Dingley C E et al. – This prospective observational study assessed the communication behaviors associated with caregiver activation during home hospice visits of patients with advanced cancer. It provides guidance for caregiver activation through enhanced communication with nurses leading to patient–centered care and improved outcomes.

Methods

• Street’s Activation Verbal Coding tool was adapted for caregiver communication
• Codes were developed for nurse communications that preceded and followed each activation statement in 60 audio–recorded home hospice visits.

Results

• Caregiver activation included knowledge demonstration of patient/care, description of care strategies, expression of opinions regarding care, requesting explanations of care, expressing concern about the patient, and redirecting the conversation toward the patient.
• Nurses communicated by providing education, reassessing the patient/care environment, validating communications, clarifying care issues, updating/revising care, and making recommendations for future care.
• Caregiver activation was also facilitated by nurses through focused care–specific questions, open–ended questions/statements, and personal questions.