title: Quality of life discordance between terminal cancer patients and family caregivers: a multicenter study.
abstract: Research studies on quality of life (QOL) discordance between cancer patients and family caregivers are limited, and the results are inconsistent. The objective of this study was to examine QOL discordance between patients and family caregivers in a hospice setting and to identify factors associated with the discordance.
  
  
  
  We enrolled 178 patient-family caregiver pairs from six tertiary hospital hospice palliative care units in South Korea in this cross-sectional study. To establish groupings based on patient and family caregiver QOL levels, we measured the QOL of patient and family caregiver pairs using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care and the Caregiver QOL Index-Cancer, respectively. Pairs were categorized into the following three groups: both good QOL pairs, only poor patient QOL, and only poor family caregiver QOL. Factors associated with only poor patient or only poor family caregiver QOL were compared to both good QOL pairs. A stepwise multivariate regression model was used to identify relevant factors.
  
  
  
  The QOL of family caregivers did not correlate significantly (P = 0.227) with QOL in terminally ill cancer patients. As well, poor emotional function in patients was the only significant factor associated with the only poor patient QOL group [adjusted odds ratio (aOR), 4.1; 95 % confidence interval (CI), 1.5-11.5]. However, emotionally distressed family caregivers (aOR, 10.2; 95 % CI, 2.8-37.5), family caregivers who professed a religion (aOR, 4.1; 95 % CI, 1.5-11.3), and family caregivers with low social support (aOR, 3.9; 95 % CI, 1.5-10.6) were independent predictors for the only poor family caregiver QOL group.
  
  
  
  Assessing the respective emotional status of both the patient and family caregiver is needed in hospice care to reduce the gap in QOL between the two groups. Further, more attention should be paid to the lack of social support for family caregivers.
authors.affiliation: Department of Palliative Medicine, Seoul St. Mary's Hospital, Catholic University College of Medicine, Seoul, Korea.
authors.forename: Yong Joo
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Youn Seon
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Family Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea. spfe0211@gmail.com.
authors.forename: In Cheol
authors.initials: IC
authors.lastname: Hwang
authors.affiliation: Department of Family Medicine, Catholic University St. Paul's Hospital, Seoul, Korea.
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Hwang
authors.affiliation: Department of Family Medicine, Ilsan Hospital, Goyang, Korea.
authors.forename: Young Sung
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Hyo Min
authors.initials: HM
authors.lastname: Kim
authors.affiliation: Department of Statistics, Dongguk University, Seoul, Korea.
authors.forename: Hong Yup
authors.initials: HY
authors.lastname: Ahn
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: So Jin
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*
keywords: Discordance; Emotional distress; Family caregiver; Quality of life; Terminal cancer
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