الفهرس 
Introduction and Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Cancer is one of the major health problems. Globally the number of new cases is expected to rise by about 70% over the next two decades. It is the leading cause of morbidity and mortality in all age groups. There are millions of cancer patients in need of palliative care. In recent years, there is a tremendous growth in palliative care as an integral part of healthcare worldwide. Interdisciplinary palliative care teams work with people and their families to clarify goals of care and provide symptom management, psycho-social, and spiritual support Palliative care is treatment to relieve symptoms caused by cancer, rather than cure, and improve the quality of patient’s life and their families. Family caregivers want concrete information about medications, tests, treatments, and resources. They also want time to have their questions answered and can provide anticipatory guidance for what the caregiver can expect. This kind of information can relieve caregivers’ distress arising from uncertainties about their ill family members’ disease and treatment status and the care they may need. Therefore, nurses play an important role to provide information toward family caregiver in a clear, understandable way through verbal, written, and electronic methods. Aim of the study The aim of this study was to assess family caregivers’ needs for patients with cancer regarding the palliative care. Subjects & method Study design: Descriptive study design was utilized in this study. Study setting: This study was conducted in Oncology Outpatient Clinic of Tanta Health Insurance Hospital affiliated to Health Insurance Organization, Tanta city, Al Gharbia Governorate. Study Subjects: purposive sampling of 400 family caregiver of patient with cancer who attended the previous setting. Tool of the study: A structured interview schedule was developed and used by the researcher in order to obtain the necessary data for this study. It consisted of the following parts: - Part (1): Socio-demographic characteristics of the family caregivers: this part contained of 16 questions included: age, sex, educational level, marital status, residence, degree of kinship, monthly income, job, previous death experience and current experience in the care of cancer patient, how many people live in the caregivers’ house hold, the patient live in the same house hold, duration of caregiving role, and physical problems. Part (2): Socio-demographic characteristics and medical history of cancer patient: this part included of 12 questions included: age, sex, education, occupation, income, marital status, number of children, protocol of treatment, duration of cancer, and its type. Part (3): Needs of the family caregivers about the Palliative care: It was developed by the researcher based on the literature review to assess the family caregivers needs, it consisted of five sections: - Section (A) Informational needs: this section included the following: 1-General informational needs about palliative care: This section contain the following: the awareness of palliative care, principles, aim, services provided, the team of palliative care, for whom palliative care should be provided, and setting that provide palliative care. 2-Specific informational needs: This section was developed by Family Caregiver Alliance (2006) it composed of (12) items that cover the needs for information about disease stage, care to the patient, dietary information, cancer-specific information, homecare information, psychological support information, health information, insurance, and social welfare information. Section (B) Financial needs: This section consisted of five questions included the need for cost of traveling to and from medical appointment, drug cost and investigation, preparing for surgery, missing work, food supply and cost of uncovered services with insurance. Section (C) Physical needs: This section consisted of twelve questions included the need for: assistance in moving, lifting, bathing, massaging, operating medical equipment, healthy food cooking, get enough time to sleep, health promotion, follow up to control their own disease, and examine current health patterns and weight changes. Section (D) Psychological needs: This section consisted of eleven questions included the need for psychological support from family member, group discussion to express emotion and reduce anxiety and time to breath. Section (E) Social needs: This section consisted of eight questions included the need for: social support from the family members and friends and health care professional, guidance from health care providers, time to attend social event like party or condolences, time for well-being and not allowed to be social isolated, social network to provide support. Scoring system of caregiver needs: The total scores of caregivers’ need was classified as follow: - Low need level <50% of the total needs score - Moderate need level 50% -70% of the needs total score - High need level > 70% of the total needs score Result: - The results of the current study can be summarized as follows: - More than one third (34.5 %) of the studied family caregiver their ranged aged 31 to less than 41 years and 59 % of the studied family caregivers lived in rural areas - Less than two thirds 61.3 % of the studied family caregiver were females, whereas 69.8% of them were married. - About one half (52.5%) of the studied family caregivers had university /post graduate education. - More than one half (52.5%) of the studied family caregivers had first degree of kinship, while about 57.3 % of them had sufficient monthly income. - More than two thirds (70.8%) of the studied family caregivers live with the patients in the same house. - Only 30% of caregivers took previous training regarding caring for the patient while 60.8% of them took the training through a professional trainer. - The majority (92.3%) of the studied patients took chemotherapy treatment. - Less than one half (46 %) of the studied family caregivers had fair general knowledge about palliative care, while, (40.8 %) of them had poor general knowledge about palliative care. - Related to specific informational needs about less than one half (46.7 %) of the studied family caregivers had high need level for information about palliative care, while more than one quarter (27.5 %) of them had low need level for information about palliative care, and the one quarter (25.8 %) of them had moderate need level for information about palliative care. - Related to financial needs, nearly half (47%) of the studied family caregivers had high financial need level for palliative care while, less than one fifth (16.8 %) of them had low financial need level, and more than one third (36.2 %) of them had moderate level of financial need for palliative care. - Few percentages (13.2%) of the studied family caregivers had high physical needs level about palliative care, while less than half (44 %) of them had low physical needs level about palliative care, and more than one- third (42.8 %) of them had moderate physical needs level about palliative care - More than half (58.3%) of the studied family caregivers had high psychological needs level about palliative care, while about one quarter 26.5 % of them had low psychological needs level, and few (15.2 %) of them had moderate psychological needs level about palliative care. - More than two thirds (70 %) of the studied family caregivers had high social needs level about palliative care, while 10.3 % of them had low social needs level about palliative care, and also 10.7 % of them had moderate social needs level about palliative care. - More than one quarter (29%) of the studied family caregivers had high total needs level about palliative care, while one quarter (25 %) of them had low total needs level, compared to less than half (46 %) of them who had moderate total needs level about palliative care. - There was a statistically significant relation between the studied family caregivers and total needs score about palliative care and all variables of their socio-demographic characteristics except marital status, occupation and presence of caregiver with the patient in the same house (p>0.05). - There was a positive correlation between all domain of palliative needs among the family caregivers (informational needs score, financial needs score, physical needs score, psychological needs score and social needs score) and the total needs score (p>0.05) Conclusion Based on the findings of the current study, it can be concluded that, less than one- third of the studied family caregivers had high total needs level about palliative care, while one quarter of them had low total needs level about palliative care, and about half of them had moderate total needs level about palliative care. There was a positive correlation between all domain of palliative needs among the family caregivers (informational needs score, financial needs score, physical needs score, psychological needs score and social needs score) and the total needs score. Recommendation 1. Community health nurse should provide special educational programs to all family caregivers to upgrade their knowledge about palliative care. 2. Instructional guidelines should be applied on a wide range through different places that serve the cancer patients. 3. Community support either governmental or non- governmental should be provided to family caregivers in order to meet their needs. 4. Further researches are required to investigate needs of family caregivers as informational needs, financial needs, physical needs, psychological needs and social needs.