Measuring caregiver outcomes in palliative care: a construct validation study of two instruments for use in economic evaluations
Measuring caregiver outcomes in palliative care: a construct validation study of two instruments for use in economic evaluations
复制标题
DOI：
10.1007/s11136-014-0848-8
复制
发表时间：
2015-05-01
影响因子：
3.5
通讯作者：
Ratcliffe, Julie
中科院分区：
文献类型：
--
作者：
Hoefman, Renske;Al-Janabi, Hareth;Ratcliffe, Julie
为接近生命尽头的病人提供护理可能会给护理人员带来相当大的负担。因此，姑息治疗干预措施的政策决定应该以这一负担的信息为指导。本研究探讨结构验证的两个偏好为基础的照顾者的结果工具，适合经济评估：照顾者的经验量表（CES）和照顾相关的生活质量（CarerQol）的工具。此外，本研究报告的照顾者在临终关怀的经验，收集资料与书面问卷之间的照顾者的病人接受姑息治疗服务在南部大都市地区的阿德莱德，南澳（n = 97）。采用CES、照顾者生活质量、过程效用（PU）和照顾者压力指数（CSI）测量照顾对照顾者的影响。研究了收敛效度、区分效度和临床效度，假设在CES上测量的较高的负效应与对CarerQol的较高的负效应相关。CES和CarerQol均与预期的积极方向相关，其中CSI的压力更小，更积极的护理体验和更多的护理PU。照顾者与被照顾者的健康状况与照顾时间长短与照顾经验呈负相关。研究结果显示，CES与照顾者生活质量量表可有效评估照顾者在临终关怀中的照顾时间长短。临终关怀的经济评估应尝试纳入这些工具，以提供更全面的评估干预措施的真正影响，特别是在家庭和朋友大量参与临终关怀的情况下。
Providing care to patients nearing the end of life can place a considerable burden on caregivers. Hence, policy decisions on interventions in palliative care should be guided by information on this burden. This study investigates construct validation of two preference-based caregiver outcome instruments suitable for economic evaluations: the Carer Experience Scale (CES) and the Care-related Quality of Life (CarerQol) instrument. Moreover, this study reports caregiver experiences in end-of-life care.Data were collected with written questionnaires among caregivers of patients receiving palliative care services in the Southern metropolitan area of Adelaide, South Australia (n = 97). The effect of caregiving on caregivers was measured with the CES, CarerQol, Process Utility (PU) and Caregiver Strain Index (CSI). Convergent, discriminative and clinical validity were studied.As hypothesized, higher negative effect of caregiving measured on the CES was associated with higher negative effect on the CarerQol. Both the CES and CarerQol were associated in the expected positive direction with less strain from caregiving (CSI), more positive care experiences and more PU from caring. Caregivers' and care recipients' health status and duration of caregiving were negatively associated with caring experiences.Our findings suggest that the CES and CarerQol validly assess the effect of caregiving on caregivers in end-of-life care. Economic evaluations in end-of-life care should attempt to incorporate such instruments to provide a more holistic assessment of the true impact of interventions, especially where family and friends are heavily involved in caregiving.