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Vitale E, Mea R, Chang YC. The Nursing-Home Care Quality Perceived Levels from Patients and Caregivers: An Explanatory Study. Patient Prefer Adherence 2023; 17:1237-1245. [PMID: 37193371 PMCID: PMC10182805 DOI: 10.2147/ppa.s409961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
Background The nursing essential mission was to satisfy patients' and caregivers' essential health-relating demand, thanks to communicational, interventional, assistance and helping skills through an appropriate approach which best satisfied both patients and their caregivers. To assess any differences in nursing-home care quality perceived levels both by patients and caregivers. Methods A cohort observational study was conducted from November 2022 to January 2023 using an online anonymous questionnaire for both patients and caregivers who received nursing-home care service. Results A total of 677 patients (43.4%) and caregivers (56.6%) were enrolled. Most interviewees benefited from the nursing-home care service less than 12 months (p = 0.014). Quality perceptions did not significantly vary from patients and caregivers (p > 0.05) for all the items proposed, with the exception of the nursing listening skills which was better assessed by caregivers than patients (p = 0.034). Conclusion Patients and caregivers perceived an average quality of nursing-home care, giving particular importance to some nursing skills, such as listening skills. The general quality of nursing care was however satisfying. Findings suggested more incisive action from health-care nurses to improve quality of nursing-home care and both patient and caregiver satisfaction.
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Affiliation(s)
- Elsa Vitale
- Centre of Mental Health Modugno, Local Health Authority Bari, Bari, Italy
| | - Rocco Mea
- Cardiovascular Department, San Carlo Hospital, Potenza, Italy
| | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
- Nursing Department, China Medical University Hospital, Taichung, Taiwan
- Correspondence: Yun-Chen Chang, School of Nursing and Graduate Institute of Nursing, China Medical University, No. 100, Section 1, Jingmao Road, Beitun District, Taichung, 406040, Taiwan, Tel +886 983503901, Email
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2
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O'Sullivan A, Alvariza A, Öhlén J, Ex Håkanson CL. The influence of care place and diagnosis on care communication at the end of life: bereaved family members' perspective. Palliat Support Care 2021; 19:664-671. [PMID: 33781369 DOI: 10.1017/s147895152100016x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the influence of care place and diagnosis on care communication during the last 3 months of life for people with advanced illness, from the bereaved family members' perspective. METHOD A retrospective survey design using the VOICES(SF) questionnaire with a sample of 485 bereaved family members (aged: 20-90 years old, 70% women) of people who died in hospital was employed to meet the study aim. RESULTS Of the deceased people, 79.2% had at some point received care at home, provided by general practitioners (GPs) (52%), district nurses (36.7%), or specialized palliative home care (17.9%), 27.4% were cared for in a nursing home and 15.7% in a specialized palliative care unit. The likelihood of bereaved family members reporting that the deceased person was treated with dignity and respect by the staff was lowest in nursing homes (OR: 0.21) and for GPs (OR: 0.37). A cancer diagnosis (OR: 2.36) or if cared for at home (OR: 2.17) increased the likelihood of bereaved family members reporting that the deceased person had been involved in decision making regarding care and less likely if cared for in a specialized palliative care unit (OR: 0.41). The likelihood of reports of unwanted decisions about the care was higher if cared for in a nursing home (OR: 1.85) or if the deceased person had a higher education (OR: 2.40). SIGNIFICANCE OF RESULTS This study confirms previous research about potential inequalities in care at the end of life. The place of care and diagnosis influenced the bereaved family members' reports on whether the deceased person was treated with respect and dignity and how involved the deceased person was in decision making regarding care.
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Affiliation(s)
- Anna O'Sullivan
- Department of Healthcare Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Anette Alvariza
- Department of Healthcare Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Capio Palliative Care, Stockholm, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden
- The Palliative Centre, Sahlgrenska University Hospital Västra Götaland Region, Gothenburg, Sweden
| | - Cecilia Larsdotter Ex Håkanson
- Department of Healthcare Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
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3
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Liljeroos M, Milberg P, Krevers B, Milberg A. Dying within dyads: Stress, sense of security and support during palliative home care. PLoS One 2021; 16:e0257274. [PMID: 34520480 PMCID: PMC8439476 DOI: 10.1371/journal.pone.0257274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/27/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives To examine similarities and dissimilarities in patient and family caregiver dyads in their experience of stress, support, and sense of security. Methods 144 patients and their family caregivers participated. Patients were admitted to six Swedish specialist palliative home care units and diagnosed with a non-curable disease with an expected short survival. We analysed similarity patterns of answers within dyads (correlations) as well as dissimilarities, expressed as the difference between within-dyad responses. The latter were subjected to a model-building procedure using GLM, with 13 sociodemographic and clinical characteristics as independent variables. Results Within dyads, patients and family caregivers scored similar in their perception of support and sense of security with care. There was also dissimilarity within dyad responses in their perception of stress and support that could be attributed to sociodemographic or clinical characteristics. When patients scored higher levels of stress than family caregivers, the family caregiver was more likely to be male. Also family caregiver attachment style (attachment anxiety), patient age and the relationship of the family caregiver to the patient explained dissimilarities within the dyads. Conclusions Patients and family caregivers within the dyads often, but not always, had similar scores. We suggest that it is important that the healthcare staff identify situations in which perceptions within the dyads regarding stress and perception of support differ, such that they can recognise patients’ and family caregivers’ unique needs in different situations, to be able to provide adequate support and facilitate dyadic coping.
