Retrospective Analysis of Emotional Burden and the Need for Support of Patients and Their Informal Caregivers after Palliative Radiation Treatment for Brain Metastases
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Patient and Caregiver Characteristics
3.2. The Caregivers’ Burden and Support
3.3. The Caregivers’ Unmet Needs
3.4. Health Care Service and Information Needs
3.5. Palliative Care
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
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Variables | Median | Range |
---|---|---|
Age of death (years) | 68 | 47–85 |
Number of organ metastases | 3.9 | 1–8 |
ECOG performance status at start of RT | 1.4 | 0–2 |
Disease duration (first diagnosis to death), (years) | 3.1 | 0–19 |
n | % | |
Sex | ||
Female | 21 | 50 |
Male | 21 | 50 |
Form of overall treatment (any treatment time) | ||
Chemotherapy | 30 | 71.4 |
Immunotherapy | 4 | 9.5 |
Targeted Therapy | 17 | 40.5 |
Hormone Therapy | 8 | 19 |
Radiotherapy in total | 42 | 100 |
WBRT | 37 | 86.1 |
PBRT | 2 | 4.7 |
SRS/SRT | 4 | 9.3 |
Surgery | 17 | 40.5 |
Entity | ||
Lung cancer | 26 | 61.9 |
Breast cancer | 4 | 9.5 |
Melanoma | 4 | 9.5 |
Urogenital cancer | 5 | 11.9 |
Others | 3 | 7.1 |
Number of brain metastases | ||
1–5 metastases | 9 | 21.4 |
6–10 metastases | 6 | 14.3 |
>10 metastases | 20 | 47.6 |
Meningeal carcinomatosis | 7 | 16.7 |
Place of death | ||
Home | 13 | 31 |
Hospital | 20 | 47.6 |
Nursing home | 8 | 19 |
Hospice | 1 | 2.4 |
Variables | n | % |
---|---|---|
Sex | ||
Female | 27 | 64.3 |
Male | 15 | 35.7 |
Relatives | ||
Spouse | 34 | 81.0 |
Daughter | 4 | 9.5 |
Sister | 4 | 9.5 |
Variables | n = 42 | % |
---|---|---|
Emotional burden of the caregiver | 33 | 78.6 |
Sufficient support by medical practitioners | 35 | 83.3 |
Sufficient support by family | 37 | 88.1 |
Health problems developed by caregiver | 10 | 23.8 |
Involvement of palliative care | 30 | 71.4 |
Outpatient | 16 | 38.1 |
Inpatient | 4 | 9.5 |
Unspecified | 10 | 23.8 |
Psycho-oncology involved | 12 | 28.6 |
Need for Support When | No Need | Already Supported | Low Need | Moderate Need | High Need | Missing |
---|---|---|---|---|---|---|
Receiving emotional support of the caregiver | 10 (23.8) | 8 (19.0) | 7 (16.7) | 4 (9.5) | 4 (9.5) | 9 (21.4) |
Coping with fears about physical or mental deterioration of the patient | 7 (16.7) | 8 (19.0) | 7 (16.7) | 5 (11.9) | 9 (21.4) | 6 (14.3) |
Handling thoughts about death or dying | 9 (21.4) | 13 (31.0) | 8 (19.0) | 1 (2.4) | 6 (14.3) | 5 (11.9) |
Providing practical care tasks (bathing, bandage changes, administering medicine) | 16 (38.1) | 7 (16.7) | 6 (14.3) | 3 (7.1) | 3 (7.1) | 7 (16.7) |
Communicating with the patient | 15 (35.7) | 4 (9.5) | 5 (11.9) | 2 (4.8) | 6 (14.3) | 10 (23.8) |
Reducing stress of the patient | 8 (19.0) | 12 (28.6) | 5 (11.9) | 3 (7.1) | 8 (19.0) | 6 (14.3) |
Balancing the needs of the patient vs. those of the caregiver | 12 (28.6) | 7 (16.7) | 6 (14.3) | 5 (11.9) | 3 (7.1) | 9 (21.4) |
Looking after the caregiver’s health (eating, sleeping) | 14 (33.3) | 10 (23.8) | 5 (11.9) | 5 (11.9) | 3 (7.1) | 5 (11.9) |
Nursing affects the caregiver’s own life | 13 (31.0) | 6 (14.3) | 5 (11.9) | 3 (7.1) | 3 (7.1) | 12 (28.6) |
Need for Support When | No Need | Already Supported | Low Need | Moderate Need | High Need | Missing |
---|---|---|---|---|---|---|
Receiving opportunities to discuss the caregivers concerns with the doctors | 9 (21.4) | 8 (19.0) | 5 (11.9) | 8 (19.0) | 7 (16.7) | 5 (11.9) |
Building confidence in doctors having discussed the patient’s case sufficiently with each other | 10 (23.8) | 7 (16.7) | 5 (11.9) | 5 (11.9) | 9 (21.4) | 6 (14.3) |
Feeling reassured about sufficient coordination of medical services | 10 (23.8) | 7 (16.7) | 6 (14.3) | 2 (4.8) | 10 (23.8) | 7 (16.7) |
Participating in decision making of the patient | 11 (26.2) | 9 (21.4) | 6 (14.3) | 4 (9.5) | 4 (9.5) | 8 (19.0) |
Being involved in the medical care of the patient | 8 (19.0) | 13 (31.0) | 3 (7.1) | 4 (9.5) | 4 (9.5) | 10 (23.8) |
Receiving information about the supportive program for the caregiver | 10 (23.8) | 8 (19.0) | 6 (14.3) | 6 (14.3) | 7 (16.7) | 5 (11.9) |
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Lütscher, J.; Siegenthaler, C.H.; Hertler, C.; Blum, D.; Windisch, P.; Shaker, R.G.; Schröder, C.; Zwahlen, D.R. Retrospective Analysis of Emotional Burden and the Need for Support of Patients and Their Informal Caregivers after Palliative Radiation Treatment for Brain Metastases. Curr. Oncol. 2022, 29, 4235-4244. https://doi.org/10.3390/curroncol29060338
Lütscher J, Siegenthaler CH, Hertler C, Blum D, Windisch P, Shaker RG, Schröder C, Zwahlen DR. Retrospective Analysis of Emotional Burden and the Need for Support of Patients and Their Informal Caregivers after Palliative Radiation Treatment for Brain Metastases. Current Oncology. 2022; 29(6):4235-4244. https://doi.org/10.3390/curroncol29060338
Chicago/Turabian StyleLütscher, Jamie, Christa Hauswirth Siegenthaler, Caroline Hertler, David Blum, Paul Windisch, Renate Grathwohl Shaker, Christina Schröder, and Daniel Rudolf Zwahlen. 2022. "Retrospective Analysis of Emotional Burden and the Need for Support of Patients and Their Informal Caregivers after Palliative Radiation Treatment for Brain Metastases" Current Oncology 29, no. 6: 4235-4244. https://doi.org/10.3390/curroncol29060338