Predictors of family members' satisfaction with hospice

This large, long-term study of families served by hospice found that nearly 95 percent said hospice had been helpful. Still, about 30 percent of family members said there was something they wish hospice had done differently. Those who had some complaint were more likely than those who had no complaints to be women, to report the patient had needed a great deal of care, to have a history of depression and greater levels of distress before and after the patient's death, and to be dissatisfied with the support they received from family members and friends.     

Differences in family caregiver outcomes by their level of involvement in discharge planning.

Family caregivers play vital roles in assisting elders after they are released from the hospital. Although health care professionals advocate involving family caregivers in discharge planning for elders, little is known about the extent to which this involvement benefits or jeopardizes the caregiver's health and their perceptions of the caregiving experience. The purpose of this study was to determine whether the level of family caregiver involvement in discharge planning for an elder made a difference in caregiver health, discharge planning satisfaction, perception of care continuity, preparedness to assist the elder, and acceptance of the caregiving role 2 weeks and 2 months postdischarge. The sample consisted of 130 family caregivers for elders hospitalized with heart failure. Telephone interviews were conducted 2 weeks and 2 months postdischarge. The findings indicated that family caregivers who reported more involvement in discharge planning had significantly higher scores on satisfaction, feelings of preparedness, and perception of care continuity 2 weeks following the elder's hospitalization than those who reported little or no involvement in planning. Caregivers who reported more involvement in planning also were more accepting of the caregiving role. At 2 months postdischarge, caregivers who reported more involvement in discharge planning reported better health and more acceptance of the caregiving role than those who had little or no involvement in planning.     

Patient and family satisfaction with discharge plans.

This study explored factors affecting patient and family satisfaction with discharge plans, an outcome of discharge planning provided by the hospital department of social work. Adequacy of discharge plans was rated by 126 patients and 130 family members within 24 hours before hospital discharge. Patient ratings of discharge plans were related to their degree of involvement in decision making, social support networks (sex and marital status), and physical condition (diagnosis and functional ability). Three types of factors were important to family members: 1) factors related to the discharge planning process, 2) the patient's discharge destination, and 3) length of patient hospital stay. Findings are discussed in terms of their implications on maximizing consumer satisfaction in the cost-conscious environment.     

Complexity of family caregiving and discharge planning

Older adults and their family caregivers face numerous decisions about hospital discharge, including where they will go and how they will receive care. Older adults who account for nearly 37% of all hospital discharges often need care and support of family members at the time of hospital discharge. This study examines decisions made by hospitalized older adults, families, and health care team members (HCTMs) about hospital discharge. The sample included older adults (n = 13, average age 84), family members (n = 12, average age 71), and HCTMs (n = 7, average age 47). Findings revealed the complexity of hospital discharge planning for older adults through five themes as follows: (a) home, (b) staying independent, (c) "advocating for them," (d) deciding what to tell, and (e) changing the plan.     

Spouses' satisfaction with caregiver support in stroke rehabilitation

OBJECTIVE: To examine the satisfaction of spouses of stroke patients with the support given to them during clinical rehabilitation and to explore the relationships between satisfaction and characteristics of the support received. METHODS: Spouses of patients with a first-ever supratentorial stroke were included (n = 194). Satisfaction was measured on a 0-10 scale. Bivariate and multivariate relationships were studied between overall satisfaction score and characteristics of the support provided (number of full days of attendance, participation in caregiver group, discipline providing most support), the spouses (age, gender, family situation, education and employment) and the patients (activity of daily living (ADL) dependency (Functional Independence Measure), length of stay). RESULTS: The median satisfaction score was 7, and 44% of all spouses scored >or=8 (very satisfied) but 23% were dissatisfied. Spouses' and patients' characteristics and satisfaction scores were not associated. Of the support characteristics the number of full days of attendance (p = 0.02), participation in a caregiver group (p = 0.006) and support received from a team member (p = 0.000) were related to satisfaction. No differences in spouses' satisfaction scores were found between the participating rehabilitation centres. Only 39% of the spouses participated in a caregiver group. The most important reason for not participating in such a group was not being aware of the opportunity to take part in a group (49%). Spouses participating in a group showed more depressive symptoms and had a more severely disabled partner. Caregiver support was primarily given by the nurse and the social worker. One in five spouses indicated not to have been supported at all by the rehabilitation team. CONCLUSION: A large proportion of the caregivers were satisfied with the care they had received, although one in four was dissatisfied. Satisfaction was related to support characteristics.     

