A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study

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...

Full description

Bibliographic Details
Main Authors: Reidun Hov, Bente Bjørsland, Bente Ødegård Kjøs, Bodil Wilde-Larsson
Format: Article
Language:English
Published: BMC 2020-01-01
Series:BMC Palliative Care
Subjects:
Online Access:https://doi.org/10.1186/s12904-020-0513-7
_version_ 1819279058147475456
author Reidun Hov
Bente Bjørsland
Bente Ødegård Kjøs
Bodil Wilde-Larsson
author_facet Reidun Hov
Bente Bjørsland
Bente Ødegård Kjøs
Bodil Wilde-Larsson
author_sort Reidun Hov
collection DOAJ
description 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.
first_indexed 2024-12-24T00:21:52Z
format Article
id doaj.art-66ca0833e40a42c0af604382a58f31e4
institution Directory Open Access Journal
issn 1472-684X
language English
last_indexed 2024-12-24T00:21:52Z
publishDate 2020-01-01
publisher BMC
record_format Article
series BMC Palliative Care
spelling doaj.art-66ca0833e40a42c0af604382a58f31e42022-12-21T17:24:33ZengBMCBMC Palliative Care1472-684X2020-01-0119111210.1186/s12904-020-0513-7A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative studyReidun Hov0Bente Bjørsland1Bente Ødegård Kjøs2Bodil Wilde-Larsson3Department of Nursing, Inland Norway University of Applied SciencesDepartment of Nursing, Inland Norway University of Applied SciencesCentre for Development of Institutional and Home Care ServicesDepartment of Nursing, Inland Norway University of Applied SciencesAbstract 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.https://doi.org/10.1186/s12904-020-0513-7SecurityQuality of palliative homecarePatient and relative dyadsQuantitative
spellingShingle Reidun Hov
Bente Bjørsland
Bente Ødegård Kjøs
Bodil Wilde-Larsson
A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
BMC Palliative Care
Security
Quality of palliative homecare
Patient and relative dyads
Quantitative
title A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
title_full A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
title_fullStr A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
title_full_unstemmed A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
title_short A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
title_sort sense of security in palliative homecare in a norwegian municipality dyadic comparisons of the perceptions of patients and relatives a quantitative study
topic Security
Quality of palliative homecare
Patient and relative dyads
Quantitative
url https://doi.org/10.1186/s12904-020-0513-7
work_keys_str_mv AT reidunhov asenseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT bentebjørsland asenseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT benteødegardkjøs asenseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT bodilwildelarsson asenseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT reidunhov senseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT bentebjørsland senseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT benteødegardkjøs senseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy
AT bodilwildelarsson senseofsecurityinpalliativehomecareinanorwegianmunicipalitydyadiccomparisonsoftheperceptionsofpatientsandrelativesaquantitativestudy