Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 53, Issue 1, Pages 59-65Publisher
WILEY
DOI: 10.1111/j.1532-5415.2005.53011.x
Keywords
communication; caregiver burden; chronic disease
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Funding
- NIA NIH HHS [K02 AG020113, R01 AG019769-01A1, R01 AG19769, R01 AG019769, K02 AG20113, K02 AG020113-01] Funding Source: Medline
- NATIONAL INSTITUTE ON AGING [R01AG019769, K02AG020113] Funding Source: NIH RePORTER
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OBJECTIVES: To examine the adequacy of caregiver-patient communication in serious illness and its relationship to caregiver burden. DESIGN: Cross-sectional cohort study. SETTING: Participants' homes. PARTICIPANTS: One hundred ninety-three persons aged 60 and older seriously ill with cancer, congestive heart failure, or chronic obstructive pulmonary disease and their caregivers. MEASUREMENTS: Communication concerns, measured in terms of agreement with statements regarding desire for and difficulty with communication about the patient's illness. Caregiver burden, measured using a 10-item subset of the Zarit Burden Inventory, with scores ranging from 0 to 40 and higher scores indicating greater burden. RESULTS: Of caregivers, 39.9% desired more communication, and 37.3% reported that communication was difficult. Of patients, 20.2% desired more communication, and 22.3% reported that communication was difficult. Disagreement regarding communication concerns was frequent in caregiver-patient pairs; of caregivers who desired more communication, 83.1% of patients did not, and of patients who desired more communication, 66.7% of caregivers did not. Caregivers who desired more communication had significantly higher caregiver burden scores than did caregivers who did not (9.2 vs 4.7, P<.001), even after adjusting for patient's diagnosis, income, and functional status and caregivers' age, sex, and relationship to the patient. CONCLUSION: A large proportion of caregivers and seriously ill older persons had an unmet desire for increased communication, although they frequently disagreed with each other about this desire. Caregivers' desire for increased communication may be a modifiable determinant of caregiver burden.
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