In the trajectory of the person with cancer, the presence of uncontrolled symptoms are the main
and frequent cause of demand for health services, which increases with the advanced stage of the
disease. The modernization of health systems advocates the domiciliation of health care, with
proximity assistance, where informal caregivers assume a role of relevance. Persons with cancer
prefer this typology of service, as well have positive impact in economic health outcomes.
However, it is essential to reflect in the shapes of the professional support, health policies and
incentives, which are needed with the finality to prevent burnout of the caregiver. As ensure the
resources to certify the self-care and quality of life of the person with cancer and informal
caregivers

Fonseca, César

Lopes, M. J.

Lopes, Manuel

Mendes, Felismina

Parreira, P.

Ramos, Ana

Tavares, Ana Patricia

International Journal of Development Research

Repositório Científico da Universidade de Évora

       ORIGINAL RESEARCH ARTICLE  THE IMPACT OF INFORMAL CAREGIVERS DURING CANCER PATIENTS’ TRAJECTORY IN ECONOMIC HEALTH OUTCOMES  1Ana Patrícia Tavares, 2Ana Filipa Ramos, 3Felismina Mendes, 4Manuel Lopes,  5Pedro Parreira and 6César Fonseca  1PhD student, Enfermeira no Centro Hospitalar Médio Tejo, EPE 2RN, MSc, PhD student, Enfermeira no Centro Hospitalar Médio Tejo, EPE 3,4,6 PhD, Professor, University of Évora, Portugal 4PhD, Professor, University of Évora, Portugal 5PhD, Professor, Coimbra Nursing School, Portugal   ARTICLE INFO                                       ABSTRACT  In the trajectory of the person with cancer, the presence of uncontrolled symptoms are the main and frequent cause of demand for health services, which increases with the advanced stage of the disease. The modernization of health systems advocates the domiciliation of health care, with proximity assistance, where informal caregivers assume a role of relevance. Persons with cancer prefer this typology of service, as well have positive impact in economic health outcomes. However, it is essential to reflect in the shapes of the professional support, health policies and incentives, which are needed with the finality to prevent burnout of the caregiver. As ensure the resources to certify the self-care and quality of life of the person with cancer and informal caregivers.      *Corresponding author  Copyright ©2017, Ana Patrícia Tavares et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.       INTRODUCTION  Globally, in 2012, there were 14.1 million new cases of cancer, 8.2 million life losses were caused by it and 32.6 million people lived with cancer (Ferlay et al., 2013). At the same time, more than 14 million new cases will emerge every year in the world, where the number of people with cancer is expected to triple by 2030, as a result of survival (WHO, 2014). Survivors continue to experience significant physical limitations compared to those without a history of cancer, namely with increased fatigue (56%), pain (35%) and insomnia (30%) (Zucca et al., 2012). The presence of symptoms persists permanently, due to the direct adverse effects of cancer, treatment, exacerbation and / or the emergence of new ones associated with relapse or second   cancer (Brant et al., 2011). The cancer survivor experiences different magnitudes of symptoms, at different stages of the disease, with negative effects on quality of life, functional status and self-care. The end of life is reported as a period of increased incidence, intensity of symptoms and emotional distress (Dyar et al., 2012). In the trajectory of the person with cancer, the presence of uncontrolled symptoms is the main and frequent cause of demand for health services (Xiao, 2010). Shi et al. (2011) reported that 1 in 4 cancer survivors experienced severe symptoms one year after diagnosis, even when the adjuvant treatments were finished. If the symptoms are not sufficiently controlled, it is not possible to perform the usual daily activities of daily living, since the capacity for self-care ISSN: 2230-9926  International Journal of Development Research Vol. 07, Issue, 09, pp.15494-15495, September, 2017  Article History:  Received 19th June, 2017 Received in revised form 17th July, 2017 Accepted 17th August, 2017 Published online 30th September, 2017  Available online at http://www.journalijdr.com  Citation: Ana Patrícia Tavares, Ana Filipa Ramos, Felismina Mendes, Manuel Lopes, Pedro Parreira and César Fonseca. 2017. “The impact of informal caregivers during cancer patients’ trajectory in economic health outcomes”, International Journal of Development Research, 7, (09), 15494-15495.           ORIGINAL RESEARCH ARTICLE                                                                            OPEN ACCESS Keywords:  Caregiver,  Typology.  is compromised (Boveldt et al., 2014). The literature identifies the inadequate symptomatic control with negative impact on the different dimensions of human living: 1) quality of life; 2) functional status; 3) perception about health status; 4) cognitive function; 5) sexuality; 6) effective coping mechanisms; 7) comfort; 8) use of health services (Xiao, 2010; Shi et al., 2011; Ripamonti et al., 2012). So, it determinate the need for professional nursing care to respond to cancer-induced imbalance, as the support and participation of the informal family caregiver in controlling suffering and promoting well-being becomes essential. The economic value of informal care represents about 50-90% of the total costs of long-term care in the Member States of the European Union (Ferrer, 2015). The total number of people providing some form of care could reach 125 million across Europe. The estimated annual value of services rendered by the care of relatives, only to the elderly, is estimated to amount to $ 375 billion, and 78% of adults in the community that continue to need long term care, depend of primary source of help (their friends and family) (National Alliance for Caregiving and Evercare, 2007).  