Date of Award

1997

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Bachelor of Nursing Honours

School

School of Nursing

Faculty

Faculty of Health and Human Sciences

First Supervisor

Davina Porock

Second Supervisor

Linda Kristjanson

Third Supervisor

Michael Smith

Abstract

Increasingly, there is greater expectation by the public, as health consumers, that they will receive care from health professionals which meets their expectations and does not leave them dissatisfied. The stress experienced by families caring for a family member with advanced cancer may be complicated when they are dissatisfied with care received from health care professionals. To further promote family satisfaction it is important therefore for health professionals to understand the theoretical underpinning of family satisfaction with care. One theoretical explanation of family member satisfaction with advanced cancer care in the palliative care setting, Porter's Discrepancy Theory, was investigated in this study. A descriptive correlational design was used to evaluate family members' expectations of care, perceptions of care, and level of satisfaction with advanced cancer care replicating one arm of Kristjanson's work (1991). Data was collected from 55 family members, who were the principal caregivers for patients with advanced cancer receiving palliative care from a home hospice service in Western Australia. Stratified random sampling was used to select participants for the study based upon the divisional areas of the home hospice service. Four instruments were used to collect data: (I) FAMCARE Scale, (2) F-Care Expectations Scale, (3) F-Care Perceptions Scale, (4) Family Assessment Device: General Functioning Subscale and a short demographic questionnaire. Data analysis included: descriptive statistics to summarise the sample, reliability testing of the instruments, calculation of the discrepancy between expectations and perceptions and testing the extent to which the discrepancy variable predicted care satisfaction using regression analysis. The relationships between sociodemographic and family care expectations, family care perceptions and family satisfaction with care variables were also examined. Discrepancy theory explained 29% of the variance in family care satisfaction. When the variables age and family functioning were added to the regression 42% of the variance in family care satisfaction was explained. An alternative model was tested using family care perceptions to explain 54% of the variance in family care satisfaction with home hospice care. Implications for clinical practice and recommendations for further research with regard to further theory testing and investigation of the less satisfied subgroup are suggested.

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