Family Caregiver Participation in Hospital Care in a Tertiary Hospital in Bangladesh: a Mixed Methods Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 353
- 试验地点
- 1
- 主要终点
- The intervention suggestions for family participation in hospital care
研究概览
简要总结
This mixed methods study aims to understand family care participation in the adult medicine wards of Chattogram Medical College Hospital, Bangladesh. The main questions it aims to answer, from the perspective of the patient, family caregiver, nurse, doctor, ward assistant, and hospital administrator, are:
- What is the role of the family caregiver in hospital care?
- What is the perceived effect of family participation in hospital care?
- What are the barriers and facilitators experienced in family participation?
- What are suggestions for family participation interventions?
These questions will be answered with three study arms:
- A prospective observational cohort (population: patients and family caregivers)
- A time and motion study (population: nurses and doctors)
- Interviews and focus group discussions (population: patients, family caregivers, nurses, doctors, ward assistants, and hospital administrators)
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Prospective Observational Cohort
- •Inclusion Criteria
- •Population
- •Patient: Admitted to the ward (in-patient)
- •Family caregiver: caregiver providing care at the bedside of the patient on the ward
- •Environment: Admitted to medicine wards 13, 14 or 16 of Chattogram Medical College Hospital
- •Admission time: Admitted in the last 48 hours
- •Adult: ≥18 years
排除标准
- •Admission time: Planned discharge or transfer within the first 24 hours of admission
- •Child: <18 years
- •Previously enrolled in this study arm
- •No consent given
- •Time and Motion
- •Inclusion Criteria
- •Population: Nurses and doctors
- •Environment: Working in the medicine wards 13, 14 or 16 of Chattogram Medical College Hospital
- •Exclusion Criteria
- •Previously enrolled in this study arm
- •No consent given
- •Qualitative (interviews and focus group discussions)
- •Inclusion Criteria
- •Population
- •Patient: Admitted to the ward (in-patient)
- •Family caregiver: Caregiver providing care at the bedside of the patient on the ward
- •Health workers: Nurses, doctors and ward assistants
- •Hospital administrator: Managers and professors
- •Environment
- •Patient: Admitted to medicine wards 13, 14 or 16 of CMCH
- •Family caregiver: Caring for their relative on wards 13, 14 or 16 of CMCH
- •Health worker: Working on wards 13, 14 or 16 of CMCH
- •Hospital administrator: Responsible for care delivery on wards 13, 14 or 16 of CMCH
- •Exclusion Criteria
- •Population
- •Patient: Unconscious or unable to participate in a conversation
- •Family caregiver: Unable to leave the patient for reasons of safety
- •Health worker: <6 months of work experience on wards 13, 14 or 16 of CMCH
- •Hospital administrator: <6 months in a management role for wards 13, 14 or 16 of CMCH
- •Admission time
- •Patient: Admitted <48 hours
- •Family caregiver: <8 cumulative hours present at patient bedside in last 48 hours
- •Child: <18 years
- •Previously enrolled in this study arm
- •No consent given
研究组 & 干预措施
Prospective Observational Cohort
Patient and family caregiver dyads will be recruited for a prospective cohort observation for at least 24 hours and a maximum of seven days. At inclusion, baseline and self-reported data from admission until inclusion will be collected. After inclusion, data will be collected every 24 hours on self-reported outcomes of the last 24 hours. Patients and family caregiver dyads will be followed until discharge, transfer to another department, death or a maximum of seven days of follow-up. If dyads stay longer than seven days, daily follow-up is ended and they are called once 14 days later to collect outcome data.
Time and Motion
Nurses and doctors will be recruited for time-and-motion observations by a trained non-participant observer during their shift on the medicine ward. Observers will use a REDCap to record where, what, for how long and how health workers perform tasks and interactions during their shifts. Observations will take place in sets of two hours each. Approximate equal amounts of observations will be done on all medicine wards. Observations will occur on different days of the week, at different shifts during the day, and at different times during a shift to collect data from different care contexts. Baseline data of the shift is recorded at the start of the observation.
Qualitative
The qualitative arm of the study involves interviews and focus group discussions with patients, family caregivers, nurses, doctors and hospital administrators. The FGDs and interviews will be performed in Bengali by a local researcher experienced in qualitative research. An interview guide is used to define themes for the conversations, however, the interviewer is encouraged to follow the flow of the conversation by changing the order of topics or asking additional questions. The main themes of the interview guide are (1) the role of family participation in hospital care, (2) the perceived effect of family participation, (3) the barriers and facilitators for family participation in hospital care, and (4) the opportunities for improving family caregiver participation in hospital care.
结局指标
主要结局
The intervention suggestions for family participation in hospital care
时间窗: During admission to the general medicine ward
The barriers and facilitators of family participation will be described with data from: 1\. Interviews and FDG: with patients, family caregivers, nurses, doctors, ward assistants, and hospital administrators.
The barriers and facilitators of family participation in hospital care
时间窗: During admission to the general medicine ward
The barriers and facilitators of family participation will be described with data from: 1. Prospective observational cohort: patient baseline characteristics, family caregiver baseline characteristics, care characteristics during follow-up (for example: tasks performed, number of caregivers present, hours caregiver is present), end of follow-up status (example: discharged, transferred, death). 2. Time and motion: division of work time of nurses and doctors, time spend interacting with patients and family caregivers. 3. Interviews and FDG: with patients, family caregivers, nurses, doctors, ward assistants, and hospital administrators.
The role of family participation in hospital care
时间窗: During admission to the general medicine ward
The role of family participation will be described with data from: 1. Prospective observational cohort: patient baseline characteristics, family caregiver baseline characteristics, care characteristics during follow-up (for example: tasks performed, number of caregivers present, hours caregiver is present), end of follow-up status (example: discharged, transferred, death). 2. Interviews and FDG: with patients, family caregivers, nurses, doctors, ward assistants, and hospital administrators.
The perceived effect of family participation in hospital care
时间窗: During admission to the general medicine ward
The perceived effect of family participation will be described with data from: 1. Time and motion: division of work time of nurses and doctors, time spend interacting with patients and family caregivers. 2. Interviews and FDG: with patients, family caregivers, nurses, doctors, ward assistants, and hospital administrators.
次要结局
未报告次要终点
研究者
Michele van Vugt
Professor
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)