Most care provided to people with dependency is not remunerated, however this economic value is considered as a spine column of long-term care. According to the report of the Social Protection Committee and the European Commission (2014), Member States should reshape health policies for greater support and monitoring of informal family caregivers, as well as recognition of their importance. However, the analysis of the impact of informal family caregivers on the reduction of health costs cannot be dissociated from its long-term effects (Krol, Papenburgand and Exel, 2015). There is a correlation between the level of dependence of the person with cancer and the burden of caregivers, with repercussions on the quality of life, which may lead to the early institutionalization of family members. The process of care delivery is considered complex, arduous and dynamic, as it is characterized by constant variations over time, being influenced by the needs of the person and by the feelings of the one who provides and who receives care (Sarmento, Pinto and Monteiro, 2010). Informal caregivers experience more overload, depression, anxiety, and physical health problems compared to non-caregivers of the same age (Davis et al, 2011). For Life After Care (2010), caregivers present not only a greater deterioration of their health status, but also face loss of income, time to leisure and breakdown of relationships.   The future of care systems will require new models and / or reform of existing systems, requiring structured support for informal caregivers. Given that there is a remnant part of the health care that is ensured by the respective network of family and friends. According to Doty (2010) two out of three (66%) elderly people with dependency receive long-term care at home. These care is exclusively provided by their family caregiver, mostly women and daughters. Thus, when analyzing the economic repercussion of caregivers, it is essential to pursue protection and incentive policies at different levels, such as the caregiver's allowance, the co-payment to the person with care needs, tax and other additional benefits, paid leave, unpaid leave, flexible work arrangements, free training and education, respite care and counseling.     REFERENCES  Boveldt, N., Vernooij-Dassen, B., Burger, N., IJsseldijk, M., Vissers, K. and Engels, Y. 2014. Pain and Its Interference with Daily Activities in Medical Oncology Outpatients. Pain Physician, 16, 379-389. Brant, J., Beck, S., Dudley, W., Cobb, P., Pepper, G. andMiaskowki, C. 2011. Symptom trajectories in posttreatment cancer survivors. Cancer Nursing, 31 (1), 67-77. Doty, P. 2010. The envolving balance of formal and informal, institutional and non-institucional long-term care for Older American: a thirty-year perspective. Public Policy and Aging Report, 20 (1), 3-9. Dyar, S., Lesperance, M., Shannon, R., Sloan, J., Colon-Otero, G. 2012. A nurse practitioner directed intervention improves the quality of life of patients with metastatic cancer: results of a randomized pilot study. Journal of Palliative Medicine, 15(8), 890-895; Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Forman, D. and Bray, F. 2013. GLOBOCAN 2012, cancer incidence anda mortality worldwide: IARC cancer Base. France: International Angency for Research on Cancer. Krol, M., Papenburg, J. and van Exel, J. 2015. Does including informal care in economic evaluations matter? A systematic review of inclusion and impact of informal care in cost-effectiveness studies. Pharmacoeconomics, 33(2), 123-135. doi: 10.1007/ s40273-014-0218-y Ripamonti, C., Santini, D., Maranzo, E., Berti, M. andRoila, F. 2012. Management of cancer pain: ESMO clinical practice guidelines. Annals of Oncology, 23, 139-154. Sarmento, E., Pinto, P., and Monteiro, S. 2010. Cuidar do idoso: Dificuldades dos familiares. Coimbra, Portugal: Formasau. Shi, Q., Smith, T., Michonski, J., Stein, K., Kaw, C. andCleenland, C. 2011. Symptom burden in cancer survivors 1 year after diagnosis. Cancer, 15, 2779-2790. World health Organization. 2014. Global battle against cancer won´t be won with treatment alone effective prevention measures urgently needed to prevent cancer crises. London: International Agency of Research on Cancer. Xiao, C. 2010. The state of science in the study of cancer symptom cluster. European Journal of Oncology Nursing, 14, 417-434. Zucca, A., Boyes, A., Linden, W. and Girgs, A. 2012. All´s well that ends well? Quality of life and physical symptoms clusters in long-term cancer survivors across cancer types. Journal of Pain as Symptom Management, 43 (4), 720-731.     15495                              Ana Patrícia Tavares, The impact of informal caregivers during cancer patients’ trajectory in economic health outcomes  ******* 

THE IMPACT OF INFORMAL CAREGIVERS DURING CANCER PATIENTS’ TRAJECTORY IN ECONOMIC HEALTH OUTCOMES

http://dspace.uevora.pt/rdpc/bitstream/10174/22846/1/8405.pdf

THE IMPACT OF INFORMAL CAREGIVERS DURING CANCER PATIENTS’ TRAJECTORY IN ECONOMIC HEALTH OUTCOMES

Abstract

Similar works

Full text

Available Versions

Repositório Científico da Universidade de Évora