当前位置： SCI文献检索 > JOURNAL OF PAIN AND SYMPTOM MANAGEMENT期刊下所有文献 > Informal Caregiver Challenges for Advanced Cancer Patients During End-of-Life Care in Johannesburg, South Africa and Distinctions Based on Place of Death.

Informal Caregiver Challenges for Advanced Cancer Patients During End-of-Life Care in Johannesburg, South Africa and Distinctions Based on Place of Death.

Abstract：

CONTEXT:In sub-Saharan Africa, late diagnosis with cancer is common. Many dying patients rely on family members for care; little is known about the challenges African informal caregivers face. OBJECTIVES:To better understand the challenges of informal caregivers at the end of life in South Africa, both at home and in inpatient facilities. METHODS:We included advanced cancer patients and caregivers from a public hospital in Johannesburg, South Africa. Study nurses interviewed patients and caregivers about their experiences. Using univariate and multivariate analyses, we determined the factors associated with greater caregiver difficulty, focusing on patients dying at home vs. in inpatient facilities. RESULTS:Among 174 informal caregivers, 62 (36%) reported "a lot" of challenges. These caregivers struggled most with keeping the patient clean (16%) and with patient interactions (34%). Symptoms associated with greater difficulty included pain (odds ratio [OR] 2.4 [95% CI 1.2-4.7]), urinary incontinence (OR 2.3 [95% CI 1.1-4.9]), fecal incontinence (OR 2.4 [95% CI 1.0-5.7]), insomnia (OR 2.9 [95% CI 1.3-6.9]), fatigue (OR 6.3 [95% CI 1.8-21.6]), extremity weakness (OR 2.9 [95% CI 1.3-6.9]), shame (OR 4.2 [95% CI 1.5-12.0]), and sadness (OR 2.3 [95% CI 1.1-4.8]). Caregivers of patients dying at home reported the greatest difficulty with patients' physical symptoms; caregivers of those dying in facilities reported the greatest difficulty with emotional symptoms. CONCLUSION:Informal caregivers of patients dying at home reported challenges with practical functional care; this effect was reduced in the inpatient setting. Skills training for these caregivers could relieve some of this burden.

journal_name

J Pain Symptom Manage

journal_title

Journal of pain and symptom management

authors

O'Neil DS,Prigerson HG,Mmoledi K,Sobekwa M,Ratshikana-Moloko M,Tsitsi JM,Cubasch H,Wong ML,Omoshoro-Jones JAO,Sackstein PE,Blinderman CD,Jacobson JS,Joffe M,Ruff P,Neugut AI,Blanchard CL

doi

10.1016/j.jpainsymman.2018.03.017

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

98-106

issue

eissn

0885-3924

issn

1873-6513

pii

S0885-3924(18)30177-5

journal_volume

pub_type

杂志文章

在线工具

Informal Caregiver Challenges for Advanced Cancer Patients During End-of-Life Care in Johannesburg, South Africa and Distinctions Based on Place of Death.