CARE SKILL AND OVERLOAD OF THE FAMILY CAREGIVER OF PATIENTS IN CANCER TREATMENT

to analyze the relationship between the characteristics of patients in cancer treatment, their family caregivers, the care provided with the overload, as well as between overload and the care skills.

Method:

a cross-sectional study conducted at the chemotherapy and radiotherapy services of a university hospital in Rio Grande do Sul (Brazil) from March to August 2017, with 132 family caregivers of patients in cancer treatment. Data was collected by an instrument that characterizes patients, caregivers and care (the Brazilian version of the Caring Ability Inventory) and the Zarit Overload Scale. The following coefficients were used: Spearman correlation, Mann-Whitney or Kruskal-Wallis.

Results:

there was a significant relationship between the total overload and the patient’s level of dependence (p=0.021) and help from others (p=0.009). The “care impact” factor was significantly related with the patient’s level of dependence (p=0.006), the caregiver’s gender (p=0.035) and the care help (p=0.043). Regarding the “perception of self-efficacy” factor, there was a significant relationship involving the caregiver’s age (p=0.036) and, in the “caregiver expectation” factor, a significant relationship was observed with the care help (p=0.002). There was a significant and negative correlation between the total care skill and the overload factor related to interpersonal relationship (p=0.035); and between the “courage” dimension and the “perception of self-efficacy” (p=0.032) and “interpersonal relationship” (p=0.008) factors.

Conclusion:

the characteristics of the patient, the caregiver and the care provided influence the overload of the family caregiver, and this overload, in turn, interferes with the care skills. These results should be considered when planning interventions that aim to guide and prepare family caregivers for home care.

DESCRIPTORS:
Caregivers; Home assistance; Family; Neoplasia; Nursing

Variables	n (%)	Overload
		Total		Impact of caregiving		Perception of self-efficacy		Expectations for care		Interpersonal relation
		Mean(±)	p-value ^*	Mean(±)	p-value ^*	Mean(±)	p-value ^*	Mean(±)	p-value ^*	Mean(±)	p-value ^*
Gender
Female	54(40.9)	20.9(10.9)	0.185	7.7(6.7)	0.250	2.9(2.4)	0.876	8.5(3.1)	0.264	1.8(2.1)	0.983
Male	78(59.1)	23.9(12.2)	0.185	9.9(8.6)	0.250	2.8(2.2)	0.876	9.2(3.2)	0.264	1.9(2.2)	0.983
Age
29-65 years old	57(43.2)	23.7(12.4)	0.508	9.1(8.2)	0.976	3.0(1.9)	0.211	9.4(3.2)	0.152	2.2(2.3)	0.203
66-91 years old	75(56.8)	21.9(11.3)	0.508	8.9(7.8)	0.976	2.7(2.5)	0.211	8.6(3.1)	0.152	1.7(2.0)	0.203
Degree of dependence
Severe/Total	37(28.0)	27.2(13.8)	0.021^†	12.6(9.6)	0.006^†	2.7(2.4)	0.566	9.7(3.3)	0.064	2.1(2.9)	0.689
Moderate	95(72.0)	20.9(10.4)	0.021^†	7.5(6.7)	0.006^†	2.9(2.2)	0.566	8.7(3.0)	0.064	1.8(1.8)	0.689

