Standardized posthospitalization education improves caregivers' overall well-being

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Standardized posthospitalization care education administered through an Oncology CarePartner Program that addressed the patient's physical and emotional needs was found to improve caregivers' overall well-being, but had no impact on the time spent on caregiving or difficulty with caregiving tasks.

That's the result of a study conducted with four groups of patients with cancers that represent a significantly longer hospital stay than other cancers: acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), lymphoma, or those undergoing blood marrow transplant (BMT). The complexity of care is significantly higher and necessitates greater caregiver burden following hospitalization, said Crista Creedle, RN, BSN, OCN®, at UNC Hospitals, Chapel Hill, North Carolina, in a presentation at the Oncology Nursing Society 36th Annual Congress.

In this study, patients who were admitted to the oncology service between February and November 2010 were eligible to participate in the Oncology CarePartner Program, in which they and their caregivers received posthospitalization care education that addressed the patient's physical and emotional needs, including central line care, infection and bleeding precautions, nutritional needs, and ways to manage fatigue. The focus for care partners centered on the interrelationships between behavior, personal, and environmental factors, and the ability to understand and complete educational skills.

The effect of the CarePartners Program on caregiver burden was evaluated by the Oberst Caregiving Burden Scale (OCBS) and Bakas Caregiving Outcomes Scale (BCOS) on two oncology units, medical/oncology (n=17) and BMT (n=21), at three times: within 5 days of admission (T1), patient discharge from the hospital (T2), and 30-days after discharge (T3). Changes in scores from T1 to T2, T1 to T3, and T2 to T3 for both the OCBS and BCOS were evaluated using Wilcoxon Signed Rank tests.

Care partners (n=38) were found to be primarily spouses (68%) or mothers (16%), white (79%), female (74%), full-time employees (47%) or retired (21%), and without other caregiving responsibilities (84%). Median age for care partners was 57 years and, for patients, 56 years; patients' median length of stay was 28 days (medical/oncology) and 22.5 days (BMT). Significant increases from T1 to T2 (median=4, P=.0007) and from T1 to T3 (median=5.5, P =.003) were seen in the BCOS; however, no significant changes in OCBS (time or difficulty) were seen.

Educational changes to address these specific areas or evaluation by different scales are both worth further investigation, Creedle concluded, noting that oncology nurses often serve as primary educators for patients and their families and, by providing standardized education, the burden felt by the caregiver can be alleviated and health outcomes improved for both the patient and caregiver.
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