Coping strategies of family carers for older relatives in Finland

Background. As the population continues to age, it is important that older people and their family carers get all the help and support they need with coping. This requires knowledge and understanding of the factors that foster and promote coping strategies, and on the other hand that complicate coping. Aims and objectives. Conducted as part of a major international research project on carers’ work and coping in four countries, the purpose of this study was to explore the coping strategies of family carers looking after older relatives in their own home and to identify related factors. Design. A survey involving 290 family carers from three towns in Finland. Methods. The data were collected with a questionnaire including the Carers’ Assessment of Managing Index developed by Nolan et al. (1995) . Results. The most helpful coping strategy was to establish one's priorities and concentrate on them. Other strategies that over 80% of the respondents regarded as helpful were believing in oneself and one's ability to handle the situation, taking life 1 day at a time, looking for positive things in each situation and relying on one's own expertise and experience. The 10 most helpful coping methods included five problem‐solving strategies, four emotional‐cognitive strategies and one managing stress strategy. The age and gender of the family carers were found to correlate with the results. Conclusions. Our findings lend further support to earlier results according to which there are both similarities and differences in the coping strategies of family carers in different countries. Relevance to clinical practice. Nurses who meet family carers of ageing individuals in their work will be able to use these results in assessing how these carers are coping and whether they need support, as well as in developing services for family carers.     

某军队医院合同制护士工作满意度及其影响因素的调查

目的 了解军队医院合同制护士的工作满意度状况,分析其影响因素.方法 采用问卷调查法对某军队医院890名合同制护士进行无记名问卷调查,并分析其结果.结果 50.2%的调查对象对工作不满意,人口统计学变量对护士的工作满意度有明显影响,护士对外部奖励、自我计划、家庭/工作平衡的满意度较低.结论 合同制护士的工作满意度较低,应通过完善合同护士职业生涯规划、规范医院薪酬管理、改善排班模式等措施提高合同护士的工作满意度,稳定护士队伍,提高整体护理质量.     

Features of problematic eating behaviors among community-dwelling older adults with dementia: Family caregivers' experience

This study aimed to explore family caregivers' experience of the problematic eating behaviors among community-dwelling older adults with dementia, and how these caregivers cope with these problems. An exploratory qualitative study using purposive sampling recruited family caregivers of community-dwelling older adults with dementia in southern Taiwan. In-depth interviews were carried out with a semi-structured interview guide. Data were saturated when the number of participants reached a certain number. The following three features were derived from the content analysis: fundamental deviations of eating behaviors, expressing needs through eating behaviors, and loss of eating ability. The results also show that caregivers often derived their own ways of coping with the problems they faced, and tended to have negative attitudes and behaviors with regard to coping with the demands of older adults with dementia. The findings of this study can provide valuable information to family caregivers with regard to the problematic eating behaviors of older adults with dementia, so that early recognition and understanding of such behaviors facilitate appropriate responses, thus reducing the burden shouldered by caregivers.     

Family carers of stroke survivors: needs, knowledge, satisfaction and competence in caring

Purpose. To examine the support required by family carers for stroke survivors.

Methods. Forty-two family carers were recruited for surveys of needs, knowledge, satisfaction, and competence in caring before and 4 - 6 weeks after discharge from an Acute Stroke Unit (ASU).

Results. Information deficits about dealing with psychological, emotional, and behavioural problems and local service information were priorities before and after discharge. Younger female carers (under 56 years) were least satisfied with communication with ASU staff. Face to face contact was valued. After discharge younger female carers, particularly of non-White ethnic groups, reported lower levels of competence in caring and higher burden. Knowledge of stroke risk factors was low in all groups. High satisfaction with treatment and therapy in the ASU, was not transferred to the community. Carers reported feeling alone and described uncoordinated services.

Conclusions. Carers are able to anticipate and prioritise their needs, value communication with staff and involvement with discharge-planning, but particular difficulties were experienced by younger female carers and those from non-White ethnic groups. This requires particular attention when developing targeted interventions for family carers from a mixed ethnic community. In-depth and longitudinal studies are needed to detail psychosocial needs and guide practice particularly amongst non-White family carers.     

