Date of Award

1-1-2000

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

Faculty

Faculty of Communications, Health and Science

First Supervisor

Dr Richard Hugman

Second Supervisor

Dr Patricia Percival

Third Supervisor

Professor Linda Kristjanson & Associate Professor Ed Helmes

Abstract

When elderly people are cared for In Aged Care Facilities (ACFs) it is known that their family members frequently suffer negative effects. These effects may be alleviated by social support and, because they feel better, family members may then offer more support to residents. In this study, the researcher tested a model with a sample of 213 family members of ACF residents. Predictive relationships were hypothesised among incentives for family members to support residents, stress related factors, the perceived formal and Informal support of family members, their psychological wellbeing, and the support they offered to residents. The researcher also developed the Relatives' of Aged Care Residents Assessment of Staff Support Tool (RACRASST) to measure family members' perceptions of support from the staff. The researcher developed the RACRASST from data obtained at interviews with family members of ACF residents and ACF staff, and from a review of the literature. The instrument underwent testing and refinement procedures, including a factor analysis. The test-retest reliability co-efficient for the scale was found to be 0.99 over 2-3 days. As used In the study, the RACRASST was a 29-ltem unidimensional scale. Response options ranged from Strongly Disagree to Strongly Agree. A not applicable option was retained to identify Items needing review. Items referred to staff/family member communication, staff care activities, staff use of the environment, and family members' perceptions of a reliable alliance between themselves and the staff. The instrument was re-examined during the study and two items were deleted because of a high percentage of missing/not applicable responses. Cronbach's alpha co-efficient for the 27-item RACRASST was 0.96. Findings of model testing confirmed hypothesised positive predictive relationships between residents' family members' well-being (the dependent variable) and both family members' perceptions of the residents' adjustment and the length of stay. Pressures related to the placement were confirmed as negatively predicting well-being In family members, and the degree to which family members felt attached to residents was confirmed as positively predicting their self-reported support of residents. The familial relationship between the family member and the resident was also confirmed as predicting family members' well-belng. Support from ACF staff was not a significant predictor of family members' well-being, and well-being failed to predict family members' support for residents. An empirical model was also developed. This model accounted for 47% of the variance in family members' well-belng and 23% of the variance In family members' self-reported support for residents. Family members' perceptions of their informal support were found to account for 7% of the variance In support for residents and 5% of the variance in pressures experienced because of the placement. Pressures in family members negatively predicted their health and well-belng, and being a residents' daughter was a positive predictor of pressures. The main conclusion is that informal support is potentially highly beneficial to residents' family members. Accordingly, it is recommended that ACF staff facilitate supportive relationships among family members and residents. Further research to develop and test the RACRASST and to test the empirical model is also recommended.

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