Hospice Satisfaction Among Patients, Family, and Caregivers: A Systematic Review of the Literature

Background: Hospice care is an underused form of intervention at the end of life. The experiences of patients, families, and other caregivers are important to consider in thinking about how to encourage greater use of hospice care, through policies and advocacy that promote its benefits. Specifically, patient, family, and other caregiver satisfaction with hospice care is important to understand better. Methods: A PRISMA-guided review of the research on hospice care satisfaction and its correlates among patients, families, and other caregivers. Included in the review is research published over the time period 2000-2023 identifying a hospice care satisfaction finding. Results: Thirty-eight studies were included in the review. Key findings were: (a) higher levels of hospice care satisfaction among patients, families, and other caregivers; and (b) correlates of hospice care satisfaction falling into the categories of communication, comfort, and support. The published literature had fewer findings related to demographic correlates of satisfaction such as age or race/ethnicity and was lacking in comparative research examining satisfaction across different types of hospice care settings. Discussion: Extant research demonstrates a consistently higher level of hospice care satisfaction among patients, families, and other caregivers. This satisfaction appears related to specific aspects of care delivery that involve effective care coordination and communication; pain and symptom management; and emotional support. Strengthening future research involves testing additional interventions aimed at enhancing satisfaction; including more comparative research across hospice care settings; and more studies that include patients as the key respondents.

Family Satisfaction with Care Provided in Intensive Care Unit; a Multi-Center, Cross-Sectional Study

Background

Healthcare provided in medical facilities should prioritize the needs of families, as it enhances the quality of care for the patients. Family satisfaction gauges how effectively healthcare professionals address the perceived needs and expectations of family members. Numerous factors, including information dissemination, communication, family dynamics, patient characteristics, hospital facilities, and the caregiving process, serve as predictors of family satisfaction. Thus, this study seeks to evaluate the satisfaction of families with the care received by patients admitted to the intensive care unit.

Methods

A hospital-based cross-sectional study involving 400 participants was conducted across multiple centers from March to June 2023. Multicollinearity was assessed by examining variance inflation factors (VIF), while the goodness-of-fit was evaluated using the Hosmer and Lemeshow test. Both bivariable and multivariable logistic regression analyses were utilized to identify factors correlated with family satisfaction. Variables with a p-value below 0.2 in the bivariable logistic regression were included in the multivariable logistic regression analysis. Adjusted Odds Ratios (AORs) with 95% Confidence Intervals were computed to indicate the strength of association. In the multivariable analysis, variables with a p-value less than 0.05 were deemed statistically significant.

Results

The overall family satisfaction with the care provided in the intensive care unit was 58.6%, with a 95% confidence interval ranging from 55.882% to 61.241%. Families expressed higher satisfaction levels with patient care (64.8%) and professional care (67.4%). However, they reported lower satisfaction levels regarding care provided for families (52.2%), the ICU environment (56.8%), and involvement of families in decision-making (55.8%). Lack of formal education (AOR: 1.949, 95% CI: 1.005, 4.169), completion of primary education (AOR: 2.581, 95% CI: 1.327, 5.021), and completion of grades 9-12 (AOR: 2.644, 95% CI: 1.411, 4.952) were found to be significantly associated with overall family satisfaction.

Conclusion and recommendation

The overall level of satisfaction is satisfactory. To enhance service quality and family satisfaction, healthcare providers should prioritize effective and regular communication with family members. Keeping them well informed about the patient's condition and treatment plan is essential.

Associations between Complaints and Organizational Characteristics among Ohio Nursing Homes

OBJECTIVES

In recent years, Ohio nursing homes (NHs) have received an increasing number of complaints. The current study aims to gain a better understanding of the relationship between NH organizational characteristics and the number of complaints.

DESIGN

Secondary data analysis was used.

SETTING AND PARTICIPANTS

Four data sources on Ohio NHs were merged. Ohio NH complaints data reported in 2018 and 2019 was linked with the 2017 Ohio Biennial Survey of Long-Term Care Facilities, 2017 Ohio Nursing Home Resident Satisfaction Survey, and 2018 Ohio Nursing Home Family Satisfaction Survey.

METHODS

Descriptive analysis, bivariate tests (ie, analysis of variance and χ2 test), and multinomial logistic regression analyses were conducted.

RESULTS

Findings included that urban location, NH administrator (NHA) and director of nursing (DON) turnover in the previous 3 years, NH size, occupancy rate, certified nursing assistant (CNA) retention, and overall family satisfaction were significantly associated with total complaints. NHA and DON turnover, NH size, CNA retention, and overall family satisfaction were found to be significantly associated with substantiated complaints.

CONCLUSIONS AND IMPLICATIONS

The importance of leadership (ie, NHA and DON) turnover, CNA retention, and family satisfaction indicates that specifically targeted efforts to improve in these areas can have a positive impact on NH quality.

Do working parents in the United States expect work location to impact job and family satisfaction in the post-pandemic period? Evidence from a survey experiment

The pandemic response allowed many parents in the United States and globally to work remotely for the first time ever which, for many, continued into the recovery. It is unclear whether, after a period when a large segment of the United States labor force worked remotely, remote work is viewed favorably or unfavorably among employed parents. We present results from a survey experiment assessing whether employed parents in the United States perceive that remote work will impact a hypothetical employed parents' job and family satisfaction and, critically, whether perceptions of work-family conflict and anticipated job rewards mediate this relationship. We find that respondents who are also employed parents perceive that hypothetical employed parents who access remote work will report lower job satisfaction and higher family satisfaction. Perceptions of work-family conflict do not mediate this association. Rather, we find that job rewards (e.g., pay, promotion, etc.) fully mediate the relationship between remote work and perceived job satisfaction. Ultimately, this indicates that employed parents perceive that remote work will bring workers like them less pay and thus lower job satisfaction but greater family satisfaction. This extends arguments about remote work in the light of the conceptualization of a flexibility stigma and a flexibility paradox. Implications for practice and theory are discussed.

We Are Done! Now What? Exploring End of Treatment Needs of Childhood Cancer Survivors and Their Parents

Background: Increased childhood cancer survival rates have spurred a new body of research pertaining to the cancer-survivorship continuum. Literature suggests a lack of research and guidelines for care at the end of treatment (EOT). To improve the transition to survivorship and determine any posttreatment challenges, this study explored the experiences of childhood cancer survivors (CCSs), parents/caregivers, and pediatric oncology health care professionals (HCPs) at EOT. Method: This study employed a mixed methods design. EOT Questionnaires were completed by CCSs and parents/caregivers within 6 months of completing treatment, and by pediatric oncology HCPs. Results: A total of 75 CCSs and parents/caregivers and 21 HCPs completed the study. The majority of parents/caregivers (78%) and older CCSs (94%) recalled having an EOT "meeting." Most were satisfied with the meeting, but described unexpected worries/problems following EOT. Family members stating they were "very satisfied" with the EOT meeting increased significantly relative to the number of EOT topics addressed. In contrast, the omission of certain psychosocial discussion topics negatively correlated with satisfaction. Oncologists provided the majority of EOT services, with infrequent provision by other HCPs. Less than 20% of HCPs characterized families as "very satisfied" with EOT services and suggested improvements to meet families' needs. Discussion: This study found unmet psychosocial and anticipatory guidance needs, indicating a lack of preparedness. The results suggest that end of cancer treatment requires a more standardized, comprehensive, and multidisciplinary approach. Enhanced education and support services are needed to promote the successful navigation of all families through this period of transition.

