Development and Evaluation of a Family-Centered Nursing Care Model for Elderly Patients

Thesis Abstract

The increasing prevalence of chronic illnesses and age-related health conditions among the elderly population has underscored the critical need for comprehensive, patient-centered nursing care that actively involves family members to improve health outcomes and enhance quality of life. Despite recognition of the importance of family involvement, existing nursing care models often lack the systematic integration of family-centered principles tailored specifically for elderly patients, resulting in suboptimal patient engagement, caregiver burden, and healthcare utilization. This study aims to develop, implement, and evaluate a Family-Centered Nursing Care Model (FCNCM) tailored for elderly patients in community and hospital settings, with specific objectives to identify key components of family-centered care, construct and pilot the model, and assess its effectiveness on patient and family satisfaction, health status, and caregiver stress. Employing a mixed-methods research design, the study utilized both qualitative and quantitative approaches to ensure comprehensive understanding and rigorous evaluation. The qualitative phase involved thematic analysis of focus group discussions and in-depth interviews with 30 elderly patients, their family members, and healthcare professionals to identify core components and contextual factors for effective family-centered care. These insights informed the development of the FCNCM, which was subsequently piloted among 150 elderly patients receiving care at a metropolitan hospital and its affiliated community clinics. The quantitative phase employed a quasi-experimental, pretest-posttest approach with an intervention and control group, each comprising 75 elderly patients matched on age, gender, and health status. Data collection involved structured questionnaires for measuring patient satisfaction (using the Patient Satisfaction with Nursing Care Quality Questionnaire), caregiver stress (assessed via the Zarit Burden Interview), and health outcomes (via the Short Form Health Survey - SF-12). Additional data on family involvement, communication quality, and perceived support were obtained through tailored interview guides and observational checklists. Validity and reliability of instruments were established through pilot testing and Cronbach’s alpha analysis, yielding coefficients above 0.8. Data analysis employed descriptive statistics, paired and independent t-tests for comparing pre- and post-intervention scores, multivariate regression analysis to identify predictors of outcomes, and thematic analysis for qualitative data. The theoretical framework integrated the Family Systems Theory and the Pender Health Promotion Model, emphasizing holistic care and proactive family engagement. It is anticipated that the implementation of the FCNCM will significantly increase patient satisfaction scores (expected mean increase of 15%), reduce caregiver stress (by approximately 20%), and improve self-reported health status among elderly patients in the intervention group, compared to the control group. Qualitative findings are expected to reveal enhanced communication, perceived family support, and empowerment as key enablers of effective care. These outcomes will demonstrate that a systematically structured family-centered approach positively influences clinical and psychosocial dimensions of elderly care while fostering collaborative partnerships between health providers and families. The study contributes to nursing knowledge by providing a replicable, evidence-based model tailored for elderly populations, addressing the gaps identified in existing frameworks and guiding policy formulation for family-inclusive geriatric care. It underscores the importance of integrating family dynamics into nursing interventions and highlights the potential for improved health outcomes, caregiver well-being, and service satisfaction through targeted model implementation. In conclusion, the study affirms that a well-developed family-centered nursing care model significantly enhances the quality of elderly care and supports sustainable health system improvements. Based on the findings, it is recommended that healthcare institutions adopt and adapt the FCNCM within their geriatric services, incorporate family engagement training for nurses, and conduct further longitudinal studies to evaluate long-term impacts. Future research should explore the scalability of the model in diverse settings and its adaptation to different cultural contexts to ensure broad applicability and effectiveness.