Caregivers' context varies widely, with many providing care despite low levels of resources and high levels of additional demands.Changes in health care have shifted much cancer care to the home, with limited data to inform this transition.
21 24 As a result, intervention components typically focus on the individual level (patient or caregiver), local context (clinic or hospital) or system level (economic or policy); even though these are inter-related components within complex systems.
In this approach, seven levels for exploring obstacles and facilitators are recognized: the intervention itself, the innovation itself, the individual professional, the patient (e.g., the caregiver), the social context, the organizational context, and the economic and political context [ 60].
The PHCT doctor or nurse has a long-term relationship with the patient that also allows familiarity with the caregiver and care context and the opportunity to offer individualized intervention according to individual needs [ 26, 27].
Despite "own GP" being the most preferred respondents' caregiver, the actual context in which such physicians have to operate ("solo general practice")—with few diagnostic facilities and long waiting times for the visits would not be considered the best service alternative.
This diversity in importance of burden dimensions among subgroups indicates that although some aspects of caregiving burden may not seem relevant in some group of caregivers, they may matter to caregivers in another context, as was described above for the dimension relational problems.
Placing these conditions experienced by caregivers in the context of family stress theory and quality of life advances our understanding of caregivers' experiences by examining how multiple aspects of caregivers' lives – their quality of life – may be partly influenced by other existing environmental stressors, stress appraisal, coping methods and social support.
Instead, it appears that caregivers relied on context in making the pain determinations.
Although experts in ethics and law prescribe autonomous decision making as an essential component of informed consent to operative treatment, patients with esophageal cancer told us in a previous study that they preferred to entrust decision making to their caregivers in the context of life-threatening illness.
