Shi
authors.initials: JS
authors.lastname: Chen
authors.forename: Siew Tzuh
authors.initials: ST
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000473:pathology; D011446:Prospective Studies; D013624:Taiwan; D013727:Terminal Care; D055815:Young Adult
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