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Impact of the caregiver burden on the effectiveness of a home-based palliative care program: A mediation analysis

Published online by Cambridge University Press:  27 September 2019

Angela J. Pereira-Morales Open the ORCID record for Angela J. Pereira-Morales [Opens in a new window] ,
Luis Enrique Valencia  and
Luis Rojas
Angela J. Pereira-Morales*
Affiliation:
SIES SALUD, Bogotá, Colombia PhD Program in Public Health, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
Luis Enrique Valencia
Affiliation:
SIES SALUD, Medellín, Colombia
Luis Rojas
Affiliation:
SIES SALUD, Bogotá, Colombia
*
Author for correspondence: Angela J. Pereira-Morales, Avenida Carrera 68# 46-14, Bogotá, Colombia. E-mail: [email protected]
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Abstract

Objective

The growing aging population and the high prevalence of several concomitant chronic diseases have contributed to the elevated rates of caregiver burden and suffering in patients. In turn, intending to relieve unnecessary pain in patients, there has been a rapid growth of outpatient palliative care programs. However, little has been studied about caregiver burden as a relevant factor potentially affecting the effectiveness of these programs. This study aimed to determine the extent of caregiver burden as a possible mediator on the effectiveness of a home-based palliative care program.

Method

Sixty-six palliative patients (56% women; mean age + SD = 71, 6 ± 17.7) and their caregivers were assessed with measures for physical, emotional, and psychological symptoms before and 1 month after the start of a home-based palliative care program.

Results

The association between caregiver burden and palliative outcomes was corroborated with a categorical regression model (p < 0.01). Caregiver burden was found to be a significant mediator in the relationship between outcome measures for palliative care at baseline and after 1 month of enrollment in the program.

Significance of results

To our knowledge, this is the first study to assess the role of caregiver burden in the effectiveness of a home-based palliative care program. Although further work is required, the results indicate that a patient-focused intervention does not have the same beneficial effect if the caregiver burden is not addressed. Future home-based palliative care programs should focus on caregivers as well as patients, with particular attention to psychosocial intervention on caregivers.

Keywords

BurdenFamily caregiverOutpatient palliative careTerminally ill patients
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 3 , June 2020 , pp. 332 - 338
Copyright
Copyright © Cambridge University Press 2019

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