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Affiliation(s)
- Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- * E-mail:
| | - Per Milberg
- IFM Biology, Linköping University, Linköping, Sweden
| | - Barbro Krevers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Milberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Advanced Home Care and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden
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Hov R, Bjørsland B, Kjøs BØ, Wilde-Larsson B. A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study. BMC Palliat Care 2020; 19:7. [PMID: 31926557 PMCID: PMC6954541 DOI: 10.1186/s12904-020-0513-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/07/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND As palliative care increasingly takes place in patients' homes, perceptions of security among patients in the late palliative phase and their relatives are important. AIM To describe and compare patient-relative dyads regarding their perceptions of security in palliative homecare, including the perceived security of the actual care given to the patients, as well as the subjective importance of that care. METHODS A cross sectional questionnaire study including 32 patient-relative dyads was conducted in an urban municipality in Norway. Patients were in a late palliative phase and received palliative homecare. Each patient proposed one relative. Data were collected using a modified version of the Quality from the Patients' Perspective instrument (QPP), which focuses on security and comprises three dimensions: medical-technical competence, identity-orientation approach and physical-technical conditions. Context-specific scales containing four aspects (competence, continuity, coordination/cooperation, availability) were added. The instrument contains two response scales; perceived reality (PR) and subjective importance (SI). Data were analysed by descriptive statistics, Chi-squared test, T-test and Wilcoxon's signed rank test. RESULTS Patients had high mean scores on the PR-scale for the sense of security in palliative homecare in the dimensions of medical-technical competence and physical-technical conditions. There were three low mean scores on the PR-scale: the aspect of continuity from patients and the aspects of continuity and coordination/cooperation from relatives. The patients scored the SI scale statistically significantly higher than the PR scale in the identity-orientation approach dimension and in the aspect of continuity, while relatives did so in all dimensions and aspects. The intra-dyadic patient-relative comparisons show statistically significant lower scores from relatives on the PR-scale in the dimensions of medical-technical competence, physical-technical conditions, identity-orientation approach and the aspect coordination/cooperation. CONCLUSIONS There are several statistically significant differences between patients and relatives' perceptions of security in the palliative homecare received (PR) compared with the subjective importance of the care (SI) and statistically significant differences in the patient-relative dyads in PR. A relatively mutual sense of security in palliative homecare is important for patient-relative dyads, as relatives often provide care and act as patients' spokespersons. What they assess as important can guide the development of palliative homecare.
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Affiliation(s)
- Reidun Hov
- Department of Nursing, Inland Norway University of Applied Sciences, Elverum, Norway. .,Centre for Development of Institutional and Home Care Services, Hamar Municipality, Hedmark, Norway.
| | - Bente Bjørsland
- Department of Nursing, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Bente Ødegård Kjøs
- Centre for Development of Institutional and Home Care Services, Hamar Municipality, Hedmark, Norway
| | - Bodil Wilde-Larsson
- Department of Nursing, Inland Norway University of Applied Sciences, Elverum, Norway.,Department of Health Science, Discipline of Nursing Science, Karlstad University, Karlstad, Sweden
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5
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Sandsdalen T, Wilde-Larsson B, Grøndahl VA. Patients' Perceptions Of The Quality Of Palliative Care And Satisfaction - A Cluster Analysis. J Multidiscip Healthc 2019; 12:903-915. [PMID: 31806988 PMCID: PMC6857653 DOI: 10.2147/jmdh.s220656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/17/2019] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Palliative care services are multidisciplinary, and the quality needs to be evaluated from the patients' perspectives. The aim was to explore the patient profiles in palliative care with respect to patients' perception of the quality of palliative care received and patient satisfaction, and to describe and compare person-related and organization-related conditions that characterize the patient profiles. PATIENTS AND METHODS A cross-sectional study, including 140 patients from four different multidisciplinary palliative care contexts in Norway, was conducted in 2014. The Quality from the Patient's Perspective questionnaire for Palliative Care, which is based upon a person-centered theoretical model, was used. Satisfaction was measured by the Emotional Stress Reaction questionnaire. Person- and organization-related conditions were measured. Hierarchical cluster analysis, ANOVA, Pearson Chi-Square Test and ANCOVA were used. RESULTS Three unique patient clusters with different patterns of perceptions of quality of care and satisfaction were identified; Cluster 1 (41%) had the best perception of care quality and were more satisfied, Cluster 2 (34%) had better perceptions of care quality and were most satisfied and Cluster 3 (25%) had worst perceptions of care quality and were less satisfied. The clusters were characterized by person-related conditions (eg, patients' sense of coherence and perceptions of subjective importance of the quality) as well as organization-related conditions (eg, physicians' competence and type of care services). CONCLUSION The results can be used by multidisciplinary healthcare personnel to tailor quality work and improve person-centered care in palliative care contexts. Improvement initiatives should focus on implementing a person-centered approach, increasing the palliative care competence of the personnel and facilitate specialized palliative care services in the homecare context.
