Dying within dyads: Stress, sense of security and support during palliative home care

PLoS One. 2021 Sep 14;16(9):e0257274. doi: 10.1371/journal.pone.0257274. eCollection 2021.

Abstract

Objectives: To examine similarities and dissimilarities in patient and family caregiver dyads in their experience of stress, support, and sense of security.

Methods: 144 patients and their family caregivers participated. Patients were admitted to six Swedish specialist palliative home care units and diagnosed with a non-curable disease with an expected short survival. We analysed similarity patterns of answers within dyads (correlations) as well as dissimilarities, expressed as the difference between within-dyad responses. The latter were subjected to a model-building procedure using GLM, with 13 sociodemographic and clinical characteristics as independent variables.

Results: Within dyads, patients and family caregivers scored similar in their perception of support and sense of security with care. There was also dissimilarity within dyad responses in their perception of stress and support that could be attributed to sociodemographic or clinical characteristics. When patients scored higher levels of stress than family caregivers, the family caregiver was more likely to be male. Also family caregiver attachment style (attachment anxiety), patient age and the relationship of the family caregiver to the patient explained dissimilarities within the dyads.

Conclusions: Patients and family caregivers within the dyads often, but not always, had similar scores. We suggest that it is important that the healthcare staff identify situations in which perceptions within the dyads regarding stress and perception of support differ, such that they can recognise patients' and family caregivers' unique needs in different situations, to be able to provide adequate support and facilitate dyadic coping.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / psychology*
  • Caregivers
  • Female
  • Home Care Services
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Prospective Studies
  • Quality of Life
  • Security Measures
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires

Grants and funding

AM This work was supported by the Medical Research Council of Southeast Sweden [grant number LIO-126821], the Swedish Society of Medicine [grant number 2008-21732], and ‘Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse [grant number 104821] The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.