title: Do perceptions of family-centered care differ in older and younger family/caregivers of U.S. veterans?
abstract: BACKGROUND
  Family-centered care (FCC) involves partnering with patients and family/caregivers ("caregivers"), engaging them in decisions, and providing support. FCC may be measured across 3 dimensions: respect, collaboration, and support and needs likely vary by caregiver age. The objective was to examine and compare caregiver perceptions of FCC by age.
  
  
  METHODS
  We mailed surveys to family/caregivers of Veterans. We collected demographics and measured respect, collaboration, and support using the Family-Centered Care Survey (FCCS). We calculated mean values and conducted bivariate comparisons, dichotomized by caregiver age (≥60 vs. <60), of demographics and FCC constructs. We completed thematic analysis on open-ended text.
  
  
  RESULTS
  Caregivers (n = 2,111) aged ≥60 versus <60 were more likely to be spouses (81% vs. 62%, p < .0001) and White (74% vs. 50%, p < .0001). Overall FCC subscales values were high: respect (3.30), collaboration (3.07), and support (2.99). Older caregivers reported higher respect (3.36 vs. 3.22, p < .001), collaboration (3.12 vs. 2.98, p < .0001), and support (3.06 vs. 2.88, p < .0001). Qualitative analysis revealed collaboration, communication, hospital climate, and physical environment as important to FCC and supplemented quantitative findings on age. Examples highlighted both positive perceptions of FCC and areas of concern, such as feeling "unheard" and "like I am bothering providers," and needing "more comfortable seating" and "better parking."
  
  
  CONCLUSIONS
  Caregivers perceived high FCC levels at VA facilities, reporting highest on respect and lowest on support. Older caregivers perceived better FCC compared with younger caregivers. Several concerns identified can be used to target improvements to FCC including: improved support, collaboration between patient/family/provider, and climate/environmental enhancements. (PsycINFO Database Record
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital.
authors.forename: Sherri L
authors.initials: SL
authors.lastname: LaVela
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Turcios
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital.
authors.forename: Alex
authors.initials: A
authors.lastname: Malhiot
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital.
authors.forename: Bella
authors.initials: B
authors.lastname: Etingen
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Hill
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Health Services Research & Development, Department of Veterans Affairs, Hines VA Hospital.
authors.forename: Scott
authors.initials: S
authors.lastname: Miskevics
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards*; D010465:Perception; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration / Q000592:standards; D014728:Veterans / Q000523:psychology