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Affiliation(s)
- Tuva Sandsdalen
- Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Bodil Wilde-Larsson
- Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Faculty of Health, Science and Technology, Department of Health Science, Discipline of Nursing Science, Karlstad University, Karlstad, Sweden
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Family ratings of ICU care. Is there concordance within families? J Crit Care 2019; 55:108-115. [PMID: 31715527 DOI: 10.1016/j.jcrc.2019.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/09/2019] [Accepted: 10/23/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE To examine heterogeneity of quality-of-care ratings within families and to examine possible predictors of concordance. MATERIALS AND METHODS We examined two aspects of agreement within families: response similarity and the amount of exact concordance in responses in a cohort of Danish ICU family members participating in a questionnaire survey (the European Quality Questionnaire: euroQ2). RESULTS Two hundred seventy-four family respondents representing 122 patients were included in the study. Identical ratings between family members occurred in 28%-59% of families, depending upon the specific survey item. In a smaller sample of 28 families whose patients died, between 39% and 86% gave identical responses to items rating end-of-life care. There was more response variance within than between families, yielding low estimates of intrafamily correlation. Statistics correcting for chance agreement also suggested modest within-family agreement. CONCLUSIONS The finding that variance is higher within than between families suggests the value of including multiple participants within a family in order to capture varying points of view.
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Olsson C, Kling E, Grundel Persson K, Larsson M. Impact of the Liverpool Care Pathway on quality end-of- care in residential care homes and home care-Nurses' perceptions. Nurs Open 2019; 6:1589-1599. [PMID: 31660187 PMCID: PMC6805710 DOI: 10.1002/nop2.364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/28/2019] [Accepted: 08/05/2019] [Indexed: 12/02/2022] Open
Abstract
AIM Aim was to describe how Registered Nurses (RNs) and assistant nurses (ANs) working in residential care homes and home care perceived quality end-of-life care after implementation of the Liverpool Care Pathway (LCP) in terms of subjective importance of care aspects and actual care given. DESIGN Descriptive cross-sectional. METHODS Registered Nurses (N = 22; 100% response rate) and ANs (N = 120; 59% response rate) working in a Swedish municipality. Data collection with a study-specific questionnaire (50 items) about perceived reality (PR) and subjective importance (SI). Non-parametric statistics. RESULTS Implementation of the LCP ensured systematic assessment and alleviation of patients' symptoms and needs. The ANs, more than the RNs, perceived that the patients received the best possible nursing and medical care (p = .01). Both groups considered that communication with patients and families as well as the information exchange between the team members was facilitated. Areas for improvement were identified about psychological and existential support and patients and families' participation in care.
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Affiliation(s)
- Cecilia Olsson
- Department of Health SciencesKarlstad UniversityKarlstadSweden
| | - Elisabeth Kling
- Department of Health SciencesKarlstad UniversityKarlstadSweden
| | | | - Maria Larsson
- Department of Health SciencesKarlstad UniversityKarlstadSweden
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8
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Jakobsson S, Eliasson B, Andersson E, Johannsson G, Ringström G, Simrén M, Jakobsson Ung E. Person-centred inpatient care - A quasi-experimental study in an internal medicine context. J Adv Nurs 2019; 75:1678-1689. [PMID: 30793351 DOI: 10.1111/jan.13953] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 11/05/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to evaluate effects of person-centred inpatient care on care processes in terms of satisfaction with care and person-centred content in medical records, and to evaluate effects on self-reported health and self-efficacy. BACKGROUND Internal medicine inpatient care is complex, covering patients varying in age, medical conditions, health status, and other aspects. There has been limited research on the impact of person-centred care (PCC) on satisfaction with care and health outcomes in internal medicine care environments regardless of diagnosis and care pathway. DESIGN A quasi-experimental study with pre- and postmeasurements. METHODS Adult patients admitted to an internal medicine inpatient unit were consecutively included over 16 weeks in 2014 and 24 weeks in 2015-2016. Data were collected before a person-centred inpatient care intervention (N = 204) and 12 months after the intervention was implemented (N = 177). Data on satisfaction with care and self-reported health were collected at discharge and medical records were reviewed. The intervention included systematically applied person-centred assessment, health plans, and persistent PCC. RESULTS After the intervention, patients rated higher satisfaction with care regarding essential components of PCC and more patients had received effective pain relief. There were no differences in information on self-care or medications, self-rated health, or self-efficacy. CONCLUSION Care focused on the foundations of person-centredness seems to enhance both patients' perceptions of satisfaction and symptom management. Situational aspects such as care pathways should be considered when implementing person-centred inpatient care. TRIAL REGISTRATION CLINICALTRIALS. GOV, REGISTRATION NUMBER NCT03725813.
