Assessments of unmet communication needs and quality of staff-family communication at geriatric facilities: Instruments development and psychometric testing.

Background: Despite an acknowledged need to improve communication between staff and family caregivers of non-communicative care recipients (i.e., care recipients who are unable to engage in discussions with the medical staff about their treatment and care at geriatric facilities), no tools exist to measure the quality of this communication nor the extent to which family caregivers' communication needs are met. Objective: To develop and test two assessment tools to evaluate the extent to which family caregivers' communication needs are met according to family caregivers and for evaluating the quality of communication with the staff member most often consulted. Design: Instrument development, including reliability, validity, and construct testing. Settings: Five geriatric facilities (two geriatric medical centers and three nursing homes) in Israel. Participants: 128 family caregivers of non-communicative care recipients at geriatric facilities. Methods: Based on our previous findings, we developed the Family Caregiver's Communication Needs Questionnaire, which assesses the extent to which family caregivers' communication needs are met according to them, and the Staff-Family Quality of Communication Questionnaire, which evaluates the quality of communication with the staff member most often consulted. We conducted personal interviews with the participants to explore both tools' items and reliability and examined the reliability and convergent validity of the Family Caregiver's Communication Needs Questionnaire