脑梗死恢复期患者家属需求及相关因素分析

目的了解脑梗死患者及家属在恢复期的需求,并分析其相关因素。方法采用自行设计的需求调查表,对81名住院患者家属进行调查。结果81名患者家属需求得分85—230分,平均（150．84±32．40）分,在7个维度中用药护理的需求最高,需求前10项中有6项是用药护理的需求,需求后10项中日常生活护理有6项,其中管道护理需求最低只占14．8％。男性家属和女性家属在日常生活护理方面的需求差异有统计学意义[（21．70±6．11）分比（17．63±5．50）分;t=3．13,P〈0．01];有、无照护经历的家属需求总分差异有统计学意义[（164．90±30．28）分比（142．12±30．81）分;t=-3．26,P〈0．01];患者家属需求的其他相关因素有护工协助照护、家属与患者的关系、家属的文化程度（P〈0．05）。结论恢复期脑梗死患者家属对用药护理、患者心理护理、家属自身需求、家庭安全环境、康复护理及预防并发症护理存在不同程度的需,护士应针对性地对家属进行宣教。     

Family satisfaction in the intensive care unit: cross-cultural adaptation of a questionnaire

PURPOSE: Family needs and expectations are often unmet in the intensive care unit (ICU), leading to dissatisfaction. This study assesses cross-cultural adaptability of an instrument evaluating family satisfaction in the ICU. MATERIALS AND METHODS: A Canadian instrument on family satisfaction was adapted for German language and central European culture and then validated for feasibility, validity, internal consistency, reliability, and sensitivity. RESULTS: Content validity of a preliminary translated version was assessed by staff, patients, and next of kin. After adaptation, content and comprehensibility were considered good. The adapted translation was then distributed to 160 family members. The return rate was 71.8%, and 94.4% of questions in returned forms were clearly answered. In comparison with a Visual Analogue Scale, construct validity was good for overall satisfaction with care (Spearman rho = 0.60) and overall satisfaction with decision making (rho = 0.65). Cronbach alpha was .95 for satisfaction with care and .87 for decision-making. Only minor differences on repeated measurements were found for interrater and intrarater reliability. There was no floor or ceiling effect. CONCLUSIONS: A cross-cultural adaptation of a questionnaire on family satisfaction in the ICU can be feasible, valid, internally consistent, reliable, and sensitive.     

维持性血液透析患者亲属焦虑状态及其影响因素的分析

目的分析维持性血液透析(MHD)患者亲属焦虑状态及其影响因素。方法选取在血液净化中心行规律血液透析患者亲属54例及同期在肾脏内科病房住院非透析患者亲属40例作为调查对象,采用焦虑自评量表评估调查对象的焦虑状态,分析焦虑情绪与年龄、性别、文化程度、职业、与患者关系、照料时间、患者透析时间、透析费用的关系。结果 66.7%的MHD患者亲属处于不同程度的焦虑状态,显著高于同期肾脏内科病房住院非透析患者亲属17.5%焦虑发生率(P<0.01);照料时间、透析费用对焦虑情绪有显著影响(PP<0.05),MHD患者透析时间对亲属焦虑情绪有显著影响(PP<0.01)。结论 MHD患者亲属焦虑情绪发生率较高,并且受照料时间、透析费用及患者透析时间影响。MHD患者亲属精神心理问题应引起医务人员的重视,并积极给予心理支持和关怀,以减少其焦虑情绪的发生率。     

影响医院中心注射室护理工作满意度的相关因素调查

目的对中心注射室护理工作的满意度进行调查,了解影响医院护理工作满意度的因素。方法选择2011年1～12月在中心注射室接受治疗的患者252例为研究对象,采用问卷法对患者进行调查,并分析影响注射室护理工作满意度的因素。结果接受调查的住院患者中,患者的满意度得分与患者的年龄、受教育程度、收入水平、住院科室、住院天数以及是否手术存在相关性。结论护理人员应重视和加强护理工作质量和效率,提高临床患者对护理工作的满意程度。     

TUVP后患者状态焦虑及相关因素研究与护理

目的探讨老年前列腺增生症患者经尿道前列腺气化电切术 (TUVP)后患者的状态焦虑 (S AI)与相关因素的关系。方法描述性相关性研究方法 ,以调查问卷的形式进行。结果TUVP后S AI水平得分 5 2 .92±13.0 0 ,与全国常模比较 ,t=7.87,P <0 .0 0 1。以 9项相关因素对S AI进行逐步多元回归分析 ,α =0 .0 5水平上其正性情绪有三个因素进入回归方程 ,按作用大小排序 ,依次为体位的舒适度、引流液颜色的变化、尿管刺激 ;负性情绪有两个因素被选入 ,即尿管刺激和血压的变化。结论了解和掌握TUVP后影响患者S AI水平的相关因素 ,可更有效地帮助其应对焦虑、减轻焦虑的不良影响 ,从而促进临床治疗康复的进程 ,提高老年前列腺增生症患者术后的生存质量。     

Family experience with intensive care unit care: Association of self-reported family conferences and family satisfaction

Purpose

A family conference is recommended as a best practice to improve communication in the intensive care unit (ICU), but this can be challenging given the setting. This study examined whether family members who reported that a family conference occurred had higher satisfaction than those who did not report that a conference was held.

