Table 2.
Structure of nursing-care for family caregivers of terminally ill cancer patients to enhance preparedness for death (the first stage)
| No | Item | Mean | SD | i | ii | iii | iv | v | vi | vii |
|---|---|---|---|---|---|---|---|---|---|---|
| (i) Support for family caregivers to prepare for bereavement by sharing time with the patient | 4.55 | 0.75 | ||||||||
| 31 | Give the family a favorable environment for a satisfactory farewell. | 4.13 | 0.76 | .96 | .03 | .06 | .00 | .01 | –.04 | –.13 |
| 30 | Explain the patient’s physical changes to the family to accept the impending death. | 4.06 | 0.83 | .87 | .02 | .02 | .01 | –.04 | .03 | .00 |
| 33 | Encourage the patient and family to spend time together and express emotions. | 4.20 | 0.77 | .84 | –.05 | –.01 | –.04 | .06 | –.02 | .03 |
| 32 | Calm the family to avoid panic and fear of the patient’s impending death. | 4.07 | 0.78 | .77 | .03 | .01 | .05 | .07 | –.01 | .01 |
| 26 | Ensure the family can get appropriate rest to enable them to be by the patient’s deathbed. | 4.14 | 0.74 | .61 | .09 | –.06 | –.06 | .11 | .05 | .17 |
| 35 | Assist the family in preparing for the funeral. | 4.12 | 0.88 | .53 | –.10 | –.03 | .16 | .18 | .03 | .02 |
| 28 | Listen to the wishes of the patient and family, such as going out or staying out, and assist them in planning for that. | 3.89 | 0.84 | .53 | .20 | .03 | –.03 | –.06 | .14 | .08 |
| 29 | Consider the diversity of family relations and not compel the family to engage with the patient. | 3.95 | 0.78 | .52 | .07 | .13 | –.04 | .04 | –.02 | .26 |
| 25 | Verify the impact of the patient’s illness on the family life and support them to have time for themselves. | 3.87 | 0.82 | .40 | .19 | –.04 | .00 | .03 | .02 | .39 |
| (ii) Support for the patient and family caregivers to enhance family ties | 3.55 | 0.79 | ||||||||
| 17 | Provide an opportunity for the patient and family to look back on what they cherished in their lives. | 3.53 | 0.94 | .02 | .84 | –.08 | .01 | .07 | .02 | .01 |
| 18 | Arrange an opportunity for the patient and family to discuss how to spend their remaining time. | 3.45 | 0.97 | .11 | .80 | .01 | .07 | –.08 | .03 | –.05 |
| 19 | Create an atmosphere for the patient and family to talk about common hobbies, other family members, and so on. | 3.63 | 0.93 | .00 | .70 | .04 | –.01 | .13 | .02 | .05 |
| 20 | Hear about changes in the family role due to illness and provide consultation. | 3.41 | 0.94 | .00 | .66 | .09 | .12 | .01 | –.01 | .05 |
| 15 | Care for the patient together, considering the family’s convenience. | 3.74 | 0.90 | –.01 | .45 | .03 | –.01 | .40 | –.06 | .06 |
| (iii) Support for family caregivers to understand the patient’s prognosis | 3.74 | 0.71 | ||||||||
| 2 | Make appointments for indicating the prognosis with more than one of the families so that they support each other. | 3.68 | 0.95 | –.07 | .15 | .71 | –.06 | .02 | .04 | –.05 |
| 3 | Ask the family how they intend to tell the patient’s prognosis to their children and provide consultation. | 3.45 | 0.98 | –.06 | .09 | .68 | .09 | –.04 | .07 | .04 |
| 1 | Accompany the family at meetings about bad news such as prognosis by the doctor. | 3.92 | 0.91 | .12 | –.05 | .67 | .00 | .00 | –.08 | –.01 |
| 4 | Evaluate the family’s understanding of the end of aggressive therapy and the patient’s prognosis. If insufficient, arrange a meeting with the doctor. | 3.86 | 0.83 | .20 | –.14 | .62 | .06 | .08 | .03 | .08 |