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Affiliation(s)
- Sofie Jakobsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Björn Eliasson
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Andersson
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gudmundur Johannsson
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gisela Ringström
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Simrén
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine & Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Jakobsson Ung
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Kim K, Heinze K, Xu J, Kurtz M, Park H, Foradori M, Nolan MT. Theories of Health Care Decision Making at the End of Life: A Meta-Ethnography. West J Nurs Res 2018; 40:1861-1884. [PMID: 28816094 PMCID: PMC6474239 DOI: 10.1177/0193945917723010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models ( n = 14) followed by family-centered ( n = 11) and behavioral change models ( n = 7). A conceptual framework was developed using themes including context of decision making, communication and negotiation of decision making, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision making at the end of life among patients with advanced illness and their caregivers.
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Affiliation(s)
| | | | - Jiayun Xu
- University of Utah, Salt Lake City, USA
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10
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Bereaved Family Members' Satisfaction with Care during the Last Three Months of Life for People with Advanced Illness. Healthcare (Basel) 2018; 6:healthcare6040130. [PMID: 30404147 PMCID: PMC6315663 DOI: 10.3390/healthcare6040130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Studies evaluating the end-of-life care for longer periods of illness trajectories and in several care places are currently lacking. This study explored bereaved family members' satisfaction with care during the last three months of life for people with advanced illness, and associations between satisfaction with care and characteristics of the deceased individuals and their family members. METHODS A cross-sectional survey design was used. The sample was 485 family members of individuals who died at four different hospitals in Sweden. RESULTS Of the participants, 78.7% rated the overall care as high. For hospice care, 87.1% reported being satisfied, 87% with the hospital care, 72.3% with district/county nurses, 65.4% with nursing homes, 62.1% with specialized home care, and 59.6% with general practitioners (GPs). Family members of deceased persons with cancer were more likely to have a higher satisfaction with the care. A lower satisfaction was more likely if the deceased person had a higher educational attainment and a length of illness before death of one year or longer. CONCLUSION The type of care, diagnoses, length of illness, educational attainment, and the relationship between the deceased person and the family member influences the satisfaction with care.
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11
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Grøndahl VA, Kirchhoff JW, Andersen KL, Sørby LA, Andreassen HM, Skaug EA, Roos AK, Tvete LS, Helgesen AK. Health care quality from the patients' perspective: a comparative study between an old and a new, high-tech hospital. J Multidiscip Healthc 2018; 11:591-600. [PMID: 30410346 PMCID: PMC6200069 DOI: 10.2147/jmdh.s176630] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose Previous studies show that the hospital environment and the behavior of health care personnel may predict patients’ perceptions of care quality. The aim of the study was to explore changes in perceived care quality from the patients’ perspective (QPP) when hospital services are relocated from an old to a new high-tech hospital and to describe what is important for patients in the high-tech hospital. Patients and methods A comparative cross-sectional design was used. The questionnaire QPP, which is based on a theoretical model of the quality of care comprising four quality dimensions, was used. Data were collected in 2015 (old hospital) and 2016 (new hospital), with 253 and 324 respondents, respectively, by consecutive sampling. Comparative statistics was used to test differences between patients’ care quality perceptions (perceived reality [PR] and subjective importance [SI]) (P≤0.05). Results The patients rated PR of all four quality dimensions (the care organization’s physical-technical conditions and sociocultural approach and the caregivers’ medical-technical competence and identity-oriented approach) higher in the new hospital. However, only the two quality dimensions concerning the care organization were rated significantly more highly. On an item level, five of the 27 items scored significantly higher on patients’ SI than on patients’ PR of the care in the new hospital, indicating a quality deficiency from the patients’ perspective. This comprised receiving effective pain relief, receiving examination and treatment within an acceptable waiting time, receiving useful information on self-care, receiving useful information on which doctors were responsible for their medical care, and having a comfortable bed. Conclusion The increase in care QPP was associated with improved environmental conditions, and no significant improvement in care quality was associated with the health care personnel. The results indicate that being in a high-tech environment does not improve patients’ perceptions of care quality provided by health care personnel. The results gave valuable information for quality improvement in clinical practice, based on the patients’ perspective.
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Affiliation(s)
| | - Jörg W Kirchhoff
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
| | | | | | | | - Eli-Anne Skaug
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
| | | | - Liv Solveig Tvete
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
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12
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Andersson M, Wilde-Larsson B, Carlsson E, Persenius M. Older people's perceptions of the quality of oral care in short-term care units: A cross-sectional study. Int J Older People Nurs 2018; 13:e12185. [PMID: 29363883 DOI: 10.1111/opn.12185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. AIM To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. METHODS A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. RESULTS The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. CONCLUSIONS Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. IMPLICATIONS FOR PRACTICE Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC.
