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2015 HSR&D/QUERI National Conference Abstract

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3073 — Do Perceptions Of Family-Centered Care Differ in Older and Younger Family/Caregivers?

LaVela SL, Center of Innovation for Complex Chronic Healthcare; Northwestern University; Turcios S, Center of Innovation for Complex Chronic Healthcare; Malhiot A, Center of Innovation for Complex Chronic Healthcare; Etingen B, Center of Innovation for Complex Chronic Healthcare; Miskevics S, Center of Innovation for Complex Chronic Healthcare;

Objectives:
To examine family/caregiver perceptions of family-centered care (FCC) in Veteran Affairs (VA) facilities and to compare perceptions of FCC by family/caregiver age.

Methods:
Cross-sectional national survey mailed to family/caregivers of Veterans who received care at 8 VA facilities (n = 2261). We collected demographic information and measured 3 FCC constructs: respect (6 items), collaboration (9 items), and support (5 items), using the Family-Centered Care Survey (FCCS). A 4-point scale was used to calculate mean values. Bivariate comparisons, dichotomized by family/caregiver age (60 and older vs. 59 and younger) of demographics and FCC constructs were conducted. Three open-ended questions about family involvement in VA quality improvement efforts and overall family/caregiver experience were asked. Thematic analysis was completed on open-ended items.

Results:
Family/caregivers (n = 2111) aged 60 and older vs. 59 and younger were more likely to be spouses of the patient (81% vs. 62%, p < 0.0001) and white (74% vs. 50%, p < 0.0001); no gender differences existed by age. Overall FCC subscales were high: respect (3.30), collaboration (3.07), and support (2.99). Older family/caregivers aged 60 and older (vs. younger) reported higher average respect (3.36 vs. 3.22, p < 0.001), collaboration (3.13 vs. 2.98, p < 0.0001), and support (3.06 vs. 2.88, p < 0.0001) values. Qualitative findings revealed key themes, several tied to collaboration, respect, support, in addition to a unique construct of access to care.

Implications:
In general, at VA facilities, family/caregivers perceive relatively high levels of FCC, reporting highest on respect and lowest on support scales. Younger (vs. older) family/caregivers reported lower perceptions of optimal FCC. Further, perceptions of FCC were highly influenced by the level of involvement with the care team.

Impacts:
Family/caregiver involvement is integral to healthcare delivery. Understanding family/caregiver perceptions of FCC can assist the VA healthcare systems in efforts to promote and nourish partnerships between care teams and family/caregivers. Our findings show that Veteran family/caregivers may benefit from additional efforts related to "support". To address potential disparities, targeted efforts to improve FCC may be aimed toward younger family/caregivers. This can lead to minimizing age disparities that may exist within the VA and ultimately, improve quality of care for the patient.