| 5 | Provide tolerable information gradually to help the family to understand the future. | 3.77 | 0.78 | .11 | .03 | .47 | .10 | .10 | .11 | .07 |
| (iv) Support for family caregivers to cope with bereavement problems | 3.00 | 0.98 | ||||||||
| 10 | Check whether the patient and family discussed after-death scenarios (bereaved families, property management, etc), and provide consultation or an introduction to a consultation desk if necessary. | 2.91 | 1.08 | .02 | .03 | –.03 | .98 | .02 | –.08 | –.05 |
| 9 | Ask the family about practical preparedness (financial affairs, family care leave, funeral, etc) and provide consultation or an introduction to a consultation desk if necessary. | 3.17 | 1.06 | –.06 | –.14 | –.04 | .72 | .07 | .20 | .13 |
| 11 | Inform the family about a place for post-mortem care such as a bereaved family association if their grief reaction to bereavement is expected to be high. | 2.91 | 1.18 | .06 | .30 | .09 | .62 | –.15 | –.06 | –.07 |
| (v) Sufficient care for the patient to provide relief for family caregivers | 4.11 | 0.64 | ||||||||
| 14 | Care for the patient to become comfortable to relieve the family and earn the trust of the family. | 4.11 | 0.72 | .17 | .06 | –.08 | .02 | .70 | .04 | .08 |
| 13 | Appreciate the effort of family participation in patient care, even if it was at a low level. | 4.15 | 0.73 | .20 | .05 | .02 | –.04 | .67 | .05 | .00 |
| 12 | Inform the family about the patient’s condition during their absence to maintain the family relations. | 4.15 | 0.73 | .29 | .01 | .13 | –.02 | .64 | –.04 | –.18 |
| 16 | Consider the family’s wishes for adequate nursing for the patient and inform them of the patient’s condition and comfort changes. | 4.04 | 0.72 | .22 | .14 | .03 | .01 | .51 | –.01 | .08 |
| (vi) Support for patient and family caregivers to decide the place of end-of-life care | 3.71 | 0.83 | ||||||||
| 7 | Provide information about end-of-life care such as a palliative care unit and home care. | 3.72 | 0.93 | .07 | .03 | .05 | –.03 | –.03 | .95 | .06 |
| 8 | Provide information about home support services such as home-visit medical care and home-visit nursing. | 3.62 | 0.94 | –.02 | .02 | .08 | .13 | .05 | .73 | .06 |
| 6 | Provide consultation about the place at the moment and at the end of life. | 3.79 | 0.84 | .08 | –.01 | .32 | –.01 | .00 | .48 | .06 |
| (vii) Support for family caregivers to express their grief | 3.05 | 0.60 | ||||||||
| 24 | Consider the family’s difficulty in expressing their feeling at different times and in different places and watch them carefully. | 3.88 | 0.84 | .20 | .03 | .06 | .01 | –.06 | –.04 | .76 |
| 22 | Consider that the anger and hostility expressed by the family is a sign of grief and accommodate them. | 3.78 | 0.83 | .11 | .20 | .01 | .03 | .02 | –.01 | .60 |
| 23 | Tell the family that crying and being upset are natural reactions and encourage them to express their feelings. | 3.96 | 0.82 | .26 | .08 | –.02 | –.01 | .01 | .02 | .59 |
| 21 | Consider that a sense of guilt, love, and hate is a normal phenomenon, and watch over the family for these reactions. | 3.65 | 0.90 | .10 | .28 | .08 | –.02 | .02 | –.05 | .48 |
| Eigenvalue | 16.96 | 2.56 | 1.87 | 1.06 | 1.03 | 0.89 | 0.71 | |||
SD: standard deviation
Extraction method: Maximum likelihood; Rotation method: Promax rotation.
5-point Likert scale: 1 = never; 2 = rarely; 3 = sometimes; 4 = often; 5 = always.