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Affiliation(s)
- Maria Andersson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Public Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Eva Carlsson
- Faculty of Health and Medicine, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Mona Persenius
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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13
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Sandsdalen T, Høye S, Rystedt I, Grøndahl VA, Hov R, Wilde-Larsson B. The relationships between the combination of person- and organization-related conditions and patients' perceptions of palliative care quality. BMC Palliat Care 2017; 16:66. [PMID: 29212539 PMCID: PMC5719731 DOI: 10.1186/s12904-017-0240-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the combination of person- and organization- related conditions and the relationships with patients' perspectives of care quality. Such a combination could contribute knowledge reflecting the complexity of clinical practice, and enhance individualized care. The aim was to investigate the relationships between the combination of person- and organization-related conditions and patients' perceptions of palliative care quality. METHODS A cross-sectional study, including 191 patients in the late palliative phase (73% response rate) admitted to hospice inpatient care (n = 72), hospice day care (n = 51), palliative units in nursing homes (n = 30) and home care (n = 38), was conducted between November 2013 and December 2014, using the instrument Quality from the Patients' Perspective specific to palliative care (QPP-PC). Data were analysed, using analysis of covariance, to explore the amount of the variance in the dependent variables (QPP-PC) that could be explained by combination of the independent variables - Person- and organization-related conditions, - while controlling for differences in covariates. RESULTS Patients scored the care received and the subjective importance as moderate to high. The combination of person- and organization - related conditions revealed that patients with a high sense of coherence, lower age (person - related conditions) and being in a ward with access to and availability of physicians (organization-related condition) might be associated with significantly higher scores for the quality of care received. Gender (women), daily contact with family and friends, and low health-related quality of life (person-related conditions) might be associated with higher scores for subjective importance of the aspects of care quality. CONCLUSION Healthcare personnel, leaders and policy makers need to pay attention to person- and organization-related conditions in order to provide person-centered palliative care of high quality. Further studies from palliative care contexts are needed to confirm the findings and to investigate additional organizational factors that might influence patients' perceptions of care quality.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88 Karlstad, Sweden
| | - Sevald Høye
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
| | - Ingrid Rystedt
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88 Karlstad, Sweden
| | | | - Reidun Hov
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
| | - Bodil Wilde-Larsson
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88 Karlstad, Sweden
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14
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Chan ZCY. A qualitative study on communication between nursing students and the family members of patients. NURSE EDUCATION TODAY 2017; 59:33-37. [PMID: 28934638 DOI: 10.1016/j.nedt.2017.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/31/2017] [Accepted: 08/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND When caring for a family as a unit, it is as crucial to communicate with the family members of a patient as it is with the patient. However, there is a lack of research on the views of nursing students on communicating with the family members of patients, and little has been mentioned in the nursing curriculum on this topic. AIM The aim of this study was to explore nursing students' experiences of communicating with the family members of patients. DESIGN A qualitative descriptive study. METHODS A total of 42 nursing students (21 undergraduate year-two students and 21 were master's year-one students) from one school of nursing in Hong Kong participated in in-depth individual interviews. Content analysis was adopted. The trustworthiness of this study was ensured by enhancing its credibility, confirmability, and dependability. RESULTS Two main themes were discerned. The first, "inspirations gained from nursing student-family communication", included the following sub-themes: (a) responding to enquiries clearly, (b) avoiding sensitive topics, (c) listening to the patient's family, and (d) sharing one's own experiences. The second, "emotions aroused from nursing student-family communication", had the following sub-themes: (a) happiness, (b) anger, (c) sadness, and (d) anxiety. CONCLUSIONS More studies on the perspectives of nursing students on communicating with family members should be conducted, to strengthen the contents and learning outcomes of nursing student-family communication in the existing nursing curriculum.
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Affiliation(s)
- Zenobia C Y Chan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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15
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Ängerud KH, Boman K, Brännström M. Areas for quality improvements in heart failure care: quality of care from the family members' perspective. Scand J Caring Sci 2017; 32:346-353. [PMID: 28543624 DOI: 10.1111/scs.12468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/21/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The complex needs of people with chronic heart failure (HF) place great demands on their family members, and it is important to ask family members about their perspectives on the quality of HF care. OBJECTIVE To describe family members' perceptions of quality of HF care in an outpatient setting. METHODS A cross-sectional study using a short form of the Quality from Patients' Perspective (QPP) questionnaire for data collection. The items in the questionnaire measure four dimensions of quality, and each item consists of both the perceived reality of the care and its subjective importance. The study included 57 family members of patients with severe HF in NYHA class III-IV. RESULTS Family members reported areas for quality improvements in three out of four dimensions and in dimensionless items. The lowest level of perceived reality was reported for treatment for confusion and loss of appetite. Treatment for shortness of breath, access to the apparatus and access to equipment necessary for medical care were the items with the highest subjective importance for the family members. CONCLUSION Family members identified important areas for quality improvement in the care for patients with HF in an outpatient setting. In particular, symptom alleviation, information to patients, patient participation and access to care were identified as areas for improvements. Thus, measuring quality from the family members' perspective with the QPP might be a useful additional perspective when it comes to the planning and implementation of changes in the organisation of HF care.