Patient and Family Satisfaction in the Intensive Care Unit of a Quaternary Care Center

Patient and family satisfaction is an indicator of quality assessment of care provided in the intensive care unit (ICU) ensuring that the quality of services provided meets not only the patients' but also their families' needs. Investigating how different variables affect their satisfaction ratings is important. We assessed patient and family satisfaction in a quaternary care center in Pakistan.

METHODS

The study was a cross-sectional survey of adult patients and families treated between December 1, 2022 and April 30, 2023 in the ICU at Pakistan Kidney and Liver Institute and Research Center (PKLI-RC), Lahore, Pakistan. We used family satisfaction in ICU 24 (FS-ICU 24) to measure satisfaction in a number of domains on a scale of 1-5 (1 = Very Dissatisfied, 5 = Fully Satisfied).

RESULTS

Of the 330 patients admitted to ICU during the study period, all patients and/or one of their family members (100%) participated in the study. Out of these, 209 (63%) were male. The mean age was 42 ± 15 years, and the overall mean patient and family satisfaction scores were 4.69 ± 0.69 and 4.55 ± 0.52, respectively. The mean score in all domains was > 4, with the exception of pain management in which it was 3.98 ± 0.53.

CONCLUSION

Patients and their families' satisfaction is an important measure of ICU quality. Not only the patients and their families were satisfied with our ICU quality of care but they also appreciated involvement in the decision-making process and quality assessment. There is a need for further research for improvement in the pain domain.

The Efficacy of Hospice-In-Place Care Versus Traditional Inpatient Care

Introduction: The hospice-in-place program at Vanderbilt University Medical Center (VUMC) is available to patients and families who elect for hospice benefits and are too unstable to be transported for hospice care. The goal of this study was to assess the satisfaction of family members of patients who died while hospitalized at VUMC and received hospice-in-place compared to the families of patients who did not receive hospice care. Methods: Next-of-kin satisfaction was measured through the administration of qualitative interviews and quantitative questionnaires. Semi-structured interviews were audio-recorded, and transcripts were analyzed using an iterative inductive-deductive approach to develop a conceptual framework. Participants were also asked to respond to a 10-question satisfaction questionnaire. Results: Forty participants were enrolled: 20 next-of-kin of patients who received hospice-in-place and 20 next-of-kin of patients who passed without hospice. Factors influencing satisfaction were organized into a conceptual framework with three categories: individual-level factors, systems-level factors, and modifying factors. For the questionnaires, the hospice-in-place group had a mean satisfaction score of 4.54 (0.76) out of five, while the non-hospice group had a mean score of 4.14 (1.00). A comparison of the two groups' responses did not show a statistically significant difference (P = 0.06). Discussion: Quantitative findings of this study showed improved satisfaction but were unable to show a significant difference in satisfaction with hospice-in-place compared to traditional care. Questionnaire results suggest that both types of care yield high satisfaction scores and are successfully supporting patients and families. The conceptual framework also adds to the understanding of end-of-life experiences at VUMC.

The Italian Family Satisfaction in the Intensive Care Unit Questionnaire: A Psychometric Evaluation Using the Rasch Model

Quality measurement of the intensive care unit (ICU) should include families' perspectives, their satisfaction with the care process and outcomes, and the evaluation of actions to improve their psychological health and wellbeing. The current study was designed to validate the Italian version of the Family Satisfaction in the Intensive Care Unit (FS-ICU) using the Rasch model. Results included reliability and separation for items and persons, item fit statistics, unidimensionality, and item characteristic curve. The study was conducted between August 2022 and February 2023. A total of 108 family members (mean age 54.9 years) completed the FS-ICU questionnaire. The instrument had a moderate discrimination ability and only five items (#21, #23, #10, #22, and #24) exhibited a misfit. The Rasch dimension explained 52.1% of the variance in the data, while the unexplained variance in the first contrast is 7.2%, which indicates a possible second dimension. FS-ICU was shown to be beneficial as an assessment instrument for family member satisfaction in the ICU, despite some flaws that need to further be addressed to improve the scale.

Pediatric Preanesthesia Anxiety and Factors of Family Satisfaction

PURPOSE

Pediatric patients scheduled for procedures with anesthesia experience stress and feelings of anxiety, but frequently lack the opportunity to report their feelings. Pediatric patient anxiety may be related to internal (patient perceptions/emotions) or external (demographic/family knowledge/satisfaction) factors. The purpose of the study was to explore patient reports of anxiety in young school-age through adolescent ages, and factors of family satisfaction before a scheduled procedure with anesthesia.

DESIGN

Cross-sectional, descriptive, and correlational.

METHODS

A voluntary survey including family-report of patient age and past anesthesia, type of procedure, family satisfaction factors (knowledge of anesthesia; perioperative concerns), and patient-report of anxiety with a visual analog scale (0-10) was offered to eligible families at their preanesthesia clinic appointment.

FINDINGS

Completed surveys from 80 families (mean age of patient = 12 years; range 7-17 years) showed legally authorized guardians (LAGs) felt the preanesthesia visit helped them understand anesthesia information, but they also had concerns, such as complications and pain. Patient anxiety ratings ranged from 0 to 10 (M = 3.3, SD = 3.1), and were slightly higher for patients 11 years and younger (M = 3.8; SD = 3.4). Anxiety ratings were not significantly correlated with other factors measured.

CONCLUSIONS

Pediatric patients, ages 7-17, report preanesthesia anxiety levels ranging from "not at all" to "worst imaginable," unrelated to demographic or family factors. Family members have perioperative concerns that need to be addressed before scheduled procedures. There is an impetus for improvement in psychosocial assessment and health care team collaboration to meet needs in a family-centered preanesthesia care model.

Family Functioning Style as a Predictor of the Quality of Cognitive Functioning of Primary School Students With ADHD

OBJECTIVE

This study aimed to specify whether family communication and satisfaction are predictors of a child's executive functions and whether attention deficit hyperactivity disorder (ADHD) severity lies in the pathway between these variables.

METHOD

Two hundred Polish children with ADHD, aged 10 to 13, were tested using Conners 3, the PU1 Battery of Cognitive Tests and Stanford-Binet Intelligence Scale, Fifth Edition (SB5). Parents filled out the FACES IV-SOR questionnaire. Structural equation modeling (SEM) was used to test the hypotheses.

RESULTS

The quality of family communication and satisfaction did not predict executive functioning in children with ADHD, and ADHD severity did not play a mediating role neither in boys or in girls. Intelligent quotient was the only predictor of executive functioning in the group of boys.

CONCLUSION

These results contrast with those of previous studies that have shown the existence of similar associations in other cultural contexts.

The Occurrence and Co-Occurrence of Harsh Parenting and Family Conflict in Hong Kong

The violation of children's right to a safe home environment is a major public health problem in need of serious attention. Evidence has been limited about the family characteristics that go with the co-occurrence of harsh parenting and family conflict. By using a representative community sample of Hong Kong families, this study aims to examine the prevalence and risk factors of harsh parenting and family conflict. This study was conducted using a secondary analysis obtained from the 2017 Hong Kong Family Survey with a sample size of 1926 respondents who have children. Results showed that participants' ages are negatively related to the occurrence and co-occurrence of harsh parenting and/or family conflict. Married mothers reported less family conflict. Fathers with lower education levels reported more experiences of family violence. Mothers reporting a higher level of family satisfaction were less associated with harsh parenting. This study provides insights into the unique and shared familial elements that prevent harsh parenting and family conflict and help facilitate the development of effective intervention strategies for family violence co-occurrence. Family-based prevention for family violence may screen for the presence of harsh parenting and family conflict and take into consideration these signals to better support families in need.

