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Association between the emotional status of family caregivers and length of stay in a palliative care unit: A retrospective study

Published online by Cambridge University Press:  11 June 2015

Seon Hee Kim ,
In Cheol Hwang ,
Ki Dong Ko ,
Young Eun Kwon ,
Hong Yup Ahn ,
Nan Young Cho  and
Seung Jin Kim
Seon Hee Kim
Affiliation:
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea
In Cheol Hwang*
Affiliation:
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea Palliative Care Unit, Incheon Regional Cancer Center, Incheon, Korea
Ki Dong Ko
Affiliation:
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea
Young Eun Kwon
Affiliation:
Palliative Care Unit, Incheon Regional Cancer Center, Incheon, Korea
Hong Yup Ahn
Affiliation:
Department of Statistics, Dongguk University, Seoul, Korea
Nan Young Cho
Affiliation:
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea
Seung Jin Kim
Affiliation:
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea
*
Address correspondence and reprint requests to: In Cheol Hwang, Department of Family Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, South Korea. E-mail: spfe0211@gmail.com.
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Abstract

Objective:

Several factors associated with referral time to hospice and/or palliative care services have been identified, but there is no literature on the association between these services and the emotional status of the family caregivers (FCs). This article is intended to address that issue.

Method:

A semistructured interview was employed to collect data for a retrospective cohort study. The primary FCs of terminally ill cancer patients were interviewed at the time of the patient's referral to the palliative care unit. Interview data were combined with patients' medical record data for our analysis. The emotional status of the FCs was categorized into one of three groups according to their responses to the anticipated death of their family member: acceptance, anxious/depressed, and denial/angry. A Cox proportional hazard model was used to examine and identify the factors related to the length of stay (LOS) in the palliative care unit.

Results:

A total of 198 patient–FC pairs were identified. The median LOS was 18 days. A multivariate analysis with adjustment for potential variables revealed significant differences in LOS according to cancer type and time since cancer diagnosis. The denial/angry FC category was independently associated with a shorter LOS (vs. acceptance, adjusted hazard ratio (aHR) 2.11; 95% confidence interval (CI), 1.11–4.03).

Significance of Results:

We found that terminally ill cancer patients who were referred late had FCs who were in denial or were angry about the anticipated death of their loved one. The emotional status of FCs should be considered when patients with terminal cancer are referred to palliative care.

Keywords

Palliative careLength of stayEmotionsFamily caregiver
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 6 , December 2015 , pp. 1695 - 1700
Copyright
Copyright © Cambridge University Press 2015 

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