Measuring intensive care nurses' perspectives on family-centered end-of-life care: evaluation of 3 questionnaires.

Full Abstract

BACKGROUND:
Attempts to improve end-of-life care increasingly focus on family-centered care, but few validated assessment tools exist.

OBJECTIVES:
To evaluate 3 new short questionnaires measuring nurses' perspectives on family-centered end-of-life care in the intensive care unit and to show the usefulness of the questionnaires.

METHODS:
Principal components analysis of data from 141 critical care nurses evaluating care given to families of 218 patients was used to develop domain scores for number of nursing activities with each family, number of barriers experienced, and nurses' satisfaction that the family's needs were met. Random effects models were used to test associations between critical care processes and outcome.

RESULTS:
Nursing activities fell into 2 domains:
general and culture-related communication/support. Barriers consisted of 2 domains:
patient/family barriers and system/team barriers. Meeting the needs of patients' families represented a single dimension. In a path model based on domain scores, general activities had significant associations with both nurse communication and meeting families' needs; patient/family barriers, with nurse communication; and nurse and physician communication, with meeting families' needs. In a path model based on total activities and barriers scores, total activities and total barriers had significant associations with nurse communication ratings and meeting families' needs. Patients' and nurses' characteristics were not significant independent predictors of meeting the needs of patients' families.

CONCLUSIONS:
The 3 questionnaires provide a consistent, valid picture of nurses' perspectives on family-centered critical care and may be useful in evaluating family care processes and outcomes and in targeting areas for improvement.

Learn Faster Today Improve your study skills

Author information

Author/s: Downey, Lois (L); Engelberg, Ruth A (RA); Shannon, Sarah E (SE); Curtis, J Randall (JR);

Affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle WA 98195, USA. ldowney(-atsign-)u.washington.edu

Grants: R01NR005226 (Agency:NINR NIH HHS)

Journal and publication information

Publication Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: American journal of critical care : an official publication, American Association of Critical-Care Nurses (Am J Crit Care), published in United States. (Language: eng)

Reference: 2006-Nov; vol 15 (issue 6) : pp 568-79

Dates: Created 2006/10/20; Completed 2007/01/30; Revised 2007/12/03;

PMID: 17053264, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Male
Outcome and Process Assessment (Health Care) - methods
Questionnaires
Reproducibility of Results
Task Performance and Analysis
Terminal Care
Washington

These are the highest related articles currently in the database:

Development of the Family Nurse Caring Belief Scale (FNCBS). 30 Oct 2007
Evaluating and improving the practice of family-centered care. 29 Jun 1999
Hospital care of children in four countries. 28 Feb 2004
Development of the Family Nursing Practice Scale. 30 Oct 2006
John's story: an application of the Calgary Family Intervention Model. 30 Dec 1999
Vigilant watching over: mothers' actions to safeguard their premature babies in the newborn intensive care nursery. 29 Nov 2001
Predictors of recognition and practice of family nursing among healthcare professionals in Japan. 30 Jul 2007
School nurses' perceptions of family-centered services: commitment and challenges. 29 Nov 2007
Families' Importance in Nursing Care: Nurses' Attitudes--an instrument development. 30 Jan 2008
[Family nursing versus pediatric nursing] 30 Oct 2000

See 100+ related articles.