An approach to psychosocial health among middle-aged and older people by remote sharing of photos and videos from family members not living together: A feasibility study

Background

As an approach to the psychosocial health of people in later adulthood, information and communication technology (ICT) is attracting attention. However, because there is still a disparity issue in ICT use, particularly for older people, considering age-friendly digital interventions is important. We examined the feasibility of an intervention by an age-friendly digital service, remote sharing of photos/videos from families not living together, for psychosocial health in middle-aged and older people.

Methods

This single-arm study recruited Japanese adults aged ≥ 50 years from web-pages of the social service, Mago-Channel (Chikaku Inc., Japan). Participants used this service for 3 months to receive photos/videos from the smartphones of their families not living together on a device set up on their home TVs and watched them there. Families not living together were encouraged to send photos/videos at least once a week, but no other restrictions on their lives, including their interactions, were imposed. After 3 months, the level of user satisfaction and changes in psychosocial health were assessed.

Results

Finally, 115 participants were included, and 106 completed the intervention; the dropout rate from the intervention was low (7.8%), and satisfaction with the program was high, indicating high feasibility. While depressive symptoms and loneliness did not change markedly, satisfaction with the relationship of families living together increased significantly, and social interactions improved, including those with families not living together.

Conclusions

High feasibility of this age-friendly digital intervention and its potential benefits on social relationships were shown, encouraging further trials with a confirmatory study design.

A Multigroup Analysis of Bidirectional Work-Family Enrichment on Family Satisfaction of Hospitality Employees during the Pandemic: Where Religiosity and Marital Status Matter

The COVID-19 pandemic has changed our lives. As many industries face a complete stand-still, it also highlights the need to maintain family satisfaction (FS) during this challenging time, empirical research on achieving this remains scant. This study elucidates how marital status influences employees' religiosity, work-family enrichment (WFE) and FS. Data from 295 employees was examined using the analyzed using the partial least squares method structural equation modeling (PLS-SEM) multigroup analysis. Results suggest that religiosity has a positive significant relationship on the bidirectionality of WFE. The multigroup analysis indicates a significant difference in how single and married employees interpret work-family experience. We extend family-work interfaces by incorporating both the construct of marital status and religiosity. It advances the body of knowledge in understanding work-family interfaces, especially in times of the pandemic.

Accepting influence in military couples: Implications for couples' communication and family satisfaction

In popular relationship resources, accepting influence is regarded as a couple-level process vital for relational satisfaction. However, empirical research has demonstrated inconsistent evidence for these suppositions, with several studies identifying no associations between accepting influence and relationship outcomes, and, furthermore, several gaps in the literature remain with regard to our knowledge on accepting influence (e.g., little identified research on military couples or family outcomes). To address these gaps, a measure of perceptions of one's partner accepting influence was retrospectively created to examine accepting influence in Army couples (N = 244). With theoretical underpinnings from family systems theory, this study used an actor-partner interdependence approach to investigate the associations between partners' accepting influence and couple communication satisfaction and satisfaction with the family. Service members' perceptions of their partners' accepting influence were associated with their own outcomes, whereas civilian spouses' perceptions of partners' accepting influence were related to both partners' outcomes. Results suggest accepting influence may be an intervention point to improve couple and family outcomes.

Family satisfaction and self-efficacy among low-income adolescents during the COVID-19 pandemic: A comparative analysis of parents' educational attainment

Purposes

Given that the period from middle to high school is important to develop and cultivate self-efficacy, reduced support in low-income families might negatively influence the development of self-efficacy among low-income students since COVID-19. This study aims to investigate the association between family satisfaction and self-efficacy among low-income students since COVID-19 and the moderating effect of parents' educational attainment on the relationship.

Methods

255 low-income students in South-Korea were selected for the final sample. The PROCESS macro 3.4 for Statistical Product and Service Solutions was used to analyze the data.

Results

Family satisfaction was positively related to self-efficacy among low-income students. There was a significant moderating effect of parents' educational attainment on the relationship between family satisfaction and self-efficacy among low-income students during the COVID-19 pandemic.

Discussion

Financial support and COVID-19 benefits should be prioritized to low-income families with adolescents to improve family relationships, leading to increase self-efficacy among low-income students. Social welfare programs targeting family relationships in low-income households should be especially targeted toward low-income households without a parent who received higher education. Life-long education should be provided to parents in low-income families who did not gain higher education as their educational attainment influences the self-efficacy of their adolescent children.

Effects of work-to-family enrichment on psychological distress and family satisfaction: A dyadic analysis in dual-earner parents

Resources that individuals acquire at work can have significant effects on their own well-being and family satisfaction, and on those of their closest family relations. Following the conservation of resources theory, this study examined the effects of work-to-family enrichment (WFE) on psychological distress (depression, anxiety, and stress) and family satisfaction (SWFaL) in different-gender dual-earner parents. The sample consisted of 473 couples - mother and father - from Temuco, Chile, who answered the Work-Family Interface scale, the Depression, Anxiety and Stress Scale, and the Satisfaction with Family Scale. The analysis was conducted using the Actor-Partner Interdependence Model (APIM). Results showed that WFE was positively associated with SWFaL for both mothers and fathers (actor effects), whereas higher WFE was linked to lower psychological distress only in fathers. For mothers and fathers, psychological distress was negatively associated with their own (actor effects) and the other parent's SWFAL (partner effects). The mediating role of psychological distress was found only for fathers' WFE and their SWFaL. These results indicate that resources from work can increase family satisfaction for both fathers and mothers in dual-earner couples with adolescent children. However, in these couples, fathers acquire affective resources (positive mood) that reduce their own psychological distress, while mothers acquire skills (managing time at home more efficiently) that they invest directly in the family domain.

The effect of an ICU liaison nurse-led family-centred transition intervention program in an adult ICU

BACKGROUND

ICUs follow a restrictive companionship policy, especially after the COVID-19 outbreak. This strategy often limits the time families spend with patients, hinders their knowledge and skills in caregiving, and the sudden transfer of ICU patients to assist with disease monitoring and daily care can be very stressful for families. It is beneficial to use the transition period of transferring ICU patients to help families adjust to the role of caregiver.

AIMS AND OBJECTIVES

To develop and implement a patient- and family-centered transitional care intervention plan for patients transferred to the ICU.

DESIGN

Prospective, pretest and posttest design.

METHODS

The experimental group received an individualized family-centered transition plan led by the ICU liaison nurse that included 1) communication with health care professionals; distribution of a transfer booklet; 2) identification of nursing issues and communication with the ward nurse; invitation of family members to participate in the patient's rehabilitation; 3) follow-up instruction on bedside range of motion exercises; and provision of a patient rehabilitation diary. Patients in the control group received only routine care. Data were collected using the General Information Questionnaire, Family Satisfaction with ICU Patients (FS-ICU), the Family Relocation Stress Scale (FRSS), and the Stanford Acute Stress Response Questionnaire (SASRQR).