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Affiliation(s)
| | - Kurt Boman
- Research Unit Skellefteå, Department of Medicine, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Margareta Brännström
- Department of Nursing, Umeå University, Umeå, Sweden.,The Arctic Research Centre, Umeå University, Umeå, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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16
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Ängerud KH, Boman K, Ekman I, Brännström M. Areas for quality improvements in heart failure care: quality of care from the patient's perspective. Scand J Caring Sci 2016; 31:830-838. [DOI: 10.1111/scs.12404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Karin H. Ängerud
- Department of Nursing; Umeå University; Umeå Sweden
- The Arctic Research Centre; Umeå University; Umeå Sweden
| | - Kurt Boman
- Research Unit Skellefteå; Department of Medicine; Umeå University; Umeå Sweden
- Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences; University of Gothenburg; Gothenburg Sweden
- Centre for Person-Centred Care; University of Gothenburg (GPCC); Gothenburg Sweden
| | - Margareta Brännström
- Department of Nursing; Umeå University; Umeå Sweden
- The Arctic Research Centre; Umeå University; Umeå Sweden
- Centre for Person-Centred Care; University of Gothenburg (GPCC); Gothenburg Sweden
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17
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Sandsdalen T, Grøndahl VA, Hov R, Høye S, Rystedt I, Wilde-Larsson B. Patients' perceptions of palliative care quality in hospice inpatient care, hospice day care, palliative units in nursing homes, and home care: a cross-sectional study. BMC Palliat Care 2016; 15:79. [PMID: 27553776 PMCID: PMC4995801 DOI: 10.1186/s12904-016-0152-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/15/2016] [Indexed: 12/25/2022] Open
Abstract
Background Patients’ perceptions of care quality within and across settings are important for the further development of palliative care. The aim was to investigate patients’ perceptions of palliative care quality within settings, including perceptions of care received and their subjective importance, and contrast palliative care quality across settings. Method A cross-sectional study including 191 patients in late palliative phase (73 % response rate) admitted to hospice inpatient care, hospice day care, palliative units in nursing homes, and home care was conducted, using the Quality from the Patients’ Perspective instrument-palliative care (QPP-PC). QPP-PC comprises four dimensions and 12 factors; “medical–technical competence” (MT) (2 factors), “physical–technical conditions” (PT) (one factor), “identity–orientation approach” (ID) (4 factors), “sociocultural atmosphere” (SC) (5 factors), and three single items (S); medical care, personal hygiene and atmosphere. Data were analysed using paired-samples t-test and analysis of covariance while controlling for differences in patient characteristics. Results Patients’ perceptions of care received within settings showed high scores for the factors and single items “honesty” (ID) and “atmosphere” (S) in all settings and low scores for “exhaustion” (MT) in three out of four settings. Patients’ perceptions of importance scored high for “medical care” (S), “honesty” (ID), “respect and empathy” (ID) and “atmosphere” (S) in all settings. No aspects of care scored low in all settings. Importance scored higher than perceptions of care received, in particular for receiving information. Patients’ perceptions of care across settings differed, with highest scores in hospice inpatient care for the dimensions; ID, SC, and “medical care” (S), the SC and “atmosphere” (S) for hospice day care, and “medical care” (S) for palliative units in nursing homes. There were no differences in subjective importance across settings. Conclusion Strengths of services related to identity–orientation approach and a pleasant and safe atmosphere. Key areas for improvement related to receiving information. Perceptions of subjective importance did not differ across settings, but perceptions of care received scored higher in more care areas for hospice inpatient care, than in other settings. Further studies are needed to support these findings, to investigate why perceptions of care differ across settings and to highlight what can be learned from settings receiving high scores.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway. .,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
| | | | - Reidun Hov
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway
| | - Sevald Høye
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway
| | - Ingrid Rystedt
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway.,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden
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18
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Skundberg-Kletthagen H, Hall-Lord ML, Hedelin B, Wangensteen S. Relatives of Inpatients Suffering from Severe Depression: Their Burden and Encounters with the Psychiatric Health Services. Issues Ment Health Nurs 2016; 37:293-8. [PMID: 27058574 DOI: 10.3109/01612840.2016.1145309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim was to investigate relatives of inpatients with severe depression - their perceptions of encountering psychiatric specialist health services and their degree of burden. Sixty-eight relatives recruited via hospital wards and community specialist health centers responded to a questionnaire, with questions from the Quality from the Patients Perspective modified to relatives and the Burden Assessment Scale. Relatives recruited via community specialist health centers perceived less received information and support than those recruited via hospital wards. Higher burden was reported among relatives receiving less information and support than they needed from the psychiatric specialist health services. Healthcare professionals are recommended to give relatives the information and support according to their needs.
