title: Factors affecting in-hospital informal caregiving as decided by families: findings from a longitudinal study conducted in acute medical units.
abstract: BACKGROUND
  Informal caregiving offered by family members has been widely studied in the community setting, but little attention to date has been dedicated to that offered at the hospital level.
  
  
  OBJECTIVE
  To describe the proportion of patients admitted to acute medical units receiving care from informal caregivers as decided by the family and to identify the factors affecting the numbers of care shifts performed by informal caregivers.
  
  
  METHODS
  A longitudinal study was performed involving 12 acute medical units located in 12 northern Italian hospitals.
  
  
  RESULTS
  All patients (N = 1464) admitted to medical units were included, and 77.1% of them received at least one shift of informal care during their in-hospital stay, especially during the mornings and afternoons. At the patient level, those at higher risk of prolonged hospitalisation and difficult discharge at admission, and those reporting higher occurrence of adverse events, such as pressure sores, confusion events and use of physical restraints during hospitalisation, were more likely receiving informal care. At the nursing care level, a higher amount of missed nursing care was associated with an increased number of care shifts offered by informal caregivers during patient hospitalisation, whereas the amount of care offered by staff was a protective factor.
  
  
  CONCLUSIONS
  Families play a care role in the care of older patients admitted to acute medical units. They contribute substantially to the care of patients, especially during morning and afternoon shifts.
authors.affiliation: Azienda per i Servizi Sanitari, Trento, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ambrosi
authors.affiliation: Azienda Ospedaliera S.Orsola - Malpighi, Bologna, Italy.
authors.forename: Catia
authors.initials: C
authors.lastname: Biavati
authors.affiliation: Azienda per i Servizi Sanitari, Trento, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Guarnier
authors.affiliation: Azienda per i Servizi Sanitari, Trento, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Barelli
authors.affiliation: Azienda per i Servizi Sanitari, Trento, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zambiasi
authors.affiliation: Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Allegrini
authors.affiliation: Fondazione Poliambulanza, Brescia, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Bazoli
authors.affiliation: Azienda Unità Sanitaria Locale n. 9, Treviso, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Casson
authors.affiliation: Azienda per i Servizi Sanitari n. 2 'Isontina', Gorizia, Italy.
authors.forename: Meri
authors.initials: M
authors.lastname: Marin
authors.affiliation: Azienda Unità Sanitaria Locale n. 6 Vicenza, Vicenza, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Padovan
authors.affiliation: Azienda per i Servizi Sanitari n.4 'Medio Friuli', Udine, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Picogna
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Taddia
authors.affiliation: Fondazione Zancan, Padua, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Salmaso
authors.affiliation: Bologna University, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiari
authors.affiliation: Azienda Ospedaliero-Universitaria, Padua, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Frison
authors.affiliation: Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Oliva
authors.initials: O
authors.lastname: Marognolli
authors.affiliation: Universidad del Dessarollo, Santiago, Chile.
authors.forename: Carla
authors.initials: C
authors.lastname: Benaglio
authors.affiliation: Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Canzan
authors.affiliation: Verona University, Verona, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Saiani
authors.affiliation: Udine University, Udine, Italy.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D064648:Critical Care Nursing / Q000458:organization & administration*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: elderly; family; hospitalisation; informal caregiving; medical units; patient outcomes