RESULTS

After the intervention, the total family satisfaction score of ICU patients in the experimental group was significantly higher than that of the control group (87.18 ± 8.38 vs 78.74 ± 10.63, p<0.001), and the satisfaction with the care and information provided was significantly higher in the experimental group compared to the control group (p < 0.001), with no significant difference between the two groups in terms of satisfaction with decision making (p>0.001). The level of relocation stress of patients' families was significantly lower in the experimental group compared to the control group after the intervention (p < 0.001). And there was no statistically significant difference between the two groups in terms of patients' acute stress disorder scores (p>0.001).

CONCLUSION

The implementation of a family-involved transition care programme significantly improved the satisfaction of ICU patients' families and reduced the stress of relocation for patients' families.

RELEVANCE TO CLINICAL PRACTICE

Focusing on the transition of ICU patients to ensure continuity of critical care and improve the quality of care for ICU patient transfers can be accomplished through a family-centered transition care plan led by the ICU liaison nurse.

The influence of family's cohesion and adaptability in family satisfaction of parents with a child with autism spectrum disorder

The current study examined whether there was significant relationship among family functioning (cohesion and adaptability) and overall family satisfaction in parents with a child with autism spectrum disorder. It was predicted that poor family adaptive functioning, poor family cohesion along with other family-related variables (child diagnosis, parents' marital status, and other siblings in the family) would predict lower levels of family satisfaction. 73 mothers and 27 fathers of a child with ASD participated in this study. Google forms were used in this electronic web research. Data were collected using the Family Adaptability and Cohesion Evaluation Scale (FACES-III) and the Family satisfaction scale (FSS). This study's results demonstrate that family adaptability along with a child's autism spectrum disorder diagnosis may be significant predictors of family satisfaction. Findings report the significance of identifying discrepancies in family functioning as they provide an insight into how family members not only view but also how they interact with each other which in turn can inform clinical interventions and the therapeutic work.

Relation Between Social Support Received and Provided by Parents of Children, Adolescents and Young Adults With Cancer and Stress Levels and Life and Family Satisfaction

Introduction

The present study aims at analysing how social support received and provided by parents of children, adolescents and young adults (AYA) diagnosed with cancer, as well as their sociodemographic and clinical variables, affect those parents’ stress levels and life and family satisfaction.

Materials and Methods

A total of 112 parents of children and AYAs who had been diagnosed with cancer and who received treatment in Malaga participated in the study. In the study, participated all parents who voluntarily agreed to fulfil the questionnaire. The main inclusion criterion was that their child had cancer. Instruments used were Questionnaire on the Frequency of and Satisfaction with Social Support (QFSSS), Paediatric Inventory for Parents (PIP), Life Satisfaction Scale and Family Satisfaction Scale.

Results

In the mean difference analyses, male parents showed 3.38 (SD = 0.56) in social support received and female parents showed M = 3.08 (SD = 0.72). Conversely, in social support provided, female parents showed 3.22 and male parents showed M = 3.55 (p = 0.020). Significant differences were also found in family satisfaction, where female parents (M = 3.64) feel more satisfied than male parents (M = 3.06; p = 0.027). Parents of children aged between 0 and 14 years (M = 3.06) feel more stress than those parents of children aged 15–21 (M = 2.61; p = 0.021). The correlation analysis shows that there is a negative and significant relation between stress levels experienced by parents when facing different situations related to the child’s disease and both types of support, received r = −0.411, p < 0.001 and provided r = −0.282, p < 0.01. There is also a positive and significant relation between life satisfaction and social support received r = 0.292, p < 0.01, and social support provided r = 0.409, p < 0.001. There is a positive and significant relation between family satisfaction and social support received r = 0.330, p < 0.01, in the same way as with social support provided r = 0.222, p < 0.05. The regression analysis related to stress levels of parents indicates that social support received predicts levels of stress significantly p < 0.001, with the variable of number of children being the one that showed to be significant p < 0.05. Social support provided showed the most significant results p = 0.001, meaning that social support provided increased life satisfaction. Social support received explains family satisfaction (p = 0.50), as it increases the family satisfaction of parents of children with cancer.

Discussion

Analysing social support received and provided, as well as sociodemographic and clinical variables, allowed us to broaden the knowledge on the effect social support has on stress levels, life satisfaction and family satisfaction in parents of children and AYAs diagnosed with cancer. This may have relevant practical implications for the design of interventions that would improve parents’ lives.

The Importance of Family and School Protective Factors in Preventing the Risk Behaviors of Youth

The aim of this study was to examine cross-sectional associations of protective factors within a family and school context with adolescent risk behaviors. The study was conducted among adolescents (n = 9682) from five cities in Croatia. Mean age of participants was 16.2 years (SD = 1.2), and 52.5% were female. Multigroup structural equation modeling was used to examine relations between school attachment, school commitment, family communication, and family satisfaction with gambling, substance use, violence, and sexual risk behavior. Data analyses were conducted in two sets, the first using the full sample, and the second using a subsample (excluding Zagreb) for which there was data on sexual risk behavior. In the first model, school attachment was negatively associated with gambling and violence, while school commitment was negatively associated with students' gambling, substance use, and violence. Gambling was also associated with family satisfaction in this model. Results from the subsample model were similar with regards to school and family factors associated with gambling, substance use, and violence, with a few exceptions. In this model, family protective factors were found not to be significantly related with any risk behavior. These study results emphasize the importance of strengthening school protective factors, school attachment, and school commitment in preventing risk behaviors in adolescents.

Survey of Family Satisfaction with Patient Care and Decision Making in Neuro-Intensive Care Unit- A Prospective Single Center Cross Sectional Study from an Indian Institute of Neurosciences

BACKGROUND

Quality of health care is a major issue. Providing care that accommodates individual patient preferences and values is termed patient-centered care.

OBJECTIVES

In this study, we assessed family satisfaction (FS) with intensive care unit (ICU) care and family satisfaction with decision making in the care of critically ill neurological/neurosurgical patients.

MATERIALS AND METHODS

The FS-ICU questionnaire was used to assess family satisfaction. Data were analyzed using frequency tables and rates.

RESULTS

Of the 154 FS-ICU questionnaires analyzed, the overall satisfaction rate with care was 59.97, with information needs was 56.52, and with decision making was 59.46. Lower satisfaction rates among families may be due to the highly morbid nature of neurological illness in their kin or due to differences in socioeconomic factors.

CONCLUSIONS

Periodic audit of the FS questionnaire is useful in assessing the quality of health care in the neuro-ICU. Efforts to incorporate suggestions of study subjects may improve FS with patient care and decision making.

Involvement of Specialist Palliative Care in a Stroke Unit in Austria-Challenges for Families and Stroke Teams

Purpose: Severe stroke poses vast challenges. Appropriate goals of care according to individual preferences and values have to be developed under time restrictions—often impeded by limited ability to communicate and the need for decisions by surrogates. The aim of our study was to explore the decision-making process and the involvement of specialist palliative care in the acute phase of severe stroke.

Methods: Twenty patients suffering from severe ischemic stroke treated in an Austrian acute inpatient stroke unit were included in a prospective study. Their families were interviewed with a questionnaire (FS-ICU 24), which covered satisfaction with care and decision-making. With a second questionnaire, decision-making processes within the stroke team were investigated.

Results: A palliative approach and early integration of specialist palliative care in severe ischemic stroke results in individualized therapeutic goals, including withholding therapeutic or life-sustaining measures, especially in patients with pre-existing illness.

Conclusions: Family members benefit from understandable and consistent information, emotional support, and a professional team identifying their needs. Stroke unit professionals need skills as well as knowledge and strategies in order to make decisions and provide treatment at the end-of-life, when there may be ethical or legal issues. Close cooperation with specialist palliative care services supports both treatment teams and families with communication and decision-making for patients with severe ischemic stroke.

