Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMC Palliat Care. 2024 Aug 2;23(1):195. doi: 10.1186/s12904-024-01480-w.
Family caregivers of terminally ill and dying people do not only experience varying levels but also different dimensions of caregiver-related strain and burden. The aim of the study was to develop a short multidimensional screening tool for the detection of burden in family caregivers in palliative care.
Family caregivers of cancer patients newly admitted to specialist inpatient palliative care (N = 232) completed questionnaires on psychological burden, quality of life, social support and need fulfillment. A latent class mixture model was used to identify discrete classes of family caregivers related to their multidimensional caregiver burden. Multinomial logistic regression analyses were performed to identify the most predictive items from a set of established questionnaires.
Four latent classes of family caregivers were identified: Currently stable caregivers (37%), Caregivers with unmet needs (20%), Psychologically burdened caregivers (30%), and High-risk caregivers (13%). Each of these classes describes a different risk profile of multidimensional family caregiver burden, although family caregivers exhibit high levels of distress across all classes. From a set of 48 items, we identified eight items that predicted the class membership best. These items represent the items of the novel multidimensional screening tool: The 8-item Screening Tool for Family Caregiver Burden in Palliative Care (CAREPAL-8). Except for social support, the items maintained fidelity to the conceptualization of multidimensional caregiver burden used in this study. A preliminary classification system was developed, which has yet to be validated.
This study represents the first step in the establishment of a practical, self-administered screening tool that might help healthcare providers to tailor caregiver care according to their burden in daily practice. Brevity of the 8-item tool might facilitate its use in routine clinical care.
终末期和临终患者的家庭照顾者不仅经历不同程度的 caregiver相关压力和负担，而且经历不同维度的压力和负担。本研究的目的是开发一种简短的多维筛查工具，用于检测姑息治疗中家庭照顾者的负担。
新入住专科姑息治疗住院患者的癌症患者的家庭照顾者（N=232）完成了关于心理负担、生活质量、社会支持和需求满足的问卷。使用潜在类别混合模型来识别与多维照顾者负担相关的离散照顾者类别。进行多项逻辑回归分析，从一组既定问卷中确定最具预测性的项目。
确定了四类家庭照顾者：目前稳定的照顾者（37%）、有未满足需求的照顾者（20%）、心理负担重的照顾者（30%）和高风险照顾者（13%）。尽管所有类别的家庭照顾者都表现出高度的困扰，但这些类别描述了不同的多维家庭照顾者负担风险特征。从 48 个项目中，我们确定了 8 个项目可以最好地预测类别的成员。这些项目代表了新的多维筛查工具的项目：姑息治疗中家庭照顾者负担的 8 项筛查工具（CAREPAL-8）。除了社会支持，这些项目保留了在本研究中使用的多维照顾者负担概念化的保真度。开发了初步的分类系统，但尚未验证。
这项研究代表了建立一种实用的、自我管理的筛查工具的第一步，该工具可能有助于医疗保健提供者根据他们在日常实践中的负担来定制照顾者护理。8 项工具的简洁性可能会促进其在常规临床护理中的使用。
