Abstract
The inclusion of family members in the acute care of older persons with complex needs results in better coordination of care and reduces the frequency and/or duration of rehospitalisation. Therefore, healthcare professionals need a tool to assess the collaboration with family members on acute hospital wards. The aims were to test the psychometric properties of the Swedish version of the Family Collaboration Scale (FCS), to investigate family members’ perception of collaboration with healthcare professionals on acute medical wards in Sweden and to compare the data with the corresponding Danish results. Three hundred and sixty family members of frail patients aged 65 or older from 13 acute medical wards answered the FCS questionnaire. In addition to descriptive statistics, psychometric methods were applied. The internal consistency of the Swedish version of the FCS was excellent, and confirmatory factor analysis revealed that its factor structure was equivalent to that of the original Danish FCS. The respondents’ ratings indicated better perceived collaboration than in the Danish case. Older age than 60 was associated with worse collaboration with healthcare professionals regarding Influence on discharge than younger respondents. Those with compulsory and health or nursing education showed better collaboration. The Swedish version of the FCS should be further evaluated for its retest reliability and as an outcome measure in intervention studies.
Highlights
For many frail older people, home care would not work without the contribution of family members as informal caregivers [1], and many researchers have predicted an increasing amount of informal caregiving in the future in societies with an ageing pattern similar to that of Sweden [2,3]
The Confirmatory factor analysis (CFA) performed in this study on the model that represents the original Family Collaboration Scale (FCS) factor structure [21] showed a significant chi-square (S-Bχ2 = 2618.20, df = 809, p < 0.001), a comparative fit index (CFI) = 0.92, an SRMR = 0.090 and an root mean square of approximation (RMSEA) = 0.079, indicating an adequate goodness of fit
The deletion of only item 43 resulted in a model with a significant chi-square (S-Bχ2 = 2529.48, df = 769, p < 0.001), a CFI = 0.92, an SRMR = 0.090 and an RMSEA = 0.080 (CI = 0.076–0.083), indicating a significantly improved fit according to chi-square (S-Bχ2 difference of 88.72 with 40 degrees of freedom less with a p < 0.0001) but no improvement in CFI, SRMR or RMSEA
Summary
For many frail older people, home care would not work without the contribution of family members as informal caregivers [1], and many researchers have predicted an increasing amount of informal caregiving in the future in societies with an ageing pattern similar to that of Sweden [2,3]. Of relevance in this connection is the broad international use of the policy term “ageing in place”, whereby older persons shall live and receive care in their home for as long as possible; it is a policy favoured both by policy makers and by many older people themselves [4–6].
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