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The impact of the caregiver-oncologist relationship on caregiver experiences of end-of-life care and bereavement outcomes.
Supportive Care in Cancer ( IF 2.8 ) Pub Date : 2020-01-03 , DOI: 10.1007/s00520-019-05185-2
Amy W An 1 , Susan Ladwig 1, 2 , Ronald M Epstein 1 , Holly G Prigerson 3 , Paul R Duberstein 4
Affiliation  

PURPOSE The quality of the relationship between oncologists and cancer patients has been associated with caregiver bereavement outcomes, but no studies have examined whether the perceived quality of the relationship between cancer caregivers and oncologists is associated with caregiver experiences of end-of-life care or psychological adjustment after the patient's death. METHODS We conducted secondary analyses of data collected in the Values and Options in Cancer Care (VOICE) study, a randomized controlled trial of an intervention that improved communication between oncologists and patients/caregivers (n = 204 dyads). At study entry, we assessed caregivers' experiences with the oncologist using four items from the Human Connection Scale. Following patients' deaths, we assessed bereaved caregivers' experiences with end-of-life cancer care (Quality of Death; Peace, Equanimity, and Acceptance in the Cancer Experience [PEACE]; Caregiver Evaluation of the Quality of End-of-Life Care [CEQUEL]; and modified Decision Regret scales) and psychological adjustment (Prolonged Grief Disorder-13 and Purpose in Life scales). We conducted multivariable regressions examining prospective associations between caregiver experiences with the oncologist at study entry and outcome variables. RESULTS Data were collected from 105 caregivers of patients who died during the course of the study. Positive experience with the oncologist was prospectively associated with better experiences of end-of-life care, as reflected in better quality of death (estimate = 0.33, SE = 0.14, p = 0.02), PEACE (estimate = 0.11, SE = 0.05, p = 0.04), and decisional regret (estimate = - 0.16, SE = 0.06, p = 0.01). Caregivers' experience with the oncologist was not significantly associated with indicators of psychological adjustment. CONCLUSION Caregivers' early experiences with oncologists may affect their experiences of the patient's end-of-life care.

中文翻译:

护理人员与肿瘤科医生的关系对护理人员临终护理和丧亲结果的影响。

目的肿瘤学家和癌症患者之间的关系质量与照顾者丧亲结果相关,但尚无研究检查癌症监护者和肿瘤医生之间关系的感知质量是否与临终护理或心理护理者的经历相关患者死亡后进行调整。方法我们对癌症护理价值与选择(VOICE)研究中收集的数据进行了二次分析,该研究是一项干预措施的随机对照试验,旨在改善肿瘤科医生与患者/护理人员之间的沟通(n = 204 dyads)。在研究开始时,我们使用“人际关系量表”中的四个项目评估了护理人员与肿瘤科医生的经验。在患者死亡之后,我们评估了丧亲者 临终癌症护理的经验(死亡质量;和平,安宁和接受癌症的经历[PEACE];临终护理质量的护理人员评估[CEQUEL];以及经过修改的决策后悔量表)和心理适应(长期悲伤障碍13和生活目的量表)。我们进行了多变量回归,研究了进入研究时与肿瘤科医生的护理人员经验之间的前瞻性关联。结果数据收集自研究过程中死亡的105位护理人员。肿瘤科医生的积极经验与更好的临终护理经验有潜在的关联,这反映在更好的死亡质量(估计值= 0.33,SE = 0.14,p = 0.02),PEACE(估计值= 0.11,SE = 0.05, p = 0.04),和决策后悔(估计值=-0.16,SE = 0.06,p = 0.01)。护理人员与肿瘤科医生的经验与心理调节指标没有显着相关。结论护理人员与肿瘤科医生的早期经验可能会影响他们对患者临终护理的经验。
更新日期:2020-01-04
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