Soek Hui Patricia Neo
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gmsnshp@nus.edu.sg
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Publication Validation of the English and translated Chinese version of the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C)(Taylor & Francis, 2019-06-15) Grace Yang; Grace Su-Yin Pang; Geok Ling Lee; Patricia Soek Hui Neo; Yin Yee Wong; Debra Limin Qu; Yin Bun Cheung; SOCIAL WORK; DUKE-NUS MEDICAL SCHOOLPublication Caregiving and its resulting effects—The care study to evaluate the effects of caregiving on caregivers of patients with advanced cancer in Singapore(2016) Chua, C.K.T; Wu, J.T; Yeewong, Y; Qu, L; Tan, Y.Y; Neo, P.S.H; Pang, G.S; DUKE-NUS MEDICAL SCHOOLInformal caregivers (IC) are key to enabling home deaths, where preferred, at the end-of-life. Significant morbidity from advanced cancer can make caregiving burdensome. However, knowledge about the nature of the caregiving burden for caregivers in Singapore is limited. Hence, the key objective in this study was to examine the impact of the caregiving burden on quality of life (QOL), mental health and work capacity among local ICs. Eligible English-speaking ICs of hospitalized advanced cancer patients were recruited through non-random sampling. The Zarit Burden Interview (ZBI), Caregiver Quality of Life Index—Cancer (CQOLC), Center for Epidemiologic Studies Depression Scale—Revised (CESD-R), and Work Productivity and Activity Impairment Questionnaire (WPAI) were interviewer-administered to eligible ICs. Altogether, 16 ICs were surveyed. The mean age of ICs was 43.8 years. Most were children of patients (43.8%), and eight ICs had high burden (ZBI > 17). Those with ZBI > 17 had lower QOL, higher depression scores as well as greater work and activity impairment. In conclusion, high caregiver burden has adverse effects on QOL, mental health and work productivity. Non-physical elements of caregiving (particularly financial and decision-making) and increased number of care roles undertaken by a single IC contribute to high burden. Future interventions for caregiving burden in Singapore should also address the financial and decision-making aspects of caregiving. Outsourcing selected aspects of the caregiving role to community services may reduce the number of caregiving aspects undertaken by a single IC and caregiver burden. © 2016 by the authors; licensee MDPI, Basel, Switzerland.Publication Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS): Prospective cohort study protocol(2018) Teo, I; Singh, R; Malhotra, C; Ozdemir, S; Dent, R.A; Kumarakulasinghe, N.B; Yeo, W.L; Cheung, Y.B; Malhotra, R; Kanesvaran, R; Yee, A.C.P; Chan, N; Wu, H.Y; Chin, S.M; Allyn, H.Y.M; Yang, G.M; Neo, P.S.H; Nadkarni, N.V; Harding, R; Finkelstein, E.A; MEDICINE; DUKE-NUS MEDICAL SCHOOLBackground: Advanced cancer significantly impacts quality of life of patients and families as they cope with symptom burden, treatment decision-making, uncertainty and costs of treatment. In Singapore, information about the experiences of advanced cancer patients and families and the financial cost they incur for end-of-life care is lacking. Understanding of this information is needed to inform practice and policy to ensure continuity and affordability of care at the end of life. The primary objectives of the Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS) cohort study are to describe changes in quality of life and to quantify healthcare utilization and costs of patients with advanced cancer at the end of life. Secondary objectives are to investigate patient and caregiver preferences for diagnostic and prognostic information, preferences for end-of-life care, caregiver burden and perceived quality of care and to explore how these change as illness progresses and finally to measure bereavement adjustment. The purpose of this paper is to present the COMPASS protocol in order to promote scientific transparency. Methods: This cohort study recruits advanced cancer patients (n = 600) from outpatient medical oncology clinics at two public tertiary healthcare institutions in Singapore. Patients and their primary informal caregiver are surveyed every 3 months until patients' death; caregivers are followed until 6 months post patient death. Patient medical and billing records are obtained and merged with patient survey data. The treating medical oncologists of participating patients are surveyed to obtain their beliefs regarding care delivery for the patient. Discussion: The study will allow combination of self-report, medical, and cost data from various sources to present a comprehensive picture of the end-of-life experience of advanced cancer patients in a unique Asian setting. This study is responsive to Singapore's National Strategy for Palliative Care which aims to identify opportunities to meet the growing need for high quality care for Singapore's aging population. Results will also be of interest to policy makers and researchers beyond Singapore who are interested to understand and improve the end-of-life experience of cancer patients. © 2018 The Author(s).