TY - JOUR
T1 - The impact of the caregiver-oncologist relationship on caregiver experiences of end-of-life care and bereavement outcomes
AU - An, Amy W.
AU - Ladwig, Susan
AU - Epstein, Ronald M.
AU - Prigerson, Holly G.
AU - Duberstein, Paul R.
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Purpose: The quality of the relationship between oncologists and cancer patients has been associated with caregiver bereavement outcomes, but no studies have examined whether the perceived quality of the relationship between cancer caregivers and oncologists is associated with caregiver experiences of end-of-life care or psychological adjustment after the patient’s death. Methods: We conducted secondary analyses of data collected in the Values and Options in Cancer Care (VOICE) study, a randomized controlled trial of an intervention that improved communication between oncologists and patients/caregivers (n = 204 dyads). At study entry, we assessed caregivers’ experiences with the oncologist using four items from the Human Connection Scale. Following patients’ deaths, we assessed bereaved caregivers’ experiences with end-of-life cancer care (Quality of Death; Peace, Equanimity, and Acceptance in the Cancer Experience [PEACE]; Caregiver Evaluation of the Quality of End-of-Life Care [CEQUEL]; and modified Decision Regret scales) and psychological adjustment (Prolonged Grief Disorder-13 and Purpose in Life scales). We conducted multivariable regressions examining prospective associations between caregiver experiences with the oncologist at study entry and outcome variables. Results: Data were collected from 105 caregivers of patients who died during the course of the study. Positive experience with the oncologist was prospectively associated with better experiences of end-of-life care, as reflected in better quality of death (estimate = 0.33, SE = 0.14, p = 0.02), PEACE (estimate = 0.11, SE = 0.05, p = 0.04), and decisional regret (estimate = − 0.16, SE = 0.06, p = 0.01). Caregivers’ experience with the oncologist was not significantly associated with indicators of psychological adjustment. Conclusion: Caregivers’ early experiences with oncologists may affect their experiences of the patient’s end-of-life care.
AB - Purpose: The quality of the relationship between oncologists and cancer patients has been associated with caregiver bereavement outcomes, but no studies have examined whether the perceived quality of the relationship between cancer caregivers and oncologists is associated with caregiver experiences of end-of-life care or psychological adjustment after the patient’s death. Methods: We conducted secondary analyses of data collected in the Values and Options in Cancer Care (VOICE) study, a randomized controlled trial of an intervention that improved communication between oncologists and patients/caregivers (n = 204 dyads). At study entry, we assessed caregivers’ experiences with the oncologist using four items from the Human Connection Scale. Following patients’ deaths, we assessed bereaved caregivers’ experiences with end-of-life cancer care (Quality of Death; Peace, Equanimity, and Acceptance in the Cancer Experience [PEACE]; Caregiver Evaluation of the Quality of End-of-Life Care [CEQUEL]; and modified Decision Regret scales) and psychological adjustment (Prolonged Grief Disorder-13 and Purpose in Life scales). We conducted multivariable regressions examining prospective associations between caregiver experiences with the oncologist at study entry and outcome variables. Results: Data were collected from 105 caregivers of patients who died during the course of the study. Positive experience with the oncologist was prospectively associated with better experiences of end-of-life care, as reflected in better quality of death (estimate = 0.33, SE = 0.14, p = 0.02), PEACE (estimate = 0.11, SE = 0.05, p = 0.04), and decisional regret (estimate = − 0.16, SE = 0.06, p = 0.01). Caregivers’ experience with the oncologist was not significantly associated with indicators of psychological adjustment. Conclusion: Caregivers’ early experiences with oncologists may affect their experiences of the patient’s end-of-life care.
KW - Bereavement
KW - Cancer
KW - Caregiver
KW - Caregiver-physician relationship
KW - Physician ratings
KW - Therapeutic alliance
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U2 - 10.1007/s00520-019-05185-2
DO - 10.1007/s00520-019-05185-2
M3 - Article
C2 - 31900620
AN - SCOPUS:85077567751
SN - 0941-4355
VL - 28
SP - 4219
EP - 4225
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 9
ER -