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The cognitively-impaired institutionalized elderly: spousal perceptions and expectations of nursing care Fong, Susan T. S.

Abstract

This study was conducted to determine the relationship between the spouses' perceptions and expectations of nursing care delivered to their cognitively-impaired institutionalized elderly mate. Data were collected by means of a self-administered questionnaire, based on the concept of caring, designed to elicit spouses' perceptions and expectations of certain identified nursing care activities. These nursing careactivities pertain to the Instrumental, Expressive, and Communicative components of a Total Transactional System, the conceptual framework. Data were analyzed using descriptive and inferential statistics in the form of a central tendency analysis and a multivariate approach using profile analysis. Results demonstrated that there was a difference between the spouses' perceptions and expectations. There was a statistically significant difference between the spouses' perceptions and expectations in that the perceptions were less than the expectations. Specifically, in the provision of physical care, the spouses' perceptions were below their expectations. In addition, nursing staff did not consistently achieve the goal of meeting the communicative and emotional needs of residents as perceived by their spouses. The conclusions support the need for nurses to consider improvements in nursing care through nursing research, specifically, in ascertaining the quality of care concept in this context. Through education, the impact of cognitive impairment as a chronic illness on the elderly person and his/her family could be better understood. Through practice, an improvement in the manner of physical and psychological care delivery could be realized. Finally, through administration, an examination of the structures supporting the delivery of nursing care to the cognitively-impaired elderly could lend motivation and assistance to the nurses responsible for care at the bedside.

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