Résumé :
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[BDSP. Notice produite par INIST-CNRS kR0x22H6. Diffusion soumise à autorisation]. Objective : To describe the effect of terminal cancer on the patient's family, finances and daily life. Methods : A cluster sample of 2000 adults (>=18 years old) who had died from cancer, and who were representative of Italy, was studied. 1900 caregivers were identified and 68% responded to a post-bereavement survey. Caregivers included the patient's child (46%), his/her spouse (31%), other relatives or friends (20%) or a health professional (3%). The median age of a caregiver was 54 years and 69% were females. During the last 3 months of the patient's life, 44% of caregivers reported difficulties in their regular employment. Results : Of the 68% of families who had to pay for some of the care, 37% had to pay for drugs, 36% for nursing and assistance and 22% for physicians. Paying for care was more frequent in the south of Italy (OR 2.5 ; 95% Cl 1.0 to 6.3) and when the patient was a housewife (OR for unit increase 2.7 ; 95% Cl 1.6 to 6.1). To cover the costs of patient care, 26% of families used all or most of their savings. Economic difficulties were greater in the south of Italy (OR 3 ; 95% Cl 1.8 to 5.1), for female caregivers (OR 1.4 ; 95% Cl 1.0 to 1.9) and for disadvantaged patients. The duration of time the patient was completely dependent strongly determined the effect caregiving had on their regular employment and on the family's financial situation. Conclusions : Although in Italy families are responsible for a small percentage of the overall costs of patient care, the effect of cancer on savings and daily life can be substantial. Strong geographical and gender differences emerged from this study.
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