Conflict between Family Caregivers and Staff in Nursing Homes: Feasibility of the Daily Diary Method

Abstract

ABSTRACTObjective: The purpose of this study was to investigate the daily diary method (DDM) for assessing family–staff conflicts in nursing homes, to provide descriptive information on conflict, and to examine the relationship between conflict and mood among family caregivers.Methods: Participants were nine caregivers that experienced conflict with staff on an ongoing basis. They were contacted daily by telephone for 14 days and were asked (1) whether a conflict had occurred, (2) to describe the severity and type of conflict, and (3) to rate their positive and negative affect.Results: Compliance was excellent with no attrition, and there were only 2 missing data points over 126 potential observations. Conflicts occurred on 22% of the days, were rated as moderately severe, and were related to poor resident care, lack of information, and staff attitudes. Participants reported significantly lower positive affect (p < .05) and higher negative affect (p < .001) on conflict versus no-conflict days. Exit interviews indicated positive attitudes towards the DDM.Conclusions: These results support the feasibility of the DDM for providing an in-depth understanding of family–staff conflict and its relationship to caregivers’ mood.Clinical Implications: The DDM would ideally be used as an outcome measure in studies that assess interventions that target high-conflict family–staff relationships.