Online citations, reference lists, and bibliographies.

The Impact Of Serious Illness On Patients' Families. SUPPORT Investigators. Study To Understand Prognoses And Preferences For Outcomes And Risks Of Treatment.

K. Covinsky, L. Goldman, E. Cook, R. Oye, N. Desbiens, D. Reding, W. Fulkerson, A. Connors, J. Lynn, R. Phillips
Published 1994 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
OBJECTIVE To examine the impact of illness on the families of seriously ill adults and to determine the correlates of adverse economic impact. DESIGN Data were collected during the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT), a prospective cohort study of outcomes, preferences, and decision making in seriously ill hospitalized adults and their families. SETTING Five tertiary care hospitals in the United States. PARTICIPANTS The 2661 seriously ill patients in nine diagnostic categories who survived their index hospitalization and were discharged home were eligible for this analysis. Surrogate and/or patient interviews about the impact of illness on the family were obtained for 2129 (80%) of these patients (mean age, 62 years; 43% women; 6-month survival, 75%). OUTCOME MEASURES Surrogates and patients were surveyed to determine the frequency of adverse caregiving and economic burdens. Multivariable analyses were performed to determine correlates of loss of family savings. RESULTS One third (34%) of patients required considerable caregiving assistance from a family member. In 20% of cases, a family member had to quit work or make another major life change to provide care for the patient. Loss of most or all of the family savings was reported by 31% of families, whereas 29% reported loss of the major source of income. Patient factors independently associated with loss of the family's savings on multivariable analysis included poor functional status (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.10 to 1.78 for patients needing assistance with three or more activities of daily living), lower family income (OR, 1.74; 95% CI, 1.37 to 2.21 for those with annual incomes below $25,000), and young age (OR, 2.85; 95% CI, 2.13 to 3.82 for those younger than 45 years compared with those 65 years or older). CONCLUSIONS Many families of seriously ill patients experience severe caregiving and financial burdens. Families of younger, poorer, and more functionally dependent patients are most likely to report loss of most or all of the family's savings.

This paper is referenced by
Guiding the guiders. Recognizing surrogates' needs and advancing communication in the intensive care unit.
Giora Netzer (2015)
Physician-Assisted Suicide
L. Snyder (2001)
Depression in family caregivers of cancer patients: the feeling of burden as a predictor of depression.
Young Sun Rhee (2008)
Factors contributing to economic burden in lung cancer spousal caregivers.
Melinda S Kavanaugh (2015)
Supporting Cancer Patients Dying at Home or at a Hospital for Taiwanese Family Caregivers
S. T. Tang (2009)
Surviving critical illness: Acute respiratory distress syndrome as experienced by patients and their caregivers
C. Cox (2009)
Financial hardship and the intensity of medical care received near death.
Reginald D Tucker-Seeley (2015)
Preparing for the Aging Population: Family Caregiving and Labor Force Matters
Denise Guerrierea (2015)
Mental problems and psycho-oncological management in cancer treatment
Hideki Onishi (2010)
Economic Burdens and Quality of Life of Family Caregivers of Cancer Patients
Y. Yun (2005)
National estimates of out-of-pocket health care expenditure burdens among nonelderly adults with cancer: 2001 to 2008.
D. Bernard (2011)
Bereavement: addressing challenges faced by advanced cancer patients, their caregivers, and their physicians.
J. Kutner (2009)
Quality of life, emotional abnormalities, and cognitive dysfunction in survivors of acute lung injury/acute respiratory distress syndrome.
R. Hopkins (2006)
The dying role.
L. Emanuel (2007)
EHRA Expert Consensus Statement on the management of cardiovascular implantable electronic devices in patients nearing end of life or requesting withdrawal of therapy.
L. Padeletti (2010)
Individual patient advocacy, collective responsibility and activism within professional nursing associations
Margaret Mahlin (2010)
Integrating Palliative Care Into the Care of Patients With Advanced Lung Cancer
Jennifer M. Kapo (2015)
Program Profile Enhancing Patient Satisfaction Through the Use of Complementary Therapies
D. Kresevic (2014)
Gender differences among Canadian spousal caregivers at the end of life.
K. Brazil (2009)
Well-being in informal caregivers of survivors of acute respiratory distress syndrome*
J. Cameron (2006)
Patient preference and outcomes-based surgical care among octogenarians and nonagenarians.
K. Lee (2006)
End-of-life care in dementia: a review of problems, prospects, and solutions in practice.
Z. Blasi (2002)
Am I doing the right thing? Provider perspectives on improving palliative care in the emergency department.
A. Smith (2009)
Practical guidance for evidence-based ICU family conferences.
J. Curtis (2008)
Opportunities for Palliative Care in Public Health.
L. de Lima (2016)
Palliative care--a shifting paradigm.
Alanna Kelley (2010)
What impact do setting and transitions have on the quality of life at the end of life and the quality of the dying process?
M. Mezey (2002)
Distressing Symptoms, Disability, and Hospice Services at the End of Life: Prospective Cohort Study
T. Gill (2018)
Impact of financial burden of cancer on survivors' quality of life.
Kathleen Fenn (2014)
Methodological considerations for researching the financial costs of family caregiving within a palliative care context
C. Gardiner (2016)
Review article: Financial stress and strain associated with terminal cancer—a review of the evidence
B. Hanratty (2007)
Family caregivers' perceived symptom distress of persons with a primary malignant brain tumor
N. Linendoll (2008)
See more
Semantic Scholar Logo Some data provided by SemanticScholar