Clinical Background of Attendance by Patient’s Family during Home Medical Care Visits

抄録

Background: In home medical care settings, some patients’ families always attend provider visits, and others only do so when needed. The clinical background behind this difference is not well defined.
Methods: A cross-sectional mail survey of families of Japanese patients who had previously received home medical care, asking whether the family had always been present the patient during home healthcare visits and their reasons. Survey results were analyzed with a multivariable adjusted logistic regression model based on the explanatory variables, for aspects related to the family’s attendance at provider visits.
Results: Among the 271 families contacted, 190 families who finally met the selection criteria were divided into two groups : 155 families (81.6%) who had always been present with the patient ; and 35 families (18.4%) who had done so only when needed. Constant attendance by family members was significantly associated with the level of care required (odds ratio [OR] : 1.40, 95% confidence interval [CI] : 1.05–1.89, p = 0.02) and age of the primary caregiver (OR : 1.05, 95% CI : 1.02–1.09, p = 0.03). However, when the family had difficulty communicating with the provider owing to the patient’s presence, families tended not to be present during visits by providers (OR : 0.41, 95% CI : 0.17–1.02, p = 0.06).
Conclusions: In home medical care settings, visiting healthcare providers should bear in mind that if the family is not always present with the patient, there is a possibility that the family is experiencing difficulty communicating with the provider owing to the patient’s presence.