Trajectories of emotional functioning and experienced care of relatives in the last year of life of patients with advanced cancer: A longitudinal analysis of the eQuiPe study

Author:

Ham Laurien12ORCID,Fransen Heidi P.1,Raijmakers Natasja J. H.1,van den Beuken‐van Everdingen Marieke H. J.34ORCID,van den Borne Ben5,Creemers Geert Jan6,de Graeff Alexander7,Hendriks Mathijs P.8,de Jong Wouter K.9,van Laarhoven Hanneke1011,van Leeuwen Lobke12,van der Padt ‐ Pruijsten Annemieke13,Smilde Tineke J.14,Stellingwerf Margriet15,van Zuylen Lia1116,van de Poll ‐ Franse Lonneke V.11718

Affiliation:

1. Department of Research & Development Netherlands Comprehensive Cancer Organization (IKNL) Utrecht The Netherlands

2. Netherlands Association for Palliative Care (PZNL) Utrecht The Netherlands

3. Centre of Expertise for Palliative Care Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands

4. Department of Anesthesiology and Pain Management Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands

5. Department of Pulmonology Catharina Hospital Eindhoven The Netherlands

6. Department of Medical Oncology Catharina Hospital Eindhoven The Netherlands

7. Department of Medical Oncology University Medical Center Utrecht Utrecht The Netherlands

8. Department of Medical Oncology Northwest Clinics Alkmaar The Netherlands

9. Department of Pulmonology Hospital Gelderse Vallei Ede The Netherlands

10. Department of Medical Oncology Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands

11. Cancer Treatment and Quality of Life Cancer Center Amsterdam Amsterdam The Netherlands

12. Department of Internal Medicine Diakonessenhuis Utrecht The Netherlands

13. Department of Internal Medicine Maasstad Hospital Rotterdam The Netherlands

14. Department of Internal Medicine Jeroen Bosch Hospital Den Bosch The Netherlands

15. Department of Pulmonology University Medical Center Utrecht Utrecht The Netherlands

16. Department of Medical Oncology Amsterdam University Medical Centers Amsterdam The Netherlands

17. Department of Medical and Clinical Psychology CoRPS – Center for Research on Psychology in Somatic Diseases Tilburg University Tilburg The Netherlands

18. Division of Psychosocial Research and Epidemiology The Netherlands Cancer Institute Amsterdam The Netherlands

Abstract

AbstractObjectiveAdvanced cancer has a major impact on both patients and their relatives. To allow for personalized support, it is important to recognize which relatives will experience a decline in emotional functioning during the patient's last year of life, when this decline will occur, and what factors are associated with it. This study aimed to examine the trajectory of emotional functioning of relatives during that time and the characteristics associated with changes in this trajectory.MethodsA prospective, longitudinal, multicenter, observational study in patients with advanced cancer and their relatives was conducted (eQuiPe). We analyzed relatives' changes in emotional functioning in the patient's last year using the EORTC QLQ‐C30 and assessed associations with sociodemographic and care characteristics using multivariable mixed‐effects analysis.Results409 relatives completed ≥1 questionnaires during the patient's last year of life. Mean age was 64 years, 61% were female and 75% were the patient's partner. During this year, mean emotional functioning declined significantly over time from 73.9 to 64.6 (p = 0.023, effect size = 0.43). The type of relationship between relatives and patients (p = 0.002), patient’ sleep problems (p = 0.033), and continuity of care (p = 0.002) were significantly associated with changes in emotional functioning.ConclusionsRelatives' emotional functioning declined during the patient's last year of life. Support for them, especially partners and relatives of patients with sleep problems, is important. Relatives who experienced more continuity of care had a less steep decline in emotional functioning.

Publisher

Wiley

Subject

Psychiatry and Mental health,Oncology,Experimental and Cognitive Psychology

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