Quality of Work Life, Nurses' Intention to Leave the Profession, and Nurses Leaving the Profession: A One-Year Prospective Survey.

PURPOSE: To examine the associations among quality of work life, nurses' intention to leave the profession, and nurses leaving the profession. DESIGN: A prospective study design was used. METHODS: Participants were 1,283 hospital nurses with a purposive sampling in Taiwan. The self-reported questionnaire consisted of three questionnaires: the Chinese version of the Quality of Nursing Work Life scale, an intention-to-leave profession questionnaire, and a demographic questionnaire. Records of nurses leaving the profession were surveyed 1 year later. Data were analyzed by descriptive statistics and inferential statistics. FINDINGS: As many as 720 nurses (56.1%) had tendencies to leave their profession. However, only 31 nurses (2.5%) left their profession 1 year later. Nurses' intention to leave the profession mediated the relationship between the milieu of respect and autonomy, quality of work life, and nurses leaving the profession. CONCLUSIONS: The milieu of respect and autonomy describing the quality of work life predicts the nurses' intention to leave the profession, and together these predict nurses leaving the profession. CLINICAL RELEVANCE: This study illustrates that nurse managers could provide effective interventions to ameliorate the milieu of respect and autonomy aspect of quality of work life to prevent nurses from leaving their profession.

Determinants of the discrepancy in patient- and caregiver-rated quality of life for persons with dementia.

AIMS: To determine factors related to the discrepancy in patient- and proxy-rated quality of life for patients with dementia; whether this discrepancy is associated with characteristics of patients, caregivers or the caregiver-patient relationship; and which characteristics best predict this discrepancy. BACKGROUND: To increase the reliability of quality of life measurements for persons with dementia, many researchers have incorporated proxy reports. However, their investigations have indicated that caregiver-rated quality of life is not the same as the patient's own rating. The factors related to this discrepancy have previously been explored, but studies rarely focussed on the quality of the caregiver-patient relationship as a determinant of the discrepancy. DESIGN: A cross-sectional design was used. METHODS: Data were gathered from community-based interviews with 120 dyads of patients with Alzheimer's disease or related dementia and their caregivers in Taipei. A structured questionnaire was used to collect data, and the main variable (quality of life-Alzheimer's disease) was rated separately by patients and caregivers. The data were analysed using intraclass correlation coefficients and multivariate regression methods. RESULTS: The agreement between patients' and caregivers' quality of life-Alzheimer's disease ratings was low. This discrepancy was significantly associated with disturbing dementia behaviour, caregivers' perceived distress for problem behaviours, caregivers' overall quality of life and quality of the caregiver-patient relationship. CONCLUSIONS: The observed discrepancy between caregiver- and patient-rated quality of life for persons with dementia was largely predicted by the quality of the caregiver-patient relationship. RELEVANCE TO CLINICAL PRACTICE: Medical professionals should cautiously deliberate when using caregiver-reported quality of life to substitute for patient-reported quality of life. When using a proxy report or a combined caregiver-patient rating, medical professionals should assess the quality of the relationship between patient and proxy.

Willingness to use respite care among family caregivers in Northern Taiwan.

AIM AND OBJECTIVES: Investigate the use of respite care among family caregivers and examine factors related to their willingness to use such care. BACKGROUND: Respite care is a pivotal service for supporting family caregivers. Although research related to respite care is not a new field in western societies, such studies have rarely been done for Asian populations. DESIGN: A cross-sectional study. METHODS: The study was conducted using a convenience sample of 100 family caregivers obtained through four home health care agencies in Northern Taiwan. Structured face-to face interviews were conducted in home settings. Caregivers were divided into a willingness group and a non-willingness group. The quantitative data were analysed using t-test, chi-square and multiple logistic regression. RESULTS: Sixty-five per cent of the caregivers interviewed did not know about respite care services. The prevalence of respite care use was 11%. Eighty-nine per cent of the caregivers had never used respite care: 60.7% of them reported that they would never use it and 39.3% of the caregivers indicated that they were willing to use respite care in the future. This study showed that willingness to use respite care was higher when the respite services matched the needs of the caregivers as well as the caregivers perceived higher caregiving burden. CONCLUSIONS: These results suggest that respite care services should be explained more explicitly to family caregivers. Also, any respite care plan must consider the family caregivers burden, both perceived and realistically. RELEVANCE TO CLINICAL PRACTICE: The willingness to use respite care is a culturally sensitive issue. Health care providers must act as advocates to improve respite care policy. They must ensure that respite care fits caregivers' needs and they must help caregivers overcome the social or cultural barriers to respite care.