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    Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers

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    Authors
    Tjia, Jennifer
    Ellington, Lee
    Clayton, Margaret F.
    Lemay, Celeste
    Reblin, Maija
    UMass Chan Affiliations
    Department of Medicine
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2015-11-01
    Keywords
    Hospice
    caregiver skills
    framework
    medication management
    symptom management
    Health Services Administration
    Health Services Research
    Neoplasms
    Pain Management
    
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    Link to Full Text
    http://dx.doi.org/10.1016/j.jpainsymman.2015.06.005
    Abstract
    CONTEXT: Family caregivers (FCGs) are often at the frontline of symptom management for patients with advanced illness in home hospice. FCGs' cognitive, social, and technical skills in complex medication management have been well studied in the literature; however, few studies have tested existing frameworks in clinical cases in home hospice. OBJECTIVES: This study sought to assess the applicability of caregiver medication management skills framework by Lau et al. in the context of family caregiving in home hospice to further the understanding of FCGs' essential medication management skills. METHODS: This was a secondary data analysis of 18 audio recorded home hospice visits transcribed verbatim; deductive content analysis of caregiver-nurse interactions was conducted. The target sample included FCGs of hospice patients who had cancer diagnoses in hospices located in the greater urban area of the Rocky Mountain West. Caregiver medication management skills were identified and categorized into the five domains of caregiver expertise. Exemplars of each domain were identified. RESULTS: An average of four medications (SD = 3.5) was discussed at each home hospice visit. Medication knowledge skills were observed in most home hospice visits (15 of 18). Teamwork skills were observed in 11 of 18 cases, followed by organizational and personhood skills (10 of 18). Symptom management skills occurred in 12 of 18 cases. An additional two subconstructs of the personhood domain-1) advocacy for the caregiver and 2) skills in discontinuing medications-were proposed. CONCLUSION: These findings support framework by Lau et al. for caregiver medication management skills and expands on the existing domains proposed. Future interventions to assess FCGs' skills are recommended.
    Source
    J Pain Symptom Manage. 2015 Nov;50(5):630-41. doi: 10.1016/j.jpainsymman.2015.06.005. Epub 2015 Jul 6. Link to article on publisher's site
    DOI
    10.1016/j.jpainsymman.2015.06.005
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/30608
    PubMed ID
    26159294
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jpainsymman.2015.06.005
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