Summary
A study “How home hospice care facilitates patient and family engagement” by Dillon (2016) aims at examining the impact of home hospice care on patient and family engagement and related factors facilitating this engagement. The research was conducted using observation and detailed interviews at a large non-profit hospice that does not belong to any religious affiliation. The sample size comprises 55 participants: 26 hospice workers, 11 family caregivers, and 18 patients (Dillon, 2016).
In particular, the author argues that home hospice care can significantly foster patients’ and families’ involvement and, thus, improve patient outcomes. Moreover, she states that hospice care can become an excellent example for other healthcare sectors in terms of holistic, patient-centered care. The study has identified three core contributors to the engagement, such as structural factors, family member support, and hospice worker strategies. Dillon also describes potential barriers to engagement, namely, challenging relationships and limited number or unwillingness of family members.
Analysis of the Article
The article is written in a clear, coherent, and convincing manner and supported by reliable statistics and authoritative opinions, which inspires trust. In the introduction, Dillon provides sufficient background information about the benefit of patients’ and caregivers’ engagement for patients’ outcomes. Herewith, the author indicates that while research on patients’ engagement is available in an abundant amount, little is performed concerning the home hospice case and its impact on the involvement and related factors (Dillon, 2016). For this reason, Dillon targets exploring this issue to reveal determinants of the engagements needing careful consideration while delivering care irrespective of medical units.
Concerning the findings, the study has detected the three most influential factors: structural factors, family member support, and hospice worker strategies. The first factors include home environment, adequate time, and relationships with hospice staff. Specifically, according to Dillon’s explanation, a home setting makes patients feel more tranquil and relaxed than in inpatient hospice because they are in a habitual environment (Dillon, 2016).
Ample time provided by workers for listening, conversation, and reflection can enhance patients’ experiences, while close relationships encourage engagement in personal care. The researcher provides words and quotes from patients’ and hospice nurses’ and counselors’ interviews to support this explanation. Overall, these elements help patients be more active and responsive to collaborations.
The analysis of family members’ support has discovered that this factor can act in two directions. First, patients become more open to cooperation with hospice nurses since they see that their caregivers are involved in their care. That is, patients take the example from their family members and feel more confident. Another direction is connected with that caregivers also become recipients of care, thereby receiving necessary education. In this regard, the author gives some instances of such behavior and mutual benefit when wives, sons, or other members learn how to deliver elementary but valuable aid.
Hospice worker strategies primarily concern providing education for patients and choices for multiple decisions. As Dillon states, education makes patients aware of risky behaviors and actions that can lead to harm and adverse events such as patient falls or overdosing (Dillon, 2016). Furthermore, nurses educate relatives about the apparent symptoms of patients’ dying and prepare them on necessary actions to help patients. Offering several choices on medications, especially opioids and sedatives, helps avoid medication administration errors. Altogether, education and informed decision-making boost trust for hospice workers’ efforts, which promotes engagement.
The presence of the section where the researcher Discuss barriers to engagement is beneficial in this study and deserves special attention. Specifically, Dillon states that complicated relationships appear to be an enormous obstacle to successful patients’ involvement in care (Dillon, 2016). Poor interaction can stem from both patients and workers, which is demonstrated in several examples provided in the article. Another barrier is related to families’ participation in care delivery. In this regard, Dillon appropriately notes that caregivers can often be absent when care is provided or not be interested and even opposed to hospice workers’ help.
Finally, it is worth evaluating the sample of the study, specifying its explicit advantages and drawbacks. The detailed description of patients’ characteristics, such as age, sex, diseases, religious and social affiliations, and others, undeniably belongs to advantages. However, the study lacks participants; that is, the sample size is small, comprising only 55 respondents (Dillon, 2016). Additionally, the survey was conducted at one hospice, and only one race, namely, white, was included. These shortcomings partly limit the accuracy and efficiency of the performed research.
Implication for the Future Nursing Practice
First of all, the study’s result convinced and encouraged me to focus more on patients’ and their caregivers’ engagements. In this respect, I should pay attention to improving patients’ settings to make them feel relaxed. I also can offer patients to receive care at home if this variant is relevant and comfortable for them. Moreover, after reading, I have realized that I should place a strong emphasis on building robust relationships with patients.
This is an integral component of successful treatment, which primarily can be achieved through active listening and interest in patients’ needs and preferences. Besides, I have comprehended the importance of patients’ education in nursing practice, which helps prevent various harmful events and alleviates care delivery. Finally, I would make more efforts to stimulate family members to be involved in their relatives’ care.
Reference
Dillon, E. C. (2016). How home hospice care facilitates patient and family engagement. Death Studies, 40(10), 591-600. Web.