Positive aspects of the family caregiving experience in hospice.

Abstract

Problem. The informal caregiving experience affects the course of bereavement and emotional wellbeing of caregivers, as well as caregiver morbidity and mortality during the bereavement period. A positive caregiving experience is more likely to result in less distress and symptomatology during bereavement. Family caregivers of hospice patients are a particular sub-set of family caregivers. Knowledge of the factors that contribute to a positive caregiving experience in the hospice care setting is needed for the development of effective interventions for family caregivers of hospice patients. Little research exists that examines the effect of hospice care on family caregivers and even less attention has been given to exploring the role hospice care plays in making the caregiving experience a positive one. The purpose of this study was to explore the predictors of a positive caregiving experience of bereaved family caregivers of hospice patients, with particular attention to the contribution of selected aspects of hospice care. Positive appraisal was examined in terms of gain derived from the caregiving experience and a sense of competence related to caregiving. Methods. This cross-sectional, non-experimental, descriptive study included a sample of 409 bereaved family caregivers of individuals who died while enrolled in hospice. Data were collected using mailed surveys sent to the caregivers and administrative data from the hospice that provided the care. Two regression models were developed: (1) to determine the contribution of caregiver characteristics, care recipient characteristics, and hospice care to caregiver competence; and (2) to determine the contribution of caregiver characteristics, care recipient characteristics, caregiver competence, and hospice care to caregiver gain. Results. Selected caregiver characteristics and hospice care explained 7.9% of the variance in caregiver competence. Selected caregiver characteristics and caregiver competence explained 31.0% of the variance in caregiver gain. Caregiver competence did not moderate the relationship between caregiver characteristics and caregiver gain. Conclusions. A sense of caregiver competence exerts significant influence on the development of caregiver gain in hospice family caregivers. Hospice professionals need to focus on those aspects of hospice care provision that are aimed at enhancing the sense of competence in family caregivers of individuals enrolled in hospice care.