Elders' and family members' perspectives in planning for hospital discharge

When elders are unable to participate in discharge planning owing to physical or cognitive impairments, clinicians often work with family members instead. Previous studies on community-dwelling elders and their family members found differences between the elder's and family member's rating of functional status (Rothman, Hedrick, Bulcroft, Hickman, & Rubinstein, 1991). Magaziner, Simonskck, and Kashner (1988) reported that family members who did not live with the elder tended to rate them as less impaired than what the older persons rated themselves. Yet, little is known about the extent to which elders' and family members' perspectives concur with respect to discharge planning. Identifying both discrepancies and areas of agreement is essential in assisting elders and their families in planning for their future needs and evaluating the options available to them. The purpose of this study was to determine the extent to which family members' expectations regarding postdischarge needs agreed with those of elders hospitalized for an acute episode of a chronic illness.     

A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers

Aims. To test the effectiveness of a discharge planning program for dyads of older stroke survivors and their family caregivers in Taiwan. Background. Family caregivers of stroke survivors often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. However, little information could be found on discharge planning programs for caregivers of stroke survivors in Asian families. Design. A randomised experimental design was used to explore the effects of a discharge planning program for 158 dyads of older stroke patients and their family caregivers. Methods. The control group (n = 86 dyads) received only routine hospital discharge planning services and the experimental group (n = 72 dyads) received routine hospital discharge planning services plus the caregiver‐oriented discharge planning program. Outcome variables were measured at baseline, before discharge and one month after hospital discharge. Variables were measured by the Nurse Evaluation of Caregiver Preparation Scale, Preparedness for Caregiving Scale, Caregiver Discharge Needs Satisfaction Scale and Perception of Balance between Competing Needs Scale. Results. Caregivers in the experimental group had significantly better nurse evaluation and self‐evaluation of preparation after the program than before, and greater satisfaction of discharge needs one month after discharge than before discharge. Caregivers in the experimental group had significantly better nurse evaluations and self‐evaluations of preparation and better satisfaction of discharge needs after the program compared with the control group. However, no significant difference was found between caregiver groups in perceived balance of competing needs. Conclusions. This discharge planning program benefited family caregivers of older stroke patients during the transition from hospitalisation to one month after discharge. Relevance to clinical practice. This caregiver‐oriented discharge planning program, with its emphasis on individualised health education and home visits following discharge may improve caregivers’ preparation and the satisfaction of their needs during the discharge transition.     

照顾者虐待老人知信行量表的初步编制

目的 初步编制照顾者虐待老人知信行量表.方法 在文献分析、面对面访谈、专家咨询和课题组讨论的基础上进行量表条目的编制,形成量表初稿,采用便利抽样方法对200名老年人照顾者进行预调查,通过t检验法、相关分析法、因子分析法等方法进行条目筛选.结果 构建了照顾者虐待老人知识、态度、行为3个分量表,各分量表的条目数分别为22、14和15个.结论 该量表具有较好的代表性、适用性和可操作性,可作为了解照顾者虐待老人知信行的测评工具,并为对照顾者的健康教育提供相关依据.     

Toward a measure of caregiver satisfaction with hospice social services

An evaluation of caregiver satisfaction with social services in a large hospice in a major southeastern city was conducted utilizing an instrument developed for this study. The usual processes for developing an instrument were followed, resulting in a survey questionnaire which was useful in testing the degree of satisfaction of caregivers with the hospice's social services. Results indicated that most caregivers were very satisfied with hospice social services. The development of such an instrument could aid others in the field in evaluating caregiver satisfaction with hospice services.     