Associations between Family Satisfaction with End-of-Life Care and Chart-Derived, Process-Based Quality Indicators in Intensive Care Units

Background/Objective: Evidence linking process-based, high-quality end-of-life (EOL) care indicators to family satisfaction with EOL care in intensive care units (ICUs) remains limited. This study aimed to fill this gap. Design/Setting/Subjects/Measures/Statistical Analysis: For this exploratory, prospective, longitudinal observational study, 278 family members were consecutively recruited from medical ICUs at two medical centers in Taiwan. Family satisfaction with ICU care was surveyed in the first month after patient death using the Family Satisfaction in the ICU questionnaire (FS-ICU). Associations between FS-ICU scores and process-based quality indicators collected over the patient's ICU stay were examined using generalized estimating equations. Results: Documentation of process-based indicators of high-quality EOL care was generally associated with higher scores for both the FS-ICU Care and FS-ICU Decision-Making domains. Higher family satisfaction with ICU care was significantly associated with physician-family prognostic communication (β [95% confidence interval (CI)]: 3.558 [2.963 to 4.154]), a do-not-resuscitate (DNR) order in place at death (23.095 [17.410 to 28.779]), and death without cardiopulmonary resuscitation (CPR) (13.325 [11.685 to 14.965]). Family members' satisfaction with decision making was positively associated with documentation of social worker involvement (4.767 [0.663 to 8.872]), a DNR order issued (10.499 [0.223 to 20.776]), and withdrawal of life-sustaining treatments (LSTs) before death (2.252 [1.834 to 2.670]). Conclusions: EOL care processes are associated with family satisfaction with EOL care in ICUs. Bereaved family members' satisfaction with EOL care in ICUs may be improved by promoting physician-family prognostic communication and psychosocial support, facilitating a DNR order and death without CPR, and withdrawing LSTs for patients dying in ICUs.

The Relationships of Nursing Home Culture Change Practices With Resident Quality of Life and Family Satisfaction: Toward a More Nuanced Understanding

Transforming nursing homes (NHs) from restrictive institutions to person-centered homes, referred to as NH culture change, is complex and multifaceted. This study, based on a survey of administrators in Minnesota NHs (n = 102), tested the domain-specific relationships of culture change practices with resident quality of life (QOL) and family satisfaction, and examined the moderating effect of small-home or household models on these relationships. The findings revealed that culture change operationalized through physical environment transformation, staff empowerment, staff leadership, and end-of-life care was positively associated with at least one domain of resident QOL and family satisfaction, while staff empowerment had the most extensive effects. Implementing small-home and household models had a buffering effect on the positive relationships between staff empowerment and the outcomes. The findings provide meaningful implications for designing and implementing NH culture change practices that best benefit residents' QOL and improve family satisfaction.

Determinants of a Variety of Deviant Behaviors: An Analysis of Family Satisfaction, Personality Traits, and Their Relationship to Deviant Behaviors Among Filipino Adolescents

In previous decades, numerous involvements of adolescents in deviant behavior have been increasing, and previous researchers examined different variables that may influence these phenomena. This study was designed to look for the possible predictors of deviant behavior, as well as its association with family satisfaction and personality traits. The study was conducted on 1500 participants ages 12-19 years old from selected schools in Nueva Ecija. The researchers used the Deviant Behavior Variety Scale (DBVS) by Sanches et al. (2016). It consists of 19 items (minor and severe) of a variety of deviant action such as thefts, drug and alcohol consumption, verbal and physical aggression, possession of weapons, vandalism, truancy, lies and defiance of authority, and selling drugs among adolescents (Sanches et al., 2016). Out of 1500 samples, 1227 met the criteria for the deviant behavior scale. Descriptive and Inferential statistics such as Mean, sd, frequency, percentage, Regression analysis, Pearson-correlation, and Mann Whitney U test were used to analyze this study. The research found that there are differences in levels of deviant behavior (Minor and Severe infractions) among sexes. Results showed that female participants have higher tendency to engage in minor infractions of deviant acts, while males had a higher rate of participation in severe infractions of deviant acts. Moreover, there is a negative/inverse association between family satisfaction and deviant behavior. This implies that respondents who participate more in deviant behaviors are found to be less satisfied with their family life, while respondents who participate less in deviant behavior are more satisfied in their family life. Lastly, the current study found that personality trait-agreeableness is found to be the best predictor of deviant behavior among adolescents.

A Prospective Study of Family Satisfaction Changes After Tracheostomy Placement in Trauma Patients

BACKGROUND

Tracheostomy is a commonly performed procedure in surgical intensive care units. Although the indications and benefits of this procedure are well known, little has been studied in the adult surgical/trauma population about patient family satisfaction after tracheostomy placement.

MATERIALS AND METHODS

We performed a prospective study at our academic level I trauma center from 2015-2016 in patients who underwent elective tracheostomy. Family members were asked to complete an eight-point questionnaire using a forced Likert scale of graded responses. Questionnaires were administered prior to tracheostomy and again at 24-and 72-hour post-tracheostomy placement. Responses were compared using univariate analysis.

RESULTS

A total of 26 family members completed all 3 surveys. Family members believed loved ones appeared more comfortable, were more interactive, and were better progressing clinically. After 72 hours, family members felt less anxiety. There was no difference in perceptions of patient distress, ability to provide support, or their worry about scars, or comfort in visiting them.

DISCUSSION

Family members believed tracheostomies provided greater patient comfort, increased interactive abilities, better progress in their care, and experienced less anxiety after placement. Family satisfaction may therefore be an additional benefit in support of earlier tracheostomy.

Family Satisfaction: Differences Between Nursing Homes and Residential Care Facilities

This study compared differences in overall family satisfaction, specific satisfaction domains, and correlates of satisfaction between nursing homes (NHs) and residential care facilities (RCFs), using data from the 2016 Ohio Long-Term Care Family Satisfaction Survey. Satisfaction was higher for RCFs overall and within nearly every domain, with the largest difference observed in the environment domain. In both facility types, higher satisfaction was associated with male respondents, older respondent age, White race, less-frequent visitation, longer anticipated length of stay, less help provided during visits, smaller facilities, lower Medicaid-reliant resident percentage, and nonprofit status. Resident age, visitation frequency, perceived assistance required, and kinship tie were differentially related to satisfaction between facility types. NH administrators should focus on the environment and the moving in process. All administrators should address how residents spend time and should be aware that residents' and their family members' characteristics may affect satisfaction levels.

Role of Work and Family Factors in Predicting Career Satisfaction and Life Success

The mediating roles of work-family balance, job satisfaction and family satisfaction in work-family dynamics research has not been explored fully to delineate their probable intervening effects. Using spillover theory as the basis, the current study tests a model to identify the role of these factors in work-family conflict (and work-role ambiguity), career satisfaction and perception of life success. Responses obtained through an online survey from a final sample of 344 academic faculty, across different educational institutions in India, tend to suggest that work-family balance mediated work-family conflict and its potential influence on life success as well as career satisfaction, and also the relationship between work-role ambiguity and both life success and career satisfaction. While job satisfaction also showed similar results except for non-significant mediation between work-role ambiguity and life success, family satisfaction mediated only between work role ambiguity and life success. The importance of job satisfaction and work-family balance is highlighted in the context of reducing the negative impact of work-family conflict and work-role ambiguity on one’s career and life satisfaction. Results and their practical and theoretical implications, and future directions of research to further our understanding of work-family dynamics, etc., are discussed.