Variables	n (%)	Overload
		Total		Impact of caregiving		Perception of self-efficacy		Expectations for care		Interpersonal relation
		Mean(±)	p-value	Mean(±)	p-value	Mean(±)	p-value	Mean(±)	p-value	Mean(±)	p-value
Gender
Female	103(78.0)	23.6(12.2)	0.138^‡	9.7(8.1)	0.035^*‡	2.8(2.3)	0.982^‡	9.1(3.2)	0.486^‡	1.9(1.9)	0.868^‡
Male	29(22.0)	19.4(9.6)	0.138^‡	6.2(6.6)	0.035^*‡	2.8(2.1)	0.982^‡	8.6(2.8)	0.486^‡	1.9(2.3)	0.868^‡
Age
18-37 years old	29(22.0)	23.0(11.2)	0.917^†	8.4(6.8)	0.904^†	3.9(2.4)	0.036^*†	9.0(3.6)	0.699^†	1.6(1.3)	0.841^†
38-57 years old	70(53.0)	22.5(11.8)		9.2(8.0)		2.6(2.2)		8.8(3.0)		1.9(2.2)
58-76 years old	33(25.0)	22.8(12.5)		9.0(8.8)		2.4(1.9)		9.2(3.0)		2.2(2.7)
Marital status
Has a partner	101(76.5)	22.5(11.4)	0.906^‡	8.9(7.9)	0.865^‡	2.8(2.2)	0.952^‡	8.9(3.0)	0.656^‡	1.8(1.9)	0.604^‡
No partner	31(23.5)	23.4(13.0)	0.906^‡	9.2(8.2)	0.865^‡	2.8(2.3)	0.952^‡	9.1(3.6)	0.656^‡	2.3(2.9)	0.604^‡
Occupational situation
Works	39(29.5)	22.7(12.1)	0.891^‡	8.6(7.3)	0.902^‡	3.2(2.7)	0.383^‡	8.9(3.2)	0.831^‡	2.0(2.1)	0.451^‡
Does not work	93(70.5)	22.7(11.7)	0.891^‡	9.1(8.2)	0.902^‡	2.7(2.0)	0.383^‡	9.0(3.1)	0.831^‡	1.9(2.2)	0.451^‡
Care time
1 to 3 months	47(35.6)	21.6(11.4)	0.412^†	8.3(6.7)	0.356^†	2.6(2.2)	0.846^†	9.0(3.2)	0.448^†	1.8(2.3)	0.564^†
4 to 6 months	36(27.3)	20.9(11.4)		7.5(7.7)		3.0(2.5)		8.5(3.2)		1.9(2.3)
7 to 12 months	25(18.9)	23.5(10.5)		10.2(7.5)		2.8(2.0)		8.7(3.3)		1.7(1.5)
>12 months	24(18.2)	26.5(13.9)		11.2(10.4)		3.1(2.1)		9.8(2.8)		2.4(2.3)
Help from others in caregiving
Yes	88(66.7)	20.9(11.4)	0.009^*‡	8.1(7.7)	0.043^*‡	2.7(2.2)	0.217^‡	8.3(3.0)	0.002^*‡	1.8(2.1)	0.516^‡
No	44(33.3)	26.2(11.7)	0.009^*‡	10.8(8.1)	0.043^*‡	3.2(2.3)	0.217^‡	10.2(3.1)	0.002^*‡	2.0(2.3)	0.516^‡

Variable	Mean	Standard Deviation	Variation	Low		Medium		High
Variable	Mean	Standard Deviation	Variation	n	%	n	%	n	%
Knowledge	52.20	3.54	44 - 61	22	16.67	87	65.91	23	17.42
Courage	46.31	3.98	37 - 57	20	15.15	91	68.94	21	15.91
Patience	40.54	2.71	34 - 48	16	12.12	100	75.76	16	12.12
CAI-BR Total	139.05	7.10	125 - 160	22	16.67	89	67.42	21	15.91

Variable	Overload		Impact of caregiving		Perception of self-efficacy		Expectations for care		Interpersonal relation
Variable	r	p-value	r	p-value	r	p-value	r	p-value	r	p-value
CAI-BR Total	-0.143	0.101	-0.133	0.128	-0.070	0.425	-0.061	0.490	-0.183	0.035^*
Knowledge	-0.103	0.241	-0.091	0.299	0.005	0.952	-0.134	0.124	-0.053	0.542
Courage	-0.161	0.065	-0.099	0.258	-0.187	0.032^*	-0.048	0.583	-0.227	0.008^*
Patience	-0.018	0.839	-0.044	0.618	0.003	0.974	0.050	0.571	-0.072	0.411

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Nara Marilene Oliveira Girardon-Perlini nara.girardon@gmail.com