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Caregiver unmet needs, burden, and satisfaction in symptomatic advanced cancer patients at a Veterans Affairs (VA) medical center

Published online by Cambridge University Press:  01 December 2003

SHIRLEY S. HWANG ,
VICTOR T. CHANG ,
YVETTE ALEJANDRO ,
PAMELA OSENENKO ,
CASAUNDRA DAVIS ,
JANET COGSWELL ,
SHANTHI SRINIVAS  and
BASIL KASIMIS
SHIRLEY S. HWANG
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey Patient Care Services, VA New Jersey Health Care System, East Orange, New Jersey University of Medicine and Dentistry of New Jersey/School of Nursing, Newark, New Jersey
VICTOR T. CHANG
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, New Jersey
YVETTE ALEJANDRO
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey Patient Care Services, VA New Jersey Health Care System, East Orange, New Jersey
PAMELA OSENENKO
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey Patient Care Services, VA New Jersey Health Care System, East Orange, New Jersey
CASAUNDRA DAVIS
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey Patient Care Services, VA New Jersey Health Care System, East Orange, New Jersey
JANET COGSWELL
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey Patient Care Services, VA New Jersey Health Care System, East Orange, New Jersey
SHANTHI SRINIVAS
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, New Jersey
BASIL KASIMIS
Affiliation:
Section of Hematology/Oncology, VA New Jersey Health Care System, East Orange, New Jersey University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, New Jersey
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Abstract

Objectives: Caregiver outcomes among those caring for symptomatic advanced cancer patients at VA Medical Centers have not been well reported. The purposes of this study were (1) to identify the caregiver characteristics and their unmet needs; (2) to examine the association between caregiver unmet needs, caregiver burden, and caregiver satisfaction; and (3) to identify the independent predictors of different caregiver outcomes.

Methods: One hundred caregivers completed three caregiver outcomes instruments: Family Inventory of Needs (FIN), Care Strain Index (CSI), and Family Satisfaction with Advanced Cancer Care (FAMCARE). The caregivers' demographics and their function, depression, health status, and social support status as well as the caregivers' perception of the patients' unmet needs (PPUN) were obtained. Principal component analysis was performed to examine the underlying dimensions of caregiver outcome measures. Pearson correlation and stepwise multivariate regression analyses were performed.

Results: The median number of unmet needs was 2 and the median CSI score was 4. Most of unmet needs were related to information needs (needing more information related to home care, finding help with the problems at home, and disease prognosis) and symptom management. The majority of caregivers were satisfied or very satisfied by the care patients received. Spouse caregivers (N = 60, 60%) were significantly older (p = 0.006) with higher unemployment rates (p = 0.001), higher depression scores (p = 0.04), and lower social support scores (p < 0.0001) than nonspouse caregivers (N = 40, 40%). The PPUN predicted caregiver burden and the presence of caregiver unmet needs independently. The presence of caregiver unmet needs was the only independent predictor of caregiver satisfaction. Caregivers with a high PPUN and higher depression score experienced a higher burden.

Significance of the research: The caregiver outcome model is proposed and needs to be further validated in a new cohort of caregivers.

Keywords

Caregiver unmet needsCaregiver burdenCaregiver satisfactionUnmet needs of advanced cancer patientsPalliative careSpouse
Type
Research Article
Information
Palliative & Supportive Care , Volume 1 , Issue 4 , December 2003 , pp. 319 - 329
Copyright
© 2003 Cambridge University Press

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