Family satisfaction with palliative care: A test of four alternative theories.
Family satisfaction with palliative care: A test of four alternative theories.
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家庭对姑息治疗的满意度：对四种替代理论的检验。
DOI：
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发表时间：
1991
期刊：
影响因子：
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通讯作者：
L. Kristjanson
中科院分区：
文献类型：
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作者：
L. Kristjanson
据报道，在家庭成员中处理晚期癌症的经历是有压力的。家庭成员所经历的压力的一个来源可能是对病人和他们自己所接受的护理的不满。保健专业人员要提供促进家庭满意度的护理，就必须衡量这一现象并了解促成满意度的因素。对文献的研究揭示了四种相互竞争的满意度解释理论，其中没有一种有坚实的实证支持。此外，这些理论还没有在家庭或那些正在接受癌症治疗的人身上得到验证。因此，本研究的目的是利用理论和实证模型来检验这些替代理论，并期望找到一个有用的模型来指导临终关怀情况下家庭的临床实践。被检验的理论有：(1)Vroom的满足理论，(2)Porter的差异理论，(3)Thibaut和Kelley的社会比较理论，(4)Ajzen和Fishbein的期望价值理论。采用因果建模方法的相关设计。从三个不同的姑息治疗机构获得了109名晚期癌症患者的家庭成员。使用五种工具收集数据：(1)FAMCARE量表，(2)F-Care需求量表，(3)F-Care期望量表，(4)F-Care感知量表，(5)简短的人口调查问卷。数据分析10包括使用描述性统计来根据人口变量总结样本，对工具进行可靠性和有效性测试，以及使用多元回归技术和残差分析进行理论和经验模型测试。在测试的四种理论中，差异理论是最可信的，占家庭护理满意度解释差异的68%。实证模型的结果是家庭护理满意度模型，它解释了78%的护理满意度差异。本文提出了理论建构和临床实践的启示，并提出了进一步研究的建议。家庭也许是健康和疾病发生的最重要的社会环境。随着越来越多的家庭需要在家中照顾受抚养或患病的成员，了解家庭对护理的需求、期望和满意度将变得越来越重要。第1章问题陈述11临终病人及其家属的护理被描述为一种独特的护理类型，需要卫生专业人员的特殊技能和知识（Kastenbaum, 1979; Parkes, 1985）。临终关怀计划已成为这些病人的另一种护理方式，部分原因是对临终病人及其家属的传统护理的不满（Edwardson, 1985; Paradis, 1984），以及对晚期癌症患者在疾病的最后阶段需要特殊护理的数量的回应。临终关怀将病人/家庭视为护理单位（Smith, 1984），据报道，临终关怀专业人员会评估家庭成员，以确保他们的社会心理需求得到满足（Hays & Arnold, 1986）。作为护理的参与者、接受者和观察者，家庭成员还要评估病人和他们自己所接受的护理。对于卫生专业人员提供的护理，促进家庭对姑息性癌症治疗的满意度，至关重要的是能够衡量这种现象，并确定有助于满意度的因素。对与满意度相关的理论文献的研究揭示了四个相互竞争的满意度解释理论，其中没有一个有坚实的实证支持。此外，这些理论还没有在家庭或特别是那些正在接受姑息性癌症治疗的人身上得到检验。因此，本研究的目的是通过理论和实证模型来检验这些替代理论，并期望找到一个有用的模型来指导姑息性癌症护理情况下的家庭护理实践。本章概述了研究的问题，研究的目的，以及研究对了解姑息性癌症护理的家庭满意度的护理和其他健康专业人员的意义。
The experience of dealing with end-stage cancer in a family member has been reported to be stressful. One source of stress experienced by family members may be dissatisfaction with care received by the patient and themselves. For health professionals to provide care that promotes family satisfaction, it is essential to measure this phenomenon and understand the elements that contribute to satisfaction. 9 An examination of the literature revealed four competing explanatory theories of satisfaction, none of which has solid empirical support. Moreover, these theories had not been tested with families or those experiencing cancer care in particular. Therefore, the aim of this research was to test these alternative theories using theoretical and empirical modeling with the expectation that a useful model would be identified to guide clinical practice of families in terminal care situations. The theories tested were: (1) Vroom's Fulfillment Theory, (2) Porter's Discrepancy Theory, (3) Thibaut and Kelley's Social Comparison Theory, and (4) Ajzen and Fishbein's Expectancy Value Theory. A correlational design with a causal modeling methodology was used. One hundred and nine family members of patients with advanced cancer were obtained from three different palliative care services. Five instruments were used to collect data: (1) FAMCARE Scale, (2) F-Care Needs Scale, (3) F-Care Expectations Scale, (4) FCare Perceptions Scale, and (5) a short demographic questionnaire. Data analysis 10 included use of descriptive statistics to summarize the sample in terms of demographic variables, reliability and validity testing of the instruments, and theoretical and empirical model testing using multiple regression techniques and residual analysis. Of the four theories tested, Discrepancy theory was the most credible, accounting for 68 percent of explained variance in family care satisfaction. Empirical modeling resulted in identification of the Family Care Satisfaction Model, which explained 78 percent of the variance in care satisfaction. Implications for theory construction and clinical practice are presented and recommendations for further research offered. The family constitutes perhaps the most important social context within which health and illness occur. As more families are required to care for dependent or ill members at home, understanding the needs, expectations, and satisfactions with care experienced by families will become increasingly important. Introduction CHAPTER I STATEMENT OF THE PROBLEM 11 Care of dying patients and their families has been described as a unique type of care requiring special skills and knowledge of health professionals (Kastenbaum, 1979; Parkes, 1985). Hospice programs have emerged as an alternative type of care for these patients, in part, because of dissatisfaction with traditional care for dying patients and their families (Edwardson, 1985; Paradis, 1984) and in response to the number of patients with end-stage cancer requiring special care during the tenninal phase of the illness. Hospice considers the patient/family as the unit of care (Smith, 1984) and hospice professionals are reported as evaluating family members to ensure that their psychosocial needs are met (Hays & Arnold, 1986). As participants, recipients and observers of care, family members also evaluate the care received by the patient and themselves. For health professionals to provide care that promotes family satisfaction with palliative cancer care, it is essential to be able to measure this phenomenon and detennine the elements that contribute to satisfaction. An examination of the theoretical literature related to satisfaction revealed four competing explanatory theories of satisfaction, none of which has solid empirical support. Moreover, these theories have not been tested with families or those 12 experiencing palliative cancer care in particular. Therefore, the aim of this research was to test these alternative theories using theoretical and empirical modeling with the expectation that a useful model will be identified to guide nursing practice with families in palliative cancer care situations. The research problem addressed, the purpose of the study, and the significance of the research for nursing and other health professionals interested in understanding family satisfaction with pailiative cancer care are outlined in this chapter.
DOI：
10.1016/0021-9681(84)90104-8
发表时间：
1984
期刊：
Journal of chronic diseases
影响因子：
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作者：
McCusker,J
通讯作者：
McCusker,J