Family Satisfaction With Nursing Home Care: Findings and Implications From Two State Comparison

Family satisfaction, while recognized as important, is frequently missing from validated measures of long-term care quality. This is the first study to compare family satisfaction across two states using validated measures and to compare the organizational and structural factors associated with higher family satisfaction with nursing home care. Data sources are family satisfaction surveys from Minnesota (MN) and Ohio (OH), linked to facility characteristics from Certification and Survey Provider Enhanced Reports (CASPER) for both states (N = 378 facilities for MN; N = 926 facilities for OH). Activities and food were among lowest rated items in both states. Relationships with staff were the highest rated domain. Higher occupancy rates, smaller facility size, and non-profit ownership consistently predicted better satisfaction in both states. Our findings show consistent organizational factors associated with family satisfaction and provide further evidence to the validity of family satisfaction as a person-centered measure of quality. This lays the foundation for tool development on the national level.

An Empirical Typology of Nursing Home Culture Change Implementation

Culture change in nursing homes (NHs) is a broad-based effort to transform NHs from impersonal institutions to genuine person-centered homes. Culture change practices have been implemented increasingly with varying levels of success. This study (a) generated an empirical typology of culture change implementation across Minnesota NHs using latent profile analysis based on the survey data from administrators in 102 NHs and (b) examined variations in NH characteristics and quality outcomes associated with the typology. Three types of culture change implementation were identified: high performers, average performers, and low performers. The distributions of culture change scores were distinct across the three types, with low performers lagging far behind others in family and community engagement, and end-of-life care. High performers were distinguished through demonstrating better resident quality of life and higher family satisfaction. The findings provide empirical support for policymakers, providers, and advocates to direct culture change expansion and resource allocation.

Family functioning and satisfaction: A comparative study between hookah users and non-users

BACKGROUND

Although there has been an exponential growth in hookah use on a global scale, research within the context of South Africa is very limited. While hookah use is known internationally to be a health and addiction risk, the focus is on university students and not on families.

AIM

This study aims to compare the family functioning and family satisfaction among hookah users and non-users.

SETTING

This study was conducted in low or middle-high class socio-economic status areas of Cape Town, South Africa.

METHODS

A quantitative method was employed to test for significant differences with a sample of 1193 participants, in which each participant represented a family. An independent t-test was used to test for significant differences between hookah users and non-users.

RESULTS

One-third (34%) of the participants indicated that they smoked hookah pipe, with the general age of onset being 16.5 years. In trying to understand the family context, it was found that 28% of hookah users indicated that the hookah pipe was used as a means of socialising with others in the family, and 24% of parents indicated that they were more accepting of family members smoking the hookah pipe. Findings also suggest that families of hookah users have less cohesion, expressiveness and family satisfaction, and more conflict and permissiveness than families of non-users.

CONCLUSION

This study provides and extends knowledge regarding the family in hookah pipe use. This information could assist in reducing hookah pipe use, and building healthier and more resilient communities by formulating prevention and intervention strategies to reduce hookah use.

The Work-Family Spillover Effects of Customer Mistreatment for Service Employees: The Moderating Roles of Psychological Detachment and Leader-Member Exchange

Past literature in the area of employee-customer interactions suggests that being mistreated by customers is deemed one of the most important work-related stressors for service employees. However, little is known about the effects of customer mistreatment on the family domain. In a representative sample of 221 front-line employees in the East China hairdressing industry using three separate surveys administered 1 month apart respectively, the current study explores the mediation effects of work-to-family conflict (WFC) and the moderation effects of psychological detachment (PD) and leader-member exchange (LMX) on the relationship between customer mistreatment and family satisfaction (FS). The research revealed that the employees confronted with intensive customer mistreatment tended to experience high levels of WFC, and WFC mediated the effects of customer mistreatment on FS. In addition, both PD and LMX attenuated customer mistreatment's direct effects on WFC and indirect effects on FS (via WFC). This study contributes to the managerial psychology literature related to the customer mistreatment construct and a better understanding of how PD and LMX act as a work-family spillover effect moderator of customer mistreatment on individuals.

Psychometric testing of the Norwegian version of the questionnaire Family Satisfaction in the Intensive Care Unit (FS-ICU-24)

INTRODUCTION

The questionnaire, Family Satisfaction in the Intensive Care Unit (FS-ICU-24), was developed to assess relatives' satisfaction with care and involvement in decision-making processes when a close family member stays in the ICU.

AIM

This study was aimed at describing the translation and exploring the psychometric properties of the Norwegian version of the questionnaire.

METHODS

The study design was a cross-sectional survey. After translating the questionnaire according to recommended procedures, 123 close relatives of patients, recently treated in ICU, responded to a mailed questionnaire including the FS-ICU-24-No. Item-to-total correlations and Cronbach's alpha coefficient were assessed for estimating reliability and construct validity was assessed by the "known groups" technique and explorative factor analysis.

RESULTS

The Cronbach's alpha coefficient of 0.96 and significant item-to-total correlations supported the homogeneity of the instrument. The construct validity was reflected in significant differences in median scores on the total scale and subscales between the group reporting lower degrees of satisfaction and the group reporting higher degrees of satisfaction. Two fixed factors with an eigenvalue >1, and an explained variance of 62.5%, emerged from the factor analysis.

CONCLUSION

The FS-ICU-24-No showed promising psychometric properties regarding reliability in this study group, which may indicate that the instrument is suitable for assessing family members' satisfaction with care and decision making in Norwegian ICU.

Measuring Outcomes of an Intensive Care Unit Family Diary Program

Patients discharged from intensive care units are at risk of short- and long-term physical, cognitive, and emotional symptoms known as post-intensive care syndrome. Family members of intensive care unit patients are at risk of similar symptoms known as post-intensive care syndrome-family. Both syndromes are common, and strategies to reduce risk factors should be employed. An intensive care unit diary project to help reduce these syndromes was implemented in 2 intensive care units using an evidence-based framework. The effects of these diaries were studied using the Family Satisfaction with Care in the Intensive Care Unit survey. Rates of referrals to a postintensive care unit recovery clinic were also observed in relation to the diaries. Although preliminary data did not reveal a significant increase in family satisfaction, the surveys provided important staff feedback. The diaries fostered feelings of compassion and caring as well as built trust between staff and family members of intensive care unit patients. The diaries increased referrals to the postintensive care unit recovery clinic.

Medical Record Quality Assessments of Palliative Care for Intensive Care Unit Patients. Do They Match the Perspectives of Nurses and Families?

RATIONALE

To understand how well palliative care is provided in the intensive care unit (ICU) and to direct improvements, measurement of the quality of care delivered is requisite.

OBJECTIVES

To measure the quality of palliative care delivered in the ICU, using chart review-derived process quality measures of palliative care in critically ill patients, and to compare these measures with family and nursing perspectives on the quality of care provided.

METHODS

We developed and operationalized a comprehensive quality evaluation measure set from previously endorsed palliative care measure statements, using a rigorous multidisciplinary Delphi process focused on optimizing the validity and feasibility of chart review-derived metrics. Fourteen process measures assessed the quality of care delivered across established domains of palliative care for the ICU. We assessed the quality of care for ICU patients with ICU length of stay exceeding 2 days from three perspectives: medical record reviews, family satisfaction reports, and nurse ratings from those providing care in the ICU.

