Effect of an integrated cancer support team on caregiver satisfaction with end-of-life care.

PURPOSE/OBJECTIVES: To test the effectiveness of an interdisciplinary cancer support team (CST) on caregiver satisfaction with end-of-life (EOL) care for family members with advanced cancer.DESIGN: Quasi-experimental pre- and post-test tandem design.SETTING: Outpatient clinics of a comprehensive cancer center in urban Cleveland, OH.SAMPLE: 106 family caregivers.METHODS: Participants were enrolled into the control or CST group. Caregiver mood state and social support were measured at enrollment as well as at 3, 9, and 15 months, and satisfaction with EOL care was measured eight weeks after the patient's death.MAIN RESEARCH VARIABLES: Caregiver mood state, social support, and satisfaction with EOL care.FINDINGS: The intervention made no statistically significant contribution to caregiver mood state or perception of social support. The intervention group reported higher satisfaction with overall EOL care as well as five specific areas of EOL satisfaction (i.e., pain relief, information about managing pain, speed in treating symptoms, information regarding side effects, and coordination of care).CONCLUSIONS: The CST yielded improved EOL satisfaction.IMPLICATIONS FOR NURSING: Although the emotional impact of an impending loss of a loved one may not change with the provision of support, perception that a loved one was well cared for in the terminal phase of illness may have long-range benefits through the grieving process. Investigation of the long-range effects of satisfaction with EOL care on the grieving process is warranted.

目的：测试跨学科癌症支持团队（CST）对晚期癌症患者家属对临终关怀满意度的有效性。 设计：准实验性的前后测串联设计。 地点：俄亥俄州克利夫兰市一个综合性癌症中心的门诊诊所。 样本：106名家庭照顾者。 方法：参与者被纳入对照组或CST组。在入组时以及3个月、9个月和15个月时测量照顾者的情绪状态和社会支持，在患者死亡8周后测量对临终关怀的满意度。 主要研究变量：照顾者的情绪状态、社会支持以及对临终关怀的满意度。 结果：干预措施对照顾者的情绪状态或社会支持感知没有产生统计学上的显著影响。干预组报告对整体临终关怀以及临终关怀满意度的五个具体方面（即疼痛缓解、疼痛管理信息、症状治疗速度、副作用相关信息和护理协调）有更高的满意度。 结论：CST提高了临终关怀满意度。 对护理的启示：尽管亲人即将离世带来的情感冲击可能不会因提供支持而改变，但认为亲人在疾病终末期得到良好照顾可能会在悲伤过程中产生长期益处。有必要对临终关怀满意度对悲伤过程的长期影响进行研究。