Factors Related to Person-Centered Care for Older Patients With Cancer and Dementia in Designated Cancer Hospitals.

BACKGROUND: Person-centered care (PCC) should be promoted for patients with cancer and dementia who are likely to be hindered from pursuing a meaningful life owing to their will not being reflected in the cancer treatment process. OBJECTIVE: This study aimed to clarify the factors related to nurses' practice of PCC for older patients with cancer and dementia in designated cancer hospitals. METHODS: An online cross-sectional survey was administered to nurses working at designated cancer hospitals in Japan. The survey items included demographic data and factors assumed to be related to nursing practice and practice of PCC. RESULTS: A multiple regression analysis indicated that the factors related to the practice of PCC were attitude toward patients with dementia (ß = 0.264, P < .001), holding conferences (ß = 0.255, P < .001), knowledge about cancer nursing (ß = 0.168, P < .001), knowledge about dementia (ß = 0.128, P = .003), and participation in dementia care training (ß = 0.088, P = .032). CONCLUSIONS: Nurses' practice of PCC may not be sufficient to provide personalized care tailored to patients' cognitive function. The factors related to PCC are attitude toward patients with dementia, holding conferences, knowledge about cancer and dementia, and dementia care training. IMPLICATIONS FOR PRACTICE: To promote PCC for patients with cancer and dementia, nurses should learn about these conditions with an interest in patients and collaborate with other professionals. Future studies should use cluster sampling and focus on the extent of cancer or dementia symptoms.

Development and validation of the Care Transitions Scale for Patients with Heart Failure: A tool for nurses to assess patients' readiness for hospital discharge.

AIM: This study aimed to develop and assess the validity and reliability of the Care Transitions Scale for Patients with Heart Failure (CTS-HF) as a nurse-reported measure for evaluating patients' readiness for hospital discharge. METHODS: We conducted a cross-sectional study of cardiovascular ward nurses from 163 hospitals across Japan. Structural validity was assessed using exploratory factor analysis with development participants and confirmatory factor analysis with validation participants. Convergent validity was assessed by correlation with the Discharge Planning of Ward Nurses scale (DPWN). Hypotheses testing for construct validity was performed as comparisons between subgroups of transitional care practice. RESULTS: Valid responses were obtained from 704 nurses (development participants, n = 352; validation participants, n = 352). The final scale comprised 21 items divided into six factors: "Clear preparation for how to manage health at home," "Adjusting to home care/support system," "Transitions of medication management from hospital to home," "Dealing with patients' concerns and questions," "Transitions of disease management from hospital to home," and "Family support." Indices of fit supported these results (comparative fit index = 0.944, root mean square error of approximation = 0.057). The CTS-HF was significantly correlated with the DPWN. The nurses' subgroup with higher transitional care practice had higher CTS-HF scores. Cronbach's alpha was .93 for the CTS-HF. CONCLUSIONS: The CTS-HF showed sufficient reliability and validity for use in evaluating discharge care. Further studies are needed regarding the usefulness of this scale in nursing practice.

Measurement tools that assess the quality of transitional care from patients' perspective: A literature review.

AIM: Transitional care is important for improving the quality of life of patients discharged from hospitals. Patient-reported experience measures help improve transitional care quality. Thus, this literature review aimed to identify and appraise measurement tools that assess transitional care quality from the patient's perspective and identify its components. METHODS: Development and validation studies were systematically searched in the PubMed and CINAHL databases. The review team appraised the methodological quality and statistical results of measurement properties using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. RESULTS: A total of 30 studies and seven instruments were identified. The target population was patients discharged from hospital to a home or nursing home (mean age = 52-84 years). The measurement time was before or after the discharge. The number of items in the original versions of the measures ranged from eight to 41, with short versions ranging from three to 12. The overall methodological quality of structural validity, internal consistency, and hypotheses testing was mostly "very good or adequate," according to COSMIN criteria. However, content validity and development were mostly "inadequate or doubtful" or not reported. The main components of included measures comprised "self-care after discharge," "providing information to the patient," "patient engagement in the care plan," and "dealing with patient's concerns." CONCLUSION: The quality appraisal results and identified components are useful for choosing measurement tools in clinical practice and research. The Care Transitions Measure is the most widely validated measurement tool.

Validity and reliability of the Japanese version of the Care Transitions Measure.

OBJECTIVE: To evaluate the validity and reliability of the Japanese Version of the Care Transitions Measure (J-CTM-15). DESIGN: Questionnaire items were translated, and a longitudinal study was conducted. SETTING: Three urban hospitals: a special functioning hospital, a regional-designated cancer care hospital, and a private hospital in the northern part of Japan. PARTICIPANTS: Patients, aged 20 years and older, who were discharged from hospitals. MAIN OUTCOME MEASURE: Reliability was measured using Cronbach α and item-total correlations. Convergent validity was measured using a Pearson correlation with the Self-Care Agency Questionnaire. Construct validity was examined by an exploratory factor analysis. Predictive validity was examined by the ability to discriminate negative post hospital experiences, including anxiety, problems at home, readmission, emergency visit, consultation via telephone, poor health condition without consultation, and by the correlation with the 12-item Short Form Health Survey (SF-12v2). RESULTS: A total of 223 and 158 participants were selected for data analyses. The Cronbach α was 0.90. The J-CTM-15 differed from the original factor model, but significantly correlated with Self-Care Agency Questionnaire and SF-12v2 scores. The J-CTM-15 also significantly discriminated between patients who did and did not display anxiety, problems at home, and poor health condition, but did not discriminate for readmission, emergency visits, and consultation via telephone. CONCLUSION: The J-CTM-15 is a valid and reliable measure of the quality of care transitions. However, insufficient levels of predictive validity and a lack of generalizability are limitations of the current study.