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Palliative medicine family conferences and caregiver psychological distress during prolonged mechanical ventilation
- Source :
- BMJ supportivepalliative care. 10(4)
- Publication Year :
- 2019
-
Abstract
- ObjectivesLittle is known about the experience of family caregivers of patients who require prolonged mechanical ventilation (PMV). We examined the perspectives of caregivers of patients who died after PMV to explore the role of palliative care and the quality of dying and death (QODD) in patients and understand the psychological symptoms of these caregivers.MethodsA longitudinal study was performed in five hospitals in Taipei, Taiwan. Routine palliative care family conferences and optional consultation with a palliative care specialist were provided, and family caregivers were asked to complete surveys.ResultsIn total, 136 family caregivers of 136 patients receiving PMV were recruited and underwent face-to-face baseline interviews in 2016–2017. By 2018, 61 (45%) of 136 patients had died. We successfully interviewed 30 caregivers of patients’ death to collect information on the QODD of patients and administer the Impact of Event Scale (IES), Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiologic Studies Depression (CES-D) scale to caregivers. We observed that more frequent palliative care family conferences were associated with poorer QODD in patients (coefficients: −44.04% and 95% CIs −75.65 to −12.44), and more psychological symptoms among caregivers (coefficient: 9.77% and 95% CI 1.63 to 17.90 on CES-D and coefficient: 7.67% and 95% CI 0.78 to 14.55 on HADS). A higher caregiver burden at baseline correlated with lower psychological symptoms (coefficient: −0.35% and 95% CI −0.58 to −0.11 on IES and coefficient: −0.22% and 95% CI −0.40 to −0.05 on CES-D) among caregivers following the patients’ death. Caregivers’ who accepted the concept of palliative care had fewer psychological symptoms after patients’ death (coefficient: −3.29% and 95% CI −6.32 to −0.25 on IES and coefficient: −3.22% and 95% CI −5.24 to −1.20 on CES-D).ConclusionsPalliative care conferences were more common among family members with increased distress. Higher caregiver burden and caregiver acceptance of palliative care at baseline both predicted lower levels of caregiver distress after death.
- Subjects :
- Adult
Male
medicine.medical_specialty
Palliative care
Taiwan
Medicine (miscellaneous)
Anxiety
Hospital Anxiety and Depression Scale
Psychological Distress
03 medical and health sciences
0302 clinical medicine
Quality of life (healthcare)
Surveys and Questionnaires
Medicine
Humans
Family
030212 general & internal medicine
Longitudinal Studies
Referral and Consultation
Depression (differential diagnoses)
Aged
Oncology (nursing)
business.industry
Family caregivers
Depression
Palliative Care
General Medicine
Caregiver burden
Middle Aged
Patient Acceptance of Health Care
Respiration, Artificial
Death
Medical–Surgical Nursing
Distress
030228 respiratory system
Caregivers
Socioeconomic Factors
Family medicine
Female
business
End-of-life care
Subjects
Details
- ISSN :
- 20454368
- Volume :
- 10
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- BMJ supportivepalliative care
- Accession number :
- edsair.doi.dedup.....1f593a5b683256a1b93a3fa3034b27d1