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Affiliation(s)
- Hege Skundberg-Kletthagen
- a Karlstad University , Department of Health Sciences , Karlstad , Sweden.,b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
| | - Marie Louise Hall-Lord
- a Karlstad University , Department of Health Sciences , Karlstad , Sweden.,b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
| | - Birgitta Hedelin
- b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
| | - Sigrid Wangensteen
- b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
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19
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Sandsdalen T, Rystedt I, Grøndahl VA, Hov R, Høye S, Wilde-Larsson B. Patients' perceptions of palliative care: adaptation of the Quality from the Patient's Perspective instrument for use in palliative care, and description of patients' perceptions of care received. BMC Palliat Care 2015; 14:54. [PMID: 26525048 PMCID: PMC4630886 DOI: 10.1186/s12904-015-0049-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Instruments specific to palliative care tend to measure care quality from relative perspectives or have insufficient theoretical foundation. The instrument Quality from the Patient's Perspective (QPP) is based on a model for care quality derived from patients' perceptions of care, although it has not been psychometrically evaluated for use in palliative care. The aim of this study was to adapt the QPP for use in palliative care contexts, and to describe patients' perceptions of the care quality in terms of the subjective importance of the care aspects and the perceptions of the care received. METHOD A cross-sectional study was conducted between November 2013 and December 2014 which included 191 patients (73% response rate) in late palliative phase at hospice inpatient units, hospice day-care units, wards in nursing homes that specialized in palliative care and homecare districts, all in Norway. An explorative factor analysis using principal component analysis, including data from 184 patients, was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's alpha and paired t-tests were used to describe patients' perceptions of their care. RESULTS The QPP instrument was adapted for palliative care in four steps: (1) selecting items from the QPP, (2) modifying items and (3) constructing new items to the palliative care setting, and (4) a pilot evaluation. QPP instrument specific to palliative care (QPP-PC) consists of 51 items and 12 factors with an eigenvalue ≥1.0, and showed a stable factor solution that explained 68.25% of the total variance. The reliability coefficients were acceptable for most factors (0.79-0.96). Patients scored most aspects of care related to both subjective importance and actual care received as high. Areas for improvement were symptom relief, participation, continuity, and planning and cooperation. CONCLUSION The QPP-PC is based on a theoretical model of quality of care, and has its roots in patients' perspectives. The instrument was developed and psychometrically evaluated in a sample of Norwegian patients with various diagnoses receiving palliative care in different care contexts. The evaluation of the QPP-PC shows promising results, although it needs to be further validated and tested in other contexts and countries.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway. .,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
| | - Ingrid Rystedt
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
| | | | - Reidun Hov
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway.
| | - Sevald Høye
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway.
| | - Bodil Wilde-Larsson
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway. .,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
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20
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Petersen GS, Knudsen JL, Vinter MM. Cancer patients' preferences of care within hospitals: a systematic literature review. Int J Qual Health Care 2015; 27:384-95. [PMID: 26265160 DOI: 10.1093/intqhc/mzv059] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2015] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Knowledge about cancer patients' preferences in health care is important because it enables care to be patient centered. However, the literature does not provide an overview. The aim of this study was to identify the dimensions of hospital-based cancer care that patients evaluate the most important using Patient-rated importance as a method. DATA SOURCE PubMed was searched in 2013/2014. STUDY SELECTION Studies were identified, if they were in accordance with specific search terms and focused on hospital-based cancer care. Totally, 11 studies were found. DATA EXTRACTION The 11 studies comprised a total of 598 items. Of these, 592 items were categorized into 19 care dimensions. The highest rated quartile of items was identified as care elements patients evaluated to be the most important. Identification of the most important dimensions was done by calculating the percentages of items within each dimension that were within the highest quartile. RESULTS OF DATA SYNTHESIS The 11 studies varied a lot in regard to aim and patient characteristics. The three most important dimensions were as follows: Rapid diagnosis and treatment; High professional standard; and Information about treatment and side(effects)/consequences. Within four dimensions, Psychosocial support, Physical facilities, Waiting time and Transparency in care, no items were within the highest quartile. CONCLUSION Patient-rated importance was a useful method in identifying the care patients preferred. Due to a limited number of studies and great diversity within studies evaluated, interpretation of results should be cautious. However, it seems that cancer patients treated in hospitals with a curative intent find treatment-related information, professional standard and short delay of diagnosis and treatment most important.
