Unique Correlates of Heart Failure and Cancer Caregiver Satisfaction With Hospice Care

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• 作者：Meredith A. MacKenzie ; PhD ; RN ; ANP-BC ; CNE^a ; ^{meredith.mackenzie@villanova.edu" class="auth_mail" title="E-mail the corresponding author} ; Harleah G. Buck ; PhD ; RN ; CHPN ; FPCN ; FAAN^b ; Salimah H. Meghani ; PhD ; MBE ; RN ; FAAN^c ; Barbara Riegel ; PhD ; RN ; FAAN ; FAHA^c
• 关键词：Heart failure ; cancer ; end of life ; hospice ; caregiver
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：51
• 期：1
• 页码：71-78
• 全文大小：137 K

文摘

Heart failure patients, along with their informal caregivers are increasingly enrolling in hospice care. Caregiver satisfaction with hospice care is a key quality indicator. The role that diagnosis plays in shaping satisfaction is unclear.

Objectives

Our aim was to identify unique correlates of caregiver satisfaction in heart failure and cancer caregivers and explore whether the identified correlates differ between the two diagnosis groups.

Methods

This was a retrospective cohort study of national data collected in 2011 by the National Hospice and Palliative Care Organization using the 61-item Family Evaluation of Hospice Care survey. We used complete Family Evaluation of Hospice Care responses of adult heart failure (n = 7324) and cancer (n = 23,871) caregivers. Multiple logistic regression was used to examine the relationship between possible correlates and caregiver satisfaction. Correlates examined included caregiver and patient demographics, patient clinical characteristics, and hospice characteristics.

Results

Caregiver-reported patient dyspnea was associated with global and symptom management satisfaction in the heart failure cohort, whereas caregiver race was associated with global and symptom management satisfaction in the cancer cohort. Nursing home placement was associated with lower satisfaction odds in both cancer and heart failure cohorts, but heart failure patients were twice as likely as cancer patients to receive care in a nursing home.

Conclusion

This study generated hypotheses about unique factors related to caregiver satisfaction among two diagnosis cohorts that require further study, particularly the impact of race on satisfaction in the cancer cohort and the management of dyspnea in heart failure hospice patients.