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Family evaluation of hospice care: Examining direct and indirect associations with overall satisfaction and caregiver confidence

Published online by Cambridge University Press:  03 July 2014

Jason M. Holland ,
Jennifer R. Keene ,
Abbie Kirkendall  and
Nora Luna
Jason M. Holland*
Affiliation:
Department of Psychology, University of Nevada, Las Vegas, Nevada
Jennifer R. Keene
Affiliation:
Department of Sociology, University of Nevada, Las Vegas, Nevada
Abbie Kirkendall
Affiliation:
School of Social Work, University of Nevada, Las Vegas, Nevada
Nora Luna
Affiliation:
Nathan Adelson Hospice, Las Vegas, Nevada
*
Address correspondence and reprint requests to: Jason M. Holland, Department of Psychology, University of Nevada, Las Vegas, 4505 South Maryland Parkway, Box 455030, Las Vegas, Nevada 89154-5030. E-mail: [email protected]
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Abstract

Objective:

The Family Evaluation of Hospice Care (FEHC) survey is widely employed by hospices, and several studies have examined this information to help inform and enhance end-of-life services. However, these studies have largely focused on examining relatively straightforward associations between variables and have not tested larger models that could reveal more complex effects. The present study aimed to examine the direct and mediating (i.e., via information/education, patient care, and family support) effects of demographic factors, length of stay, timing of referral, patient symptom severity, location of services, and relationship to caregiver on two outcome variables: overall satisfaction and caregiver confidence.

Method:

Surveys were collected from 3226 participants who had lost a loved one who received hospice services. Structural equation modeling was employed to examine the direct and mediating effects of the independent variables on the two outcomes of interest.

Results:

Participants reporting on racial minority patients, patients with more symptoms, and those referred too late or too early were the most likely to express some discontentment with hospice services. The information/education these individuals received was the only mediating factor significantly associated with caregiver confidence. More positive perceptions of patient care and information/education were both significantly related to greater overall satisfaction.

Significance of Results:

These findings help to (1) pinpoint those most at risk for being less satisfied with hospice, (2) identify which aspects of care may be most strongly related to overall outcomes, and (3) provide a model for examining complex associations among FEHC variables that may be employed by other researchers.

Keywords

Palliative careHospiceMediationSatisfactionSelf-efficacyEnd of lifeCaregivers
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 901 - 908
Copyright
Copyright © Cambridge University Press 2014 

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