Factorial structure of quality of life, satisfaction with caregiving and caregiver burden in palliative care: A systematic review.
Laura Llop-Medina, Francisco Ródenas-Rigla, Alfonso Gallego-Valadés and 1 others
PMID 38268259WHAT IT FOUND
Three common palliative care questionnaires measure different things depending on who fills them out and where they are used.
A single total score for caregiver satisfaction or burden may hide important differences in how patients and families interpret care.
Key findings
01The FAMCARE satisfaction scale is mostly interpreted as measuring one single global judgement of care, but some cultural versions split it into four distinct areas like information, physical care, and pain management.
02The Zarit Burden Interview for caregivers showed a one-factor structure in palliative care, which contradicts the two-factor model (personal and role strain) seen in other populations, though this is based on only one study.
03The EORTC QLQ-C30 quality of life tool produced conflicting structures, with some studies supporting a single global score and others identifying nine separate domains, indicating the concept is multidimensional.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 16 studies were included, with just one study for the ZBI tool. A meta-analysis was not possible due to heterogeneous reporting methods and missing statistical data in the included studies. The review did not cover tools that assess knowledge and attitudes of formal caregivers, limiting the scope of quality assessment instruments reviewed.
Declared interests
The authors declared no conflicts of interest. The research was funded by MCIN/AEI and the European Union's Horizon 2020 programme.
The easy way to misread this
Do not assume that a total score on the FAMCARE or ZBI represents a single underlying concept for all patients or caregivers. The review shows that the factor structure is unstable across cultures and settings, so a global score may mask specific areas of dissatisfaction or burden that require different nursing responses.