| Summary: | 碩士 === 輔英科技大學 === 護理系碩士班 === 101 === Purpose: This study aims to explore the relationship between perceived patients’ good-death and grief from bereaved family members’ perspective after the patients had received the hospice palliative care services.
Methods: This study conducted in a cross-sectional correlation research design. Questionnaire survey method as well as purposive sampling and snow-ball sampling were also employed in this study. Face-to-face structured questionnarie interview was also used to assess demographic characteristics, good-death, and grief among patients and bereaved family members. The study surveyed 99 family members within four hospitals which provided hospice care (including hospice care ward, hospice home care, and combined hospice care) located in Kaohsiung and Pingtung area. After approved by the hospital and recruited the cases referred from social work department or hospice care case manager, the researcher contacted to the bereaved family members by telephone to access their emotional situation. After acquired informed consent the researcher would explain the details of the study including the purpose, method, time and place for interview.
Inventory: The questionnaire consisted of four sections. The first of which was intended to elicit patients demographic information. The second section asked bereaved family members’ demographic information and the relationship with the patients. Good death Inventory (GDI) was used in section three to access the perceived patients’ good-death from family members. GDI was a fifty-four items rated in 7-points Likert scale with eighteen themes; back translation was also used in this scale and the reliability test showed satisfied results in this study (α = .75 ~ .96).The last part was Revised Grief Experience Inventory (RGEI) to access family members’ level of grief. RGEI was a 6-point Likert scale with 22 items and contained four sub-scales. The higher score of GDI and RGEI represented higher level of good death and grief.
Results: The study revealed that the level of patients’ good-death was on the average level; grief among bereaved family members showed a below-average level. On the good-death dimension, patients showed a lower level of physical and psychological comfort ( = 10.99), unawareness of death ( = 12.95), and independence ( = 11.12); a higher level of good relationship with family ( = 16.61) and being respected as an individual ( = 15.88) were observed in this study. Bivariate analysis indicated close social relationship (r = .34, p < .01), patients with cancer (t = 3.08, p = .003), home death patients (t = 2.31, p = .023), and shorter duration between diseased and dead (r = -.21, p < .05) were correlated with good-death. Kinship relation was found correlate with grief, couples showed higher level of grief than other relationship (F = 3.54, p = .006). Although this study revealed insignificant correlation between good-death and grief (r = -.002, p > .05), however, several factors within good-death and grief were found correlate with statistically significant. Nature death as well as pride and beauty within good-death dimension were correlated with grief dimension’s depression and stress and guilty. Patients who died naturally was negatively associated with stress and guilty (r = -.20); higher level of pride and beauty was found have lower level of depression (r = -.24) and stress and guilty (r = -.25). Stepwise regression analysis revealed that grief could be predicted by kinship relation (couple, beta = .22, p = .023; anut, beta = -.35, p = .000; grandparents, beta = -.34, p = .001), gender (beta = -.26, p = .004), religion type (beta = -.30, p = .002), and marriage status (beta = -.23, p = .016).
Conclusion: The findings from this study will support future nursing practitioners as an empirical reference when proving hospice care services to patients and family members. The study also proposes recommendations for future nursing administration, education, and services to provide better care services for patients in end-of-life process and families as well as enhance quality of hospice palliative care and nursing practice.
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