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A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
Inland Norway University of Applied Sciences, Norway; Centre for Development of Institutional and Home Care Services, Norway.ORCID iD: 0000-0001-7154-3078
Inland Norway University of Applied Sciences, Norway.
Centre for Development of Institutional and Home Care Services, Hamar Municipality, Hedmark, Norway.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Inland Norway University of Applied Sciences, Norway.ORCID iD: 0000-0001-7082-6834
2020 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 19, no 1, p. 1-12, article id 7Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BioMed Central, 2020. Vol. 19, no 1, p. 1-12, article id 7
Keywords [en]
Security, Quality of palliative homecare, Patient and relative dyads, Quantitative
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-77251DOI: 10.1186/s12904-020-0513-7ISI: 000513604800001PubMedID: 31926557OAI: oai:DiVA.org:kau-77251DiVA, id: diva2:1414204
Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2020-04-27Bibliographically approved

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Wilde-Larsson, Bodil

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