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Affiliation(s)
| | - Janne Lehmann Knudsen
- Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Mette Marianne Vinter
- Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, Copenhagen DK-2100, Denmark
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21
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Karlou C, Papathanassoglou E, Patiraki E. Caring behaviours in cancer care in Greece. Comparison of patients', their caregivers' and nurses' perceptions. Eur J Oncol Nurs 2015; 19:244-50. [DOI: 10.1016/j.ejon.2014.11.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 11/15/2014] [Accepted: 11/19/2014] [Indexed: 11/28/2022]
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22
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Sandsdalen T, Hov R, Høye S, Rystedt I, Wilde-Larsson B. Patients' preferences in palliative care: A systematic mixed studies review. Palliat Med 2015; 29:399-419. [PMID: 25680380 DOI: 10.1177/0269216314557882] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is necessary to develop palliative care to meet existing and future needs of patients and their families. It is important to include knowledge of patient preferences when developing high-quality palliative care services. Previous reviews have focused on patient preferences with regard to specific components of palliative care. There is a need to review research on patient's combined preferences for all elements that constitute palliative care. AIM The aim of this study is to identify preferences for palliative care among patients in the palliative phase of their illness, by synthesizing existing research. DATA SOURCES Studies were retrieved by searching databases - the Cochrane Library, Medline, CINAHL, PsycINFO, Scopus and Sociological Abstracts - from 1946 to 2014, and by hand searching references in the studies included. DESIGN A systematic mixed studies review was conducted. Two reviewers independently selected studies for inclusion and extracted data according to the eligibility criteria. Data were synthesized using integrative thematic analysis. RESULTS The 13 qualitative and 10 quantitative studies identified included participants with different illnesses in various settings. Four themes emerged representing patient preferences for care. The theme 'Living a meaningful life' illustrated what patients strived for. The opportunity to focus on living required the presence of 'Responsive healthcare personnel', a 'Responsive care environment' and 'Responsiveness in the organization of palliative care'. CONCLUSION The four themes may be useful for guiding clinical practice and measurements of quality, with the overall goal of meeting future needs and improving quality in palliative care services to suit patients' preferences.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Nursing and Mental Health, Faculty of Public Health, Hedmark University College, Elverum, Norway Discipline of Nursing Science, Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Reidun Hov
- Department of Nursing and Mental Health, Faculty of Public Health, Hedmark University College, Elverum, Norway
| | - Sevald Høye
- Department of Nursing and Mental Health, Faculty of Public Health, Hedmark University College, Elverum, Norway
| | - Ingrid Rystedt
- Discipline of Nursing Science, Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Bodil Wilde-Larsson
- Department of Nursing and Mental Health, Faculty of Public Health, Hedmark University College, Elverum, Norway Discipline of Nursing Science, Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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23
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Papastavrou E, Efstathiou G, Tsangari H, Karlou C, Patiraki E, Jarosova D, Balogh Z, Merkouris A, Suhonen R. Patients’ decisional control over care: a cross-national comparison from both the patients’ and nurses’ points of view. Scand J Caring Sci 2015; 30:26-36. [DOI: 10.1111/scs.12218] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/03/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Evridiki Papastavrou
- Department of Nursing; School of Health Studies; Cyprus University of Technology; Limassol Cyprus
| | | | - Haritini Tsangari
- Department of Economics and Finance; University of Nicosia; School of Business; Nicosia Cyprus
| | - Chryssoula Karlou
- Department of Nursing; National and Kapodistrian University of Athens; Athens Greece
| | - Elisabeth Patiraki
- Department of Nursing; National and Kapodistrian University of Athens; Athens Greece
| | - Darja Jarosova
- Faculty of Medicine; Department of Nursing; University of Ostrava; Ostrava Czech Republic
| | - Zoltan Balogh
- Faculty of Health Care Sciences; Semmelweis University Budapest; Budapest Hungary
| | - Anastasios Merkouris
- Department of Nursing; School of Health Studies; Cyprus University of Technology; Limassol Cyprus
| | - Riitta Suhonen
- Department of Nursing Science; University of Turku; Turku Finland
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Bobrovitz N, Santana MJ, Kline T, Kortbeek J, Stelfox HT. The use of cognitive interviews to revise the Quality of Trauma Care Patient-Reported Experience Measure (QTAC-PREM). Qual Life Res 2015; 24:1911-9. [PMID: 25589232 DOI: 10.1007/s11136-015-0919-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE The "Quality of Trauma Care Patient-Reported Experience Measure" is the first measure of patient experiences with overall injury care. The objective of this study was to use cognitive interviews to inform revision of the measure into a parsimonious set of items that function as intended, in preparation for multicenter testing. METHODS Concurrent and retrospective cognitive interviews with injured patients (n = 17) and family members (n = 13) using semi-structured interview guides. Responses were analyzed using thematic analysis. RESULTS Six broad themes were identified and guided revisions: (1) participants did not have the information to answer items (n = 9); (2) items were ambiguous or were inconsistently interpreted (n = 13); (3) items did not measure the intended constructs (n = 6); (4) items included assumptions about healthcare processes (n = 4); (5) items measured non-priority aspects of injury care (n = 8); and (6) items were redundant (n = 5). Two issues resulted in key conceptual and content changes: participants' difficulty to evaluate pre-hospital, emergency department, and intensive care unit services due to recall issues and the challenge to evaluate the effectiveness and equity of care. In total, 39 items were deleted, 28 new items developed, and the final instrument included 63 items. CONCLUSIONS Our results informed changes to item content, format, and response options. This study highlights key issues to consider when incorporating patient/family perspectives into quality measurement, most notably, that few participants can assess the quality of care in the pre-hospital and emergency department phases of care and that novel methods are needed to evaluate the effectiveness and equity of care.
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Affiliation(s)
- Niklas Bobrovitz
- Nuffield Department of Primary Care Health Sciences, University of Oxford, 2nd Floor, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK,
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25
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Maguire R, Papadopoulou C, Kotronoulas G, Simpson MF, McPhelim J, Irvine L. A systematic review of supportive care needs of people living with lung cancer. Eur J Oncol Nurs 2013; 17:449-64. [PMID: 23246484 DOI: 10.1016/j.ejon.2012.10.013] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/23/2012] [Accepted: 10/30/2012] [Indexed: 11/18/2022]
Affiliation(s)
- Roma Maguire
- School of Nursing & Midwifery, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, UK.
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