Perceptions of care coordination in cancer patient-family caregiver dyads
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ORIGINAL ARTICLE
Perceptions of care coordination in cancer patient-family caregiver dyads Izumi Okado 1
&
Ian Pagano 1 & Kevin Cassel 1 & Randall F. Holcombe 1
Received: 15 April 2020 / Accepted: 8 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To examine cancer patients and their family caregivers’ perspectives of care coordination (CC) using a dyadic research design. Methods In this pilot cross-sectional study, 54 patient-family caregiver dyads completed a validated care coordination instrument (CCI) and its parallel family caregiver instrument (CCICG) from June to September 2019. The sample available for analysis included data from 32 dyads, which included patients receiving active therapy for any cancer type and their primary family caregivers aged 18 years or older. Mixed regression models were used to examine dyadic differences. Results The overall family caregiver scores demonstrated a bimodal pattern; thus, we conducted analyses using aggregate data as well as by highCG and lowCG subgroups. Among dyads in the lowCG subgroup, family caregivers reported significantly lower scores than patients on the total CCI and the three CC domains: Communication, Navigation, and Operational. Caregiver gender, the absence of a patient navigator, and practice setting (hospital-based ambulatory) significantly predicted dyadic differences in the lowCG subgroup. In item-level analyses, family caregivers in the lowCG subgroup reported lower scores than patients on the items related to patient-physician communication. Conclusion A subgroup of family caregivers reported poorer perception of CC than patients, suggesting that those family caregivers and providers may benefit from intervention. Further understanding of patient-family caregiver dyads’ perspectives of CC can inform development of strategies to integrate family caregivers into the cancer care team, develop effective CC interventions for family caregivers, and contribute to improved quality and value of cancer care. Keywords Cancer . Care coordination . Patients . Family caregivers . Dyads
Introduction Each year, nearly 2.8 million individuals in the USA provide care for a family member with cancer [1]. A cancer diagnosis affects both the patient and his/her family, particularly if a family member serves as a primary informal caregiver and undertakes the responsibilities of coordinating care. Care coordination (CC) is defined by the Agency for Healthcare Research Quality as “deliberate organization of patient care Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05764-8) contains supplementary material, which is available to authorized users. * Izumi Okado [email protected] 1
University of Hawaii Cancer Center, 701 Ilalo St. 6th Floor, Honolulu, HI 96813, USA
activities between two or more participants, including the patient, involved in a patient’s care to facilitate the appropriate delivery of healthcare services” [2]. CC is particularly complex for cancer
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