Aim/s: To explore next of kin satisfaction with cancer care, map next of kin suggestions for involvement and combine this information to create a basis for improving quality and safety in hospitals.
Design: Convergent parallel mixed-methods design applying the 20-item FAMCARE Scale survey instrument for quantitative measurement of satisfaction with care and with an open-ended question used for qualitative analysis.
Data sources: Responses from 238 next of kin (November 2016-November 2017).
Methods: Exploratory factor analysis, regression analysis and qualitative content analysis were combined.
Results: Both hospitals scored better in medical treatment (median, interquartile range: 1.5, 1.1-2.0), than in satisfaction with information and involvement of next of kin (1.9, 1.3-2.4), p < .001 (Wilcoxon signed ranks test). After adjusting for differences in demographical and clinical variables, the total FAMCARE scores were 13% higher (95% confidence interval: 1%-27%, Wald p = .029) at one of the hospitals. Qualitative findings support that the hospitals are not providing an equal offer to next of kin involvement in hospital cancer care that includes a proactive approach.
Conclusion: As a basis for quality and safety improvement, next of kin satisfaction and involvement in cancer care should be addressed in a two-sided perspective, balancing the next of kin's need for involvement in cancer treatment with the patient's perspective.
Impact: There is limited knowledge of next of kin satisfaction with hospital cancer care and how next of kin would like to be involved in this trajectory. Several aspects of satisfaction with cancer care can prompt change to improve service quality and safety (e.g. information, involvement, practical care), but this is an underused source of information. Next of kin are key in cancer care and our study demonstrates a potential large impact on future practical ways of improving cancer care service provision in an integrative perspective including next of kin.
目的: 探讨直系亲属对癌症护理的满意度,绘制直系亲属参与建议图,并结合此类信息,为提高医院护理质量和安全性奠定基础。 设计: 采用集合并行混合法设计,使用20个条目FAMCARE量表对护理满意度进行定量测量,并采用开放式问题进行定性分析。 数据来源: 238名直系亲属(2016年11月至2017年11月)的回复。 方法: 探索性因素分析、回归分析与定性内容分析相结合。 结果: 两所医院在医疗方面的得分(中位数,四分位数范围:1.5,1.1-2.0)均高于直系亲属对信息和参与度的满意度得分(1.9,1.3-2.4),p< .001(威尔科克森符号秩检验)。在调整了人口统计学和临床变量的差异后,其中一家医院的FAMCARE总分高出13%(95%可信区间:1%-27%,Wald p= .029)。定性研究结果表明,医院并未向直系亲属提供参与医院癌症护理的同等待遇,包括采取积极主动的方法。 结论: 作为提高护理质量和安全性的基础,直系亲属对癌症护理的满意度和参与度应从两个方面着手解决,平衡直系亲属参与癌症治疗的需要以及患者观点之间的关系。 影响: 对于直系亲属对医院癌症护理的满意度以及直系亲属希望如何参与这一轨迹的了解尚且有限。但对于癌症护理满意度,有几个方面可促使改变,以提高服务质量和安全性(如信息、参与度、实际护理),但这方面的信息来源目前尚未得以充分利用。直系亲属在癌症护理中发挥关键作用,而我们的研究也表明,从包括直系亲属在内的综合角度出发,其可能会对未来改善癌症护理服务提供的实践方法产生重大影响。.
Keywords: FAMCARE; cancer nursing; hospitals; mixed method; next of kin; patient safety; quality; survey.
© 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.