Perceptions of the care received from Australian palliative care services: A caregiver perspective

ABSTRACT Background: Caregiver satisfaction and experience surveys help health professionals to understand, measure, and improve the quality of care provided for patients and their families. Objective: Our aim was to explore caregiver perceptions of the care received from Australian specialist palliative care services. Method: Caregivers of patients receiving palliative care in services registered with Australia's Palliative Care Outcomes Collaboration were invited to participate in a caregiver survey. The survey included the FAMCARE–2 and four items from the Ongoing Needs Identification: Caregiver Profile questionnaire. Results: Surveys were completed by 1,592 caregivers from 49 services. Most respondents reported high satisfaction and positive experiences. Caregivers receiving care from community-based palliative care teams were less satisfied with the management of physical symptoms and comfort (odds ratio [OR] = 0.29; 95% confidence interval [CI95%] = 0.14, 0.59), with patient psychological care (OR = 0.56; CI95% = 0.32, 0.98), and with family support (OR = 0.52; CI95% = 0.35, 0.77) than caregivers of patients in an inpatient setting. If aged over 60 years, caregivers were less likely to have their information needs met regarding available support services (OR = 0.98; CI95% = 0.97, 0.98) and carer payments (OR = 0.99; CI95% = 0.98, 1.00). Also, caregivers were less likely to receive adequate information about carer payments if located in an outer regional area (OR = 0.41; CI95% = 0.25, 0.64). With practical training, caregivers receiving care from community services reported inadequate information provision to support them in caring for patients (OR = 0.60; CI95% = 0.45, 0.81). Significance of Results: While our study identified caregivers as having positive and satisfactory experiences across all domains of care, there is room for improvement in the delivery of palliative care across symptom management, as well as patient and caregiver support, especially in community settings. Caregiver surveys can facilitate the identification and evaluation of both patients' and caregivers' experiences, satisfaction, distress, and unmet needs.

[1]  D. Currow Caregivers’ three-cornered hats: Their tricornes , 2015, Palliative medicine.

[2]  D. Meier,et al.  A survey of bereaved family members to assess quality of care on a palliative care unit. , 2015, Journal of palliative medicine.

[3]  K. Eagar,et al.  A survey of patients’ experience of pain and other symptoms while receiving care from palliative care services , 2015, BMJ Supportive & Palliative Care.

[4]  R. Ray,et al.  Palliative care professional education via video conference builds confidence to deliver palliative care in rural and remote locations , 2014, BMC Health Services Research.

[5]  K. Brazil,et al.  A Comparison of Support Needs Between Rural and Urban Family Caregivers Providing Palliative Care , 2014, The American journal of hospice & palliative care.

[6]  Afaf Girgis,et al.  Physical, psychosocial, relationship, and economic burden of caring for people with cancer: a review. , 2013, Journal of oncology practice.

[7]  Y. Chang,et al.  Factors that affect quality of dying and death in terminal cancer patients on inpatient palliative care units: perspectives of bereaved family caregivers. , 2013, Journal of pain and symptom management.

[8]  T. Trauer,et al.  Research priorities associated with family caregivers in palliative care: international perspectives. , 2011, Journal of palliative medicine.

[9]  Catherine Adams,et al.  Caregiver satisfaction with out-patient oncology services: utility of the FAMCARE instrument and development of the FAMCARE-6 , 2011, Supportive Care in Cancer.

[10]  D. Currow,et al.  Reliability testing of the FAMCARE-2 scale: measuring family carer satisfaction with palliative care , 2010, Palliative medicine.

[11]  R. Urquhart,et al.  Do available questionnaires measure the communication factors that patients and families consider important at end of life? , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  Sydney Morss Dy,et al.  A Systematic Review of Satisfaction with Care at the End of Life , 2008, Journal of the American Geriatrics Society.

[13]  V. Masson Dying well. , 2008, The American journal of nursing.

[14]  David C. Currow,et al.  Specialized palliative care services are associated with improved short- and long-term caregiver outcomes , 2007, Supportive Care in Cancer.

[15]  Sonja McIlfatrick,et al.  Assessing palliative care needs: views of patients, informal carers and healthcare professionals. , 2007, Journal of advanced nursing.

[16]  M. Adams Patient and Carer Satisfaction with Palliative Care Services: A Review of the Literature , 2005 .

[17]  L. Kristjanson,et al.  Palliative Care for Families: Remembering the Hidden Patients , 2004, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[18]  Joshua Hauser,et al.  Supporting family caregivers at the end of life: "they don't know what they don't know". , 2004, JAMA.

[19]  S. Kaasa,et al.  Measuring quality of palliative care: Psychometric properties of the FAMCARE Scale , 2003, Quality of Life Research.

[20]  E. Nicholas An Outcomes Focus in Carer Assessment and Review: Value and Challenge , 2003 .

[21]  Gerard J Fitzsimmons,et al.  From the Australian Institute of Health and Welfare , 2014, Communicable diseases intelligence quarterly report.

[22]  S. Kaasa,et al.  Family satisfaction with end-of-life care for cancer patients in a cluster randomized trial. , 2002, Journal of pain and symptom management.

[23]  Karen Donelan,et al.  When the caregiver needs care: the plight of vulnerable caregivers. , 2002, American journal of public health.

[24]  J. Teno Palliative care teams: self-reflection - past, present, and future. , 2002, Journal of pain and symptom management.

[25]  K. White,et al.  Empowerment through information: supporting rural families of oncology patients in palliative care. , 2000, The Australian journal of rural health.

[26]  M Smith,et al.  Predictors of Family Satisfaction with an Australian Palliative Home Care Service: A Test of Discrepancy Theory , 1999, Journal of palliative care.

[27]  L. Kristjanson Validity and reliability testing of the FAMCARE Scale: measuring family satisfaction with advanced cancer care. , 1993, Social science & medicine.

[28]  J. Hockley Palliative care teams , 1990 .