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Sources of meaning in family caregivers of terminally ill patients supported by a palliative nursing care team: A naturalistic three-month cohort study

Published online by Cambridge University Press:  02 May 2017

Juan Valdés-Stauber ,
Rafael Lemaczyk  and
Reinhold Kilian
Juan Valdés-Stauber*
Affiliation:
Zentrum für Psychiatrie Südwürttemberg, Department of Psychiatry and Psychotherapy I, University of Ulm, Germany
Rafael Lemaczyk
Affiliation:
General Practitioner, Bad Waldsee and Bad Wurzach, Germany
Reinhold Kilian
Affiliation:
Bezirkskrankenhaus Günzburg, Department of Psychiatry and Psychotherapy II, University of Ulm, Germany
*
Address correspondence and reprint requests to: Juan Valdés-Stauber, Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Straße 2, 88214 Ravensburg, Germany. E-Mail: [email protected].
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Abstract

Objective:

Our aim was to identify possible patterns of change or durability in sources of meaning for family caregivers of terminally ill patients after the onset of support at home by an outreach palliative nursing team during a three-month survey period.

Method:

The Sources of Meaning and Meaning in Life Questionnaire (SoMe) was administered to 100 caregivers of terminally ill patients at four measurement timepoints: immediately before the onset of the palliative care (t0), and at 1 week, 1 month, and 3 months after t0. Time-dependent changes were assessed for the completed subsample (n = 24) by means of bivariate linear as well as quadratic regression models. Multivariate regressions with dimensions of meaning in life as dependent variables were performed for the whole sample by means of random-effects models: dependent variables changed over time (four timepoints), whereas regressors remained constant.

Results:

No significant differences were found for psychosocial and clinical variables or for sources of meaning between the uncompleted and completed subsamples. Growth curve analyses revealed no statistically significant but tendentiously parabolic changes for any dimensions or for single sources of meaning. In multivariate models, a negative association was found between patient age, psychological burden of family caregivers, and changes in total SoMe score, as well as for the superordinate dimensions.

Significance of Results:

According to our hypothesis, sources of meaning and meaning in life seem to remain robust in relatives caring for terminally ill family members during the three-month survey period. A parabolic development pattern of single sources of meaning indicates an adjustment process. An important limitation of our study is the small number of participants compared with larger multivariate models because of high dropout rates, primarily due to the death of three-quarters of the participants during the survey period.

Keywords

Palliative careFamily caregiversPalliative nursing teamsSources of meaningPsychological burden
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 3 , June 2018 , pp. 246 - 259
Copyright
Copyright © Cambridge University Press 2017 

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