School of Medicine and College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
J Palliat Med. 2023 Dec;26(12):1618-1626. doi: 10.1089/jpm.2023.0008. Epub 2023 Jun 13.
Underserved Hispanic patients often experience unmet palliative care (PC) needs, particularly those with noncancer diagnoses such as Alzheimer's disease and related dementias. Most caregivers for Hispanic patients are family relatives who are less likely to use health care and community resources and experience high caregiver burden. We adapted a culturally tailored patient navigator (PN) intervention to provide support and improve PC outcomes for Hispanics with Alzheimer's disease and related dementias and their family caregivers (FCGs). To explore Hispanic FCGs' experiences and perceptions of caregiving for a loved one, and how our PN intervention impacted their needs. Qualitative descriptive. FCG participants ( = 10) from our randomized control trial's intervention group were recruited from academic and safety net hospitals and community-based clinics across urban and rural Colorado in the United States. Data obtained from individual, semistructured, 30-minute telephone interviews were recorded, transcribed, translated, and analyzed using NVivo and qualitative thematic analyses. Four major themes emerged: and . Subthemes highlighted differing definitions of "contributing," role resentment, and interpersonal issues. Varying familial expectations underscore FCG strain when the burden of caregiving is not shared. Participants used various coping strategies as necessary support and gained awareness through education, guidance, and referrals to resources. PNs helped FCGs and patients beyond the intervention's scope. Providing support and awareness to FCGs, and incorporating cultural beliefs, may improve PC access to disparate populations and guide future interventions. Clinical Trial Registration Number NCT03181750.
服务不足的西班牙裔患者经常面临未满足的姑息治疗(PC)需求,特别是那些患有非癌症诊断的患者,如阿尔茨海默病和相关痴呆症。大多数西班牙裔患者的照顾者是家庭亲属,他们不太可能使用医疗保健和社区资源,并承受着较高的照顾者负担。我们对一种文化适应的患者导航员(PN)干预措施进行了改编,为患有阿尔茨海默病和相关痴呆症及其家庭照顾者(FCG)的西班牙裔患者提供支持,并改善 PC 结局。为了探讨西班牙裔 FCG 对亲人照顾的经验和看法,以及我们的 PN 干预措施如何影响他们的需求。 定性描述性研究。我们的随机对照试验干预组的 FCG 参与者( = 10)从美国科罗拉多州城乡的学术和安全网医院以及社区诊所招募。从个别、半结构化、30 分钟的电话访谈中获得的数据进行记录、转录、翻译,并使用 NVivo 和定性主题分析进行分析。出现了四个主要主题:照顾负担、需求和期望、资源利用、角色和身份。亚主题突出了“贡献”的不同定义、角色不满和人际关系问题。当照顾负担没有分担时,不同的家庭期望强调了 FCG 的紧张。参与者使用了各种应对策略作为必要的支持,并通过教育、指导和转介资源获得了意识。PN 不仅帮助了 FCG,还帮助了患者,超出了干预的范围。为 FCG 提供支持和意识,并融入文化信仰,可能会改善不同人群获得 PC 的机会,并为未来的干预措施提供指导。临床试验注册号 NCT03181750。