以家庭照护者需求为导向的出院准备计划在脑卒中患者中的应用研究

目的:探讨以家庭照护者需求为导向的出院准备计划在脑卒中患者中的应用效果。方法:92例脑卒中患者随机分为观察组和对照组各46例,观察组家庭照护者给予以家庭照护者需求为导向的出院准备计划,对照组则对家庭照护者不进行特殊干预。比较2组家庭照护者出院准备度、患者出院期间照护情况以及患者生活质量。结果:2组出院后1周、1个月和2个月家庭照护者出院准备度与出院当日比较,均明显提高(P0.05),且观察组各时间点明显高于对照组(P0.05)。出院后,观察组在患者照护结果各条目评分上明显优于对照组(P0.05)。观察组出院后1周、1个月和2个月患者生活质量与出院当日及对照组比较均明显提高(P0.05),对照组出院后各时间点比较差异无统计学意义。结论:以家庭照护者需求为导向的出院准备计划的实施能够提高家庭照护者的准备度,改善出院后患者照护结果,提升患者的生活质量,值得推广应用。     

Predictors of family satisfaction with an Australian palliative home care service: a test of discrepancy theory

Five interesting findings emerged from this study: Although study results demonstrate support for Porter's Discrepancy Theory, the most compelling outcome is the finding that family care perceptions may be the best predictor of family care satisfaction. Family members' age may be a predictor of family care satisfaction. Family functioning may be a useful clinical indicator to identify families who are less satisfied with care and in greater need of support. The length of time that clients receive the care service may alter family care satisfaction. Differences in findings reported in this study compared with Canadian results point to the need for cross-cultural research in this area. This research is the first Australian study to test discrepancy theory as a framework for understanding family care satisfaction in a home hospice context. Results from this study may assist health care providers to more sensitively address the care perceptions of families in this care setting and extend theory development research that is needed to guide palliative care practice with families.     

Predictors of patient satisfaction with telephone nursing services

Patient satisfaction has been shown to be a factor in clinical outcomes, health care quality, and patient follow-through. Thus, a high level of satisfaction is a desired outcome of patient care. This article examines predictors of patient satisfaction with telephone nursing services among a sample of 1,939 respondents, using a conceptual model derived from the literature and preliminary work. The study was conducted in medical offices and call centers of a large national health maintenance organization. Calls were taped and content coded and then matched with caller questionnaire data. In the final multivariate predictive models, patient health status; caller ratings of expectations met by the nurse for listening, clarity, and collaboration; and nurse competence were the strongest predictors of satisfaction. Consistent with the literature, findings suggest that nurses should expand interpersonal communication skills, and systems should reduce barriers to effective listening, clarity, and collaboration with callers.     

Living with loss: dementia and the family caregiver.

Two focus group interviews with 15 relatives, investigated family caregivers' perceptions of having a relative in a dementia care unit. Data analysis revealed the significant theme of living with loss. The results demonstrate that the burden of care giving creates growing stress and tension that continues even when the family member is placed into a residential care setting. The findings suggest that health professionals must be prepared to assist family members with the anticipatory grieving of losses that accrue with the changing relationship with the relative and health care staff. Furthermore, there is a need to look for a means of helping and supporting family caregivers so that they can develop a sense of satisfaction and accomplishment in their care giving role.     

Predictors of patient satisfaction with inpatient hospital nursing care

The purpose of this predictive nonexperimental study was to investigate the influence of registered nurse (RN) job satisfaction, context of care, structure of care, patient-perceived nurse caring, and patient characteristics on patient satisfaction with inpatient hospital nursing care in an academic medical center in north-central West Virginia. Convenience samples of patients (N = 362) and RNs (N = 90) were recruited from two medical units, two surgical units, and three intensive care step-down units. Causal modeling identified patient-perceived nurse caring as the major predictor of patient satisfaction, with nurse/physician (RN/MD) collaboration as the only other direct predictor. Age had an indirect influence on patient satisfaction. Strategies to achieve and maintain patient satisfaction should address the enhancement of patient-perceived nurse caring and RN/MD collaboration.