Materials and Methods

The study used a retrospective data analysis of family satisfaction based on family member's responses to a questionnaire. Families of all the patients admitted to ICUs of 2 quaternary hospitals in an integrated health system were surveyed.

Results

The families of 457 patients who matched the inclusion and exclusion criteria were surveyed with a 55.6% response rate. Family satisfaction with decision making was significantly higher (83.6 vs 78.2, P = .0211) for families who reported that family conferences occurred. No significant difference in the satisfaction with care and overall satisfaction scores was found (84.2 vs 80.0, P = .10). Patients whose families reported a family conference were older and had higher mortality.

Conclusion

This study confirms that families who report attending family conferences are more satisfied with decision making in the ICU. This study highlights the need to increase communication in ICUs.     

A comparison of the factors influencing life satisfaction between Korean older people living with family and living alone

SHIN S.H. & SOK S.R. (2012) A comparison of the factors influencing life satisfaction between Korean older people living with family and living alone. International Nursing Review 59 , 252–258 Background: As the global population of older people continuously increases, many countries are beginning to experience health problems associated with older age. These countries may be interested in knowing and understanding the health problems experienced by the older Korean population, which is projected to age the most rapidly. Aim: This study aimed to compare and examine the factors that influence the life satisfaction between older people living with their family and those living alone. Methods: A cross‐sectional survey was conducted. The participants comprised a total 300 older Koreans (150 living with their family, 150 living alone) aged 65 years or over who met the eligibility criteria. All measures were self‐administered. Data were analysed using the SAS statistical software program version 6.12 (SAS Institute Inc., Cary, NC). Results: The older people living with their family were better than the older people living alone in perceived health status, self‐esteem, depression and life satisfaction. Perceived health status, self‐esteem, depression, age and monthly allowance were found to be the factors related to the life satisfaction of older people living with their family and those living alone. The factors that were found to have the greatest influence on the life satisfaction of older people living with their family and those living alone were depression and perceived health, respectively. Conclusions: This study may help healthcare providers to understand the factors that can influence the life satisfaction among older people living with their family and living alone in Korea.     

Family caregivers' subjective experiences of satisfaction in dementia care: aspects of burden, subjective health and sense of coherence

Family caregivers experience both positive and negative reactions in caregiving situations. There has been considerably less published about the positive aspects, however. The general aim of this study was to explore a previously developed instrument to study rewards gained by caregivers and to determine the factors associated with satisfaction in family members caring for patients with dementia living at home. The study group consisted of 153 such family members. Standardized interview schedules exploring different background characteristics, and instruments for assessment of the degree of dementia in the patients and the caregivers' total burden and degree of satisfaction were used. Factorial analysis of the Caregiver's Assessment of Satisfactions Index was performed and it became more specific for conditions of dementia when it was reduced. Stressors as measured by the Caregiver Burden scale and satisfaction can coexist and assess different aspects of the caregiver's situation. The caregiver can perceive both moderate burden and great satisfaction at the same time, and further studies may help to broaden our understanding of how we can reduce the degree of burden whilst increasing the sense of satisfaction.     

Hip fracture: family caregivers' burden and related factors for older people in Taiwan

Aims. The purpose of this study was to explore the burden experienced by caregivers during the transition from hospital to home. Background. With a growing older population, home‐based care has gradually gained more recognition. Most older people with hip fracture in Taiwan have to be discharged at a relatively early stage. Therefore, the caregiving tasks falls on the families. Methods. A total of 98 older people with hip fracture and their caregivers were interviewed. The sample was selected from three medical centres in Taipei, and questionnaires were collected at one week and one month following hospital discharge. Results. (i) Family caregivers were usually women (63.3%) with spouses being the primary caregivers in most cases (30.6%). About one‐third of caregivers took care of other family members on top of their responsibilities caring for the sick elders at home, and 77.6% shared the care tasks with others. (ii) The caregivers experienced moderate burdens. About 91.8% of caregivers reported ‘I feel sad watching the elder's health deteriorating’, 84.9% reported ‘I must keep an eye on the elder constantly’ and 56.7% reported ‘Taking care of the sick elder at home makes me feel exhausted’. (iii) Caregiver burden and the functional level of older people were adversely correlated. (iv) Caregivers who were unable to access other resources for help and/or had provided care to the older person prior to the fracture resulting in hospitalization experienced a higher burden. Conclusions. These findings should be helpful in the formulation of evidence‐based discharge planning and home health care services. Relevance to clinical practice. Comprehensive discharge planning and developing social support systems for family caregivers to reduce caregivers burden are needed.     

