International journal of palliative nursing
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Although investigators have identified rewards and difficulties from assuming the role of caregiver for persons with cancer and persons with Alzheimer's disease, few studies have examined factors that lead to role strain for caregivers of persons with both oncological and neurological symptoms. In this study qualitative methods were used to analyse data from self-report questionnaires from 43 caregivers of adults with a primary malignant brain tumour (PMBT) in the USA. ⋯ The data suggest that health-care providers (HCPs) may decrease role strain by helping to identify competing demands, clarifying expectations of the role, providing information to caregivers on how to use formal and informal support systems to delegate care tasks, and by teaching caregivers how and when to ask for help. HCPs may also assist caregivers by providing information on managing cognitive and neuropsychiatric problems at home, what to expect at the end of life, and by following up to determine the caregiver's ability to integrate information into providing care.
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The need for a specialized clinical regimen for patients with dementia who require palliative care has only recently been recognized. Structured approaches to palliative care are not well developed. The recognition and treatment of pain is an important part of this management risk. ⋯ Validity and internal reliability, assessed by calculating Gamma and Cronbach's alpha, were found to be satisfactory. Qualitative evidence gathered from users of the scale indicated that it was considered a useful clinical device that could be completed within one minute. Further analysis of the use of the scale in clinical settings, testing of inter-rater reliability and examination of the limitations found in this study will commence early in 2004.