Evidence map›Paper›PMID 25934560›Full record

ArticleBMC palliative care2015

End-of-life care research with bereaved informal caregivers--analysis of recruitment strategy and participation rate from a multi-centre validation study.

Stephanie Stiel, Maria Heckel, Sonja Bussmann, Martin Weber, Christoph Ostgathe

Registry-linked trialOpen access · goldAbstract readMulticenter StudyValidation Study
In one paragraph

Article in BMC palliative care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03566732 (International Care Of the Dying Evaluation), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03566732 completednot on this mapstarted 2017, after this paper: background citation

International Care Of the Dying Evaluation (CODE): Quality of Care for Cancer Patients as Perceived by Bereaved Relatives

TypeobservationalSponsorUniversity of BergenRan2017 to 2018Enrolled914ConditionsNeoplasms, Bereavement, Quality of Life
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Benefits and Burdens of Research Participation: A Mixed Methods Systematic Review in Palliative and End-of-Life Care.Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association · 2025
    Pooled it
  2. Comfort, benefit, and distress: An exploratory study of research experiences of bereaved parents in the neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  3. Palliative medicine · 2026
    Article
  4. Article
  5. The quality of care of the dying in hospital-next-of-kin perspectives.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Stephanie StielDepartment of Palliative Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany. stephanie.stiel@uk-erlangen.de.
Maria HeckelDepartment of Palliative Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany. maria.heckel@uk-erlangen.de.
Sonja BussmannInterdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany. bussmann@posteo.de.
Martin WeberInterdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany. martin.weber@unimedizin-mainz.de.
Christoph OstgatheDepartment of Palliative Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany. christoph.ostgathe@uk-erlangen.de.
Universitätsklinikum Erlangen · DEUniversity Medical Center of the Johannes Gutenberg University Mainz · DEComprehensive Cancer Center Erlangen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne essential element of research is the successful recruitment of participants. However, concerns are obvious regarding the ethical implications of involving terminally ill and even dying patients and their informal caregivers as research participants. This study aims to illustrate central issues encountered when recruiting bereaved informal caregivers for a questionnaire validation study on the quality of dying and death.

methodsBetween July 2012 and November 2013, informal caregivers of deceased inpatients who were treated at two palliative care units in Germany were invited to participate in a questionnaire validation study. Informal caregivers were called by a trained researcher at the end of the fourth week after death at the earliest and by the sixteenth week after death at the latest and asked to participate in a face-to-face interview in their private home.

resultsThe overall participation rate of all eligible informal caregivers was 76.1% (226/297). The mean burden score was 2.5 (NRS from 0=no burden to 10=maximum burden; n=221). Higher burden scores (≥4) were associated with emotional and burdensome memories (n=34) being invoked throughout the interview. Severe or maximum burden scores (≥7) were stated by 13.2% of participants. The average time between the associated patient's death and the informal caregiver's interview was 57.3 days (range 26-176 days, median 49.5 days). 5.3% of all 226 interviews were not completed due to different reasons. Participants' comments on the way in which the study was conducted gave insight into their motivation to take part in the study and their evaluation of the interview situation.

conclusionsThe recruitment strategy can be recommended to other researchers developing research with bereaved carers. The burden caused by study participation was acceptable to the researchers carrying out this research, although a small group of participants experienced high levels of burden which should be anticipated and appropriate support services offered. Family caregivers are willing to support end-of-life care research, have different motivations for participation and even reported benefits from participation. Nevertheless, study designs have to take into account and ease the potential burden of interviews for caregivers experiencing grief.

Indexed as

BereavementPatient SelectionAdultAgedAge FactorsCaregiversFemaleGermanyHealth Services ResearchHumansMaleMiddle AgedPalliative CareResearch DesignSex FactorsSurveys and Questionnaires

Identifiers

PMID25934560
PMCPMC4422133
OpenAlexW2079433559

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.