The older patient's experience of encountering professional carers and close relatives during an acute confusional state: an interview study

Background

Acute confusional state (ACS) is a common and difficult condition among older patients with a variety of opinions about how to act when encountering patients with ACS. Few studies to our knowledge have been found exploring the encounter from the perspective of older patients and their experiences.

Objectives

The aim of this study was to understand the experiences of older patients with ACS when encountering professional carers and close relatives.

Design

In order to understand older patients’ experiences of encounters during their ACS a latent qualitative content analysis was used.

Settings

The data collection took place at two geriatric wards in an emergency hospital in a metropolitan area.

Participants

The inclusion criteria included being aged 65 years or older and having suffered from ACS, according to the DSM-IV criteria, and having regained lucidity. Participants were being cared for at one of two geriatric wards. Patients diagnosed with dementia were excluded. About 150 patients were screened, 67 patients fulfilled the inclusion criteria and seven patients were included in the study, four females and three males, aged between 78 and 98 years.

Methods

Data were collected by interviews.

Results

Three themes were found, namely; ‘Feeling lonely within the perceived reality of ACS’, with three sub-themes: the unequal encounter, keeping a distance and being an outsider; ‘striving towards understanding’ with two sub-themes: searching for answers and it takes time to understand; and ‘feelings of participation in the encounter’ with two sub-themes: a mutual understanding and feeling safe and supported.

Conclusions

Within the encounter the older patients with ACS are searching for answers to what is happening and why. The patients feel dependent on the persons they encounter and their willingness to understand and communicate. The patients also feel lonely, unnecessarily questioned and untrustworthy; but they can also feel safe, trusted and understood.     

医院合同护士压力源及其影响因素的调查与分析

目的 探讨合同护士主要压力源及其影响因素.方法 采用护士工作压力源量表对北京市某医院109名合同护上进行调查.结果 合同护士总工作压力水平为(2.76±0.52)分.排在前3位的压力源依次是护理々业及工作方面、工作量及时间分配方面和病人护理方面.,职称、科窜对合同护士工作压力的影响均有统计学意义(P<0.05).结论 合同护上压力程度高,其中经常倒班、工资及其他待遇低、晋升和继续深造的机会太少、担心上作中出现差错事故等是合同护士主要的压力源.合同护士压力程度受不同科室及职称的影响.建议从医院管理者和合同护士自身方面共同努力,减轻上作压力.     

三级医院住院患者跌倒与坠床相关因素分析

目的 探讨住院患者在院期间跌倒和坠床的高发因素,以便采取有效措施减少此类事件的发生.方法 采用回顾性研究,对跌倒、坠床的各因素进行统计学分析.结果 住院病人不同年龄段的跌倒、坠床例数存在集中趋势,跌倒、坠床病人年龄集中点为73岁,高峰年龄为57～90岁;跌倒、坠床时间无时点集中趋势,男患者、无陪人患者发生此类事件机率大.结论 对住院患者跌倒和坠床高发因素的研究,对减少此类事件的发生有指导意义.     

前置胎盘与胎盘植入相关因素分析

目的 总结前置胎盘与胎盘植入的相关因素及对母婴的影响.方法 对2007年10月至2010年4月间收治的96例前置胎盘和12例前置胎盘合并胎盘植入患者的孕周、胎盘位置、产妇年龄、妊娠次数、产后出血量及新生儿Apgar 评分等指标进行回顾性分析.结果 7 968产妇中,前置胎盘者发生率为1.20%(96/7 968).前置胎盘合并胎盘植入者12例,占前置胎盘的12.5%(12/96).胎盘植入的发生率与产妇孕产次、胎盘位置明显相关,而与其年龄、孕周关系无明显相关性.中央型胎盘胎盘植入的发生率明显高于边缘性胎盘,差异具有显著性(P<0.05).合并胎盘植入组产后出血、新生儿窒息和早产发生率均明显高于前置胎盘组,差异具有显著性(P<0.05).结论 胎盘植入与前置胎盘有相关关系,中央型前置胎盘及3次以上妊娠为胎盘植入的高危因素.胎盘植入严重危害母婴生命,针对胎盘植入的危险因素加以预防,对提高母婴生活质量有重要意义.