MEASUREMENTS AND MAIN RESULTS

We evaluated the care over a 7-month period of 150 patients (mean age, 63.9 yr [SD 13.4], average ICU length of stay, 7.5 d [SD 7.2]). Overall, ICU patients received 53.1% of recommended palliative care. The Family Satisfaction with Care in the Intensive Care Unit total scores from 136 family members (response rate, 91%) were high, 85.7 (SE 2.0) and 86.0 (SE 1.6), at the two sites but not correlated to measured quality delivered. Nurses rated the quality of care higher than medical record review (mean, 77.3% [SD 13.4]; n = 135) and similarly correlation with chart based process measures was poor.

CONCLUSIONS

Delivering high-quality palliative care in the ICU requires assessing key patient-centered domains. However, assessments from different perspectives do not always agree with technical quality of care as measured through chart-based metrics. We found deficits across seven domains of technical quality that were not correlated with either nurse or family ratings. Despite care gaps, families were generally satisfied with the care delivered. We conclude that each measurement perspective provides an independent view that can guide quality improvement and innovation work as well as subsequent research.

Family members' satisfaction with care and decision-making in intensive care units and post-stay follow-up needs-a cross-sectional survey study

Aim

The aim of this study was to explore family members' satisfaction with care and decision‐making during the intensive care units stay and their follow‐up needs after the patient's discharge or death.

Design

A cross‐sectional survey study was conducted.

Methods

Family members of patients recently treated in an ICU were participating. The questionnaire contented of background variables, the instrument Family Satisfaction in ICU (FS‐ICU 24) and questions about follow‐up needs. Descriptive and non‐parametric statistics and a multiple linear regression were used in the analysis.

Results

A total of 123 (47%) relatives returned the questionnaire. Satisfaction with care was higher scored than satisfaction with decision‐making. Follow‐ up needs after the ICU stay was reported by 19 (17%) of the participants. Gender and length of the ICU stay were shown as factors identified to predict follow‐up needs.

Family satisfaction with patient care in critical care units in Pakistan: a descriptive cross-sectional study

AIM

To assess family satisfaction with care provided to patients in critical care units in Islamabad.

METHOD

A descriptive cross-sectional study was conducted in 11 medical and surgical critical care units at two private hospitals in Islamabad, Pakistan. The purposive sample consisted of 323 immediate family members and other relatives and friends (referred to as family members in this article) of 323 patients admitted to the critical care units for at least 24 hours. The revised Critical Care Family Satisfaction Survey was used for data collection. Descriptive statistics were used for data analysis.

FINDINGS

A total of 149/323 (46%) family members were 'very satisfied' with the honesty (openness) of staff in explaining the patient's condition, and 137/323 (42%) family members were 'very satisfied' with the nurses' availability to speak to them. A total of 143/323 (44%) family members were 'satisfied' with the honesty (openness) of staff in explaining the patient's condition, and 131/323 (41%) were 'satisfied' with the nurses' availability to speak to them. A few family members (21/323, 6%) were 'very dissatisfied' with the flexibility of the visiting hours and a few (20/323, 6%) were 'very dissatisfied' with the noise level in the critical care units. Some family members (38/323, 12%) were 'not satisfied' with the flexibility of the visiting hours, and some (18/323, 6%) were 'not satisfied' with the noise level in the critical care units.

CONCLUSION

The majority of family members (244/323, 75%) were 'satisfied' or 'very satisfied' that their relatives' needs were being met in the critical care units. However, qualitative data indicate that most family members wanted greater involvement in decision making. These findings should be considered by staff working in critical care settings to ensure high-quality patient care.

A model of work-family conflict and well-being among Malaysian working women

BACKGROUND

Work and family are the two most important domains in a person's life. Lack of balance between work and family can lead to adverse consequences such as psychological distress; however, the effect of work-family conflict on psychological distress might be mediated by job and family dissatisfaction.

OBJECTIVES

This study examines a model of the four dimensions of work-family conflict and their consequences on psychological distress. In particular, we test whether job and family satisfaction mediate the effect of the four dimensions of work-family conflict on psychological distress.

METHODS

This cross-sectional study was conducted among 567 Malaysian women who are working in the public services.

RESULTS

Structural Equation Modeling confirmed the mediating role of family satisfaction in the effect of strain-based work interference into family and time-based family interference into work on psychological distress. In addition, our results revealed a significant path that links job to family satisfaction. Moreover, time-based work interference into family and strain-based family interference into work significantly and negatively affect job satisfaction, which in turn influence family satisfaction and eventually affect psychological distress.

CONCLUSION

The results of our study show that organizations need to develop and adapt family friendly policies to mitigate level of employees' work-family conflict.

Conflicts in the intensive care unit

Conflicts in intensive care units (ICUs) are common and concern all professional groups, patients and their families. Both intra- and inter-team conflicts occur. The most common conflicts occur between nurses and physicians, followed by those within nursing teams and between ICU personnel and family members. The main causes of conflicts are considered to be unsatisfactory quality of the information provided, inappropriate ways of communication and improper approach towards treatment of patients. ICU conflicts can have serious consequences not only for families but also for patients, physicians, nurses and wider society. Lack of communication among ICU teams is likely to impair cooperation and ICU team-family contacts. From the point of view of patients and their families, communication skills, as one of the factors affecting the satisfaction of families with treatment, are essential to ensure high quality of ICU treatment. While conflicts are generally unfavourable, they can also have positive implications for the parties involved, depending on their prevalence and management, as well as the community they concern.

Subjective Psychological Well-Being in Families with Blind Children: How Can We Improve It?

The aim of this work was to examine family well-being in a sample of Spanish families with blind children. Sixty-one participants reported their perceived economic status, the level of job satisfaction, and state-anxiety symptoms. The participants of our study scored higher on state-anxiety and lower on material well-being than the normative sample, although these differences did not reach statistical significance. They also scored higher on job satisfaction and family satisfaction than the general population. A negative correlation was found between state-anxiety and material well-being (r = - 0.62, p = 0.001) and between state-anxiety and family satisfaction (r = - 0.57, p = 0.001). A positive correlation was found between material well-being and job satisfaction (r = 0.40, p = 0.001), and between material well-being and family satisfaction (r = 0.41, p = 0.001). Higher levels of material well-being, job satisfaction, and family satisfaction were associated with lower levels of anxiety in these families. However, no statistically significant correlation was found between family satisfaction and job satisfaction. Our results suggest that the family experience of having a disabled child is evolving, and this implies achieving greater job and family satisfaction than the normative samples, although anxiety scores continue to be higher and material well-being scores remain lower. On the whole, our results confirm that it is necessary to provide these families with more economic resources, which would have a positive impact on their subjective psychological well-being, decreasing their state-anxiety, and increasing their satisfaction with life.

A Three-wave Study of Antecedents of Work-Family Enrichment: The Roles of Social Resources and Affect

On the basis of conservation of resources theory (Hobfoll, ) and the resource-gain-development perspective (Wayne, Grzywacz, Carlson, & Kacmar, ), this paper examines the differential impact of specific social resources (supervisory support and family support) on specific types of affect (job satisfaction and family satisfaction, respectively), which, in turn, influence work-to-family enrichment and family-to-work enrichment, respectively. A sample of 276 Chinese workers completed questionnaires in a three-wave survey. The model was tested with structural equation modelling. Job satisfaction at time 2 partially mediated the relationship between time 1 supervisory support and time 3 work-to-family enrichment (capital), and the effect of supervisory support on work-to-family enrichment (affect) was fully mediated by job satisfaction. Family satisfaction at time 2 fully mediated the relationship between time 1 family support and time 3 family-to-work enrichment (affect, efficiency). Implications for theory, practice and future research are discussed.

