CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea; Faculty of Nursing, Hai Phong University of Medicine and Pharmacy, Haiphong, Vietnam.
CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
J Am Med Dir Assoc. 2024 Sep;25(9):105166. doi: 10.1016/j.jamda.2024.105166. Epub 2024 Jul 20.
Family caregivers of older adults receiving home care often find themselves in situations in which they must make important and difficult decisions, which can cause conflict and regret. To tailor shared decision making in this context, we aimed to identify the most difficult decisions they faced, assess their levels of decision regret, and explore the associated factors.
This study used a cross-sectional design.
Participants included 165 caregivers of older adults who received home care services in Korea.
We identified difficult decisions perceived by family caregivers of older adults and evaluated decision regret using the Decision Regret Scale (DRS), decisional conflict using the Decisional Conflict Scale (DCS), burden of care using the Short Zarit Burden Inventory, and Preference Control Scale (PCS). We then performed descriptive, bivariate, and multivariate linear regression analyses to identify factors predicting decision regret.
The most frequently reported difficult decisions were related to place of living (71.6%), management of health conditions (15.1%), and end-of-life decisions (13.3%). The mean DCS score was 37.09 (12.67), the DRS score was 32.33 (15.91), and the burden score was 21.81 (8.25). Matching decisions with preferences and aligning decision-making roles significantly reduced regret, while decision conflicts increased regret.
The positive associations between decision regret, decision conflict, and the alignment of decision-making roles highlight the intricate dynamics involved in the decision-making process for family caregivers. These findings emphasize the need for tailored interventions that recognize and address the diverse factors influencing caregivers' decision-making experiences. Future research exploring the efficacy of targeted interventions such as decision-support programs or caregiver education initiatives could offer valuable insights into mitigating decision-related challenges and improving the overall well-being of both caregivers and care recipients.
接受家庭护理的老年人的家庭护理人员经常发现自己处于必须做出重要且困难的决策的情况下，这可能会导致冲突和遗憾。为了在这种情况下定制共享决策，我们旨在确定他们面临的最困难的决策，评估他们的决策遗憾程度，并探讨相关因素。
本研究采用横断面设计。
参与者包括 165 名在韩国接受家庭护理服务的老年人的护理人员。
我们确定了老年人家庭护理人员感知到的困难决策，并使用决策遗憾量表（DRS）评估决策遗憾程度，使用决策冲突量表（DCS）评估决策冲突，使用简短 Zarit 负担量表和偏好控制量表（PCS）评估照顾负担。然后，我们进行了描述性、双变量和多变量线性回归分析，以确定预测决策遗憾的因素。
报告最多的困难决策与居住地点（71.6%）、健康状况管理（15.1%）和临终决策（13.3%）有关。DCS 得分的平均值为 37.09（12.67），DRS 得分为 32.33（15.91），负担得分 21.81（8.25）。使决策与偏好匹配并调整决策角色显著降低了遗憾，而决策冲突增加了遗憾。
决策遗憾、决策冲突与决策角色一致性之间的积极关联突显了家庭护理人员决策过程中涉及的复杂动态。这些发现强调需要进行有针对性的干预，以认识和解决影响护理人员决策体验的各种因素。未来的研究探索针对决策支持计划或护理人员教育计划等有针对性干预措施的效果，可能会为减轻与决策相关的挑战和改善护理人员和护理接受者的整体幸福感提供有价值的见解。