The satisfaction of families in the care of their loved ones in CCUs in Lebanon

BACKGROUND

The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care.

AIMS

To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction.

METHODS

A cross-sectional descriptive design was conducted using the Critical Care Family Satisfaction Survey (CCFSS). The participants were 123 adult relatives or significant others of patients cared for in both adult and paediatric intensive care units for at least 3 days.

RESULTS

The CCFSS showed acceptable internal reliability and construct validity in a Lebanese population. In general, families were satisfied with the care their loved ones received in the CCUs, and the least satisfaction was in the area of 'comfort' and the highest was in 'assurance'. Younger family members with more education were less satisfied with care and Christian families expressed less satisfaction with informational needs compared with Muslim families. Families of children in the paediatric CCU expressed least satisfaction with care. Gender, residency, relationship to patient, unit, prior experience in a CCU and diagnosis had no effect on satisfaction scores.

CONCLUSIONS

Assessment of family satisfaction in different cultures is important as each culture has specific needs that are essential to decipher.

IMPLICATIONS FOR PRACTICE

Patient satisfaction leads to improved quality of care; thus, it behoves nurses to meet the needs of families from different cultures to help them cope and increase their satisfaction, which leads to improve patient outcomes.

How adolescents with anorexia nervosa and their parents perceive family functioning?

This study aims at examining whether adolescent girls diagnosed with anorexia nervosa and their parents differ in perceiving the different aspects of family functioning. Moreover, the discrepancy between adolescent girls and healthy controls on Family Adaptability and Cohesion Evaluation Scales dimensions, family communication, and family satisfaction is investigated. The study includes 36 female anorexia patients and their parents and 36 healthy controls. The results showed a different view between mothers and their daughters with regard to the dimension of rigidity. In addition, girls with anorexia nervosa were less satisfied about family environment and rated their families as less communicative, flexible, cohesive, and more disengaged, compared to controls.

Music Therapy is Associated With Family Perception of More Spiritual Support and Decreased Breathing Problems in Cancer Patients Receiving Hospice Care

CONTEXT

Music therapy is a common discretionary service offered within hospice; however, there are critical gaps in understanding the effects of music therapy on hospice quality indicators, such as family satisfaction with care.

OBJECTIVES

The purpose of this study was to examine whether music therapy affected family perception of patients' symptoms and family satisfaction with hospice care.

METHODS

This was a retrospective, cross-sectional analysis of electronic medical records from 10,534 cancer patients cared for between 2006 and 2010 by a large national hospice. Logistic regression was used to estimate the effect of music therapy using propensity scores to adjust for non-random assignment.

RESULTS

Overall, those receiving music therapy had higher odds of being female, having longer lengths of stay, and receiving more services other than music therapy, and lower odds of being married/partnered or receiving home care. Family satisfaction data were available for 1495 (14%) and were more likely available if the patient received music therapy (16% vs. 12%, P < 0.01). There were no differences in patient pain, anxiety, or overall satisfaction with care between those receiving music therapy vs. those not. Patients who received music therapy were more likely to report discussions about spirituality (odds ratio [OR] = 1.59, P = 0.01), had marginally less trouble breathing (OR = 0.77, P = 0.06), and were marginally more likely to receive the right amount of spiritual support (OR = 1.59, P = 0.06).

CONCLUSION

Music therapy was associated with perceptions of meaningful spiritual support and less trouble breathing. The results provide preliminary data for a prospective trial to optimize music therapy interventions for integration into clinical practice.

Validity and reliability of Turkish version of family satisfaction in the intensive care unit

To evaluate the quality of care that is provided in intensive care units, needs and satisfaction of the patient relatives must also be considered. The aim of the study is to test the Turkish version of the Family Satisfaction in the Intensive Care Unit (FS-ICU-24) Survey, which was developed by Heyland et al. This study was planned and applied as a methodological study. Survey was conducted in the intensive care units of a military education and research hospital and a medical faculty hospital, department of anaesthesia and reanimation in the capital city Ankara of Turkey. Sample of the survey was composed of 120 participants. Cronbach's alpha value for the FS-ICU-24 general internal consistency in this study was calculated as 0.95 for total scale. In this study, the Turkish version of the FS-ICU-24 was found to be reliable and valid with Turkish population.

Effectiveness of nursing interventions based on family needs on family satisfaction in the neurosurgery intensive care unit

BACKGROUND

Since the family is a social system, the impairment in each of its component members may disrupt the entire family system. One of the stress sources for families is accidents leading to hospitalization particularly in the intensive care unit (ICU). In many cases, the families' needs in patient care are not met that cause dissatisfaction. Since the nurses spend a lot of time with patients and their families, they are in a good position to assess their needs and perform appropriate interventions. Therefore, this study was conducted to determine the effectiveness of nursing interventions based on family needs on family satisfaction level of hospitalized patients in the neurosurgery ICU.

MATERIALS AND METHODS

This clinical trial was conducted in the neurosurgery ICU of Al-Zahra Hospital, Isfahan, Iran in 2010. Sixty four families were selected by simple sampling method and were randomly placed in two groups (test and control) using envelopes. In the test group, some interventions were performed to meet their needs. In the control group, the routine actions were only carried out. The satisfaction questionnaire was completed by both groups two days after admission and again on the fourth day.

FINDINGS

Both of the intervention and control groups were compared in terms of the mean satisfaction scores before and after intervention. There was no significant difference in mean satisfaction scores between test and control groups before the intervention. The mean satisfaction score significantly increased after the intervention compared to the control group.

CONCLUSIONS

Nursing interventions based on family needs of hospitalized patients in the ICU increase their satisfaction. Attention to family nursing should be planned especially in the ICUs.

Using the medical record to evaluate the quality of end-of-life care in the intensive care unit

RATIONALE

We investigated whether proposed "quality markers" within the medical record are associated with family assessment of the quality of dying and death in the intensive care unit (ICU).

OBJECTIVE

To identify chart-based markers that could be used as measures for improving the quality of end-of-life care.

DESIGN

A multicenter study conducting standardized chart abstraction and surveying families of patients who died in the ICU or within 24 hrs of being transferred from an ICU.

SETTING

ICUs at ten hospitals in the northwest United States.

PATIENTS

Overall, 356 patients who died in the ICU or within 24 hrs of transfer from an ICU.

MEASUREMENTS

The 22-item family assessed Quality of Dying and Death (QODD-22) questionnaire and a single item rating of the overall quality of dying and death (QODD-1).

ANALYSIS

The associations of chart-based quality markers with QODD scores were tested using Mann-Whitney U tests, Kruskal-Wallis tests, or Spearman's rank-correlation coefficients as appropriate.

RESULTS

Higher QODD-22 scores were associated with documentation of a living will (p = .03), absence of cardiopulmonary resuscitation performed in the last hour of life (p = .01), withdrawal of tube feeding (p = .04), family presence at time of death (p = .02), and discussion of the patient's wish to withdraw life support during a family conference (p < .001). Additional correlates with a higher QODD-1 score included use of standardized comfort care orders and occurrence of a family conference (p < or = .05).

CONCLUSIONS

We identified chart-based variables associated with higher QODD scores. These QODD scores could serve as targets for measuring and improving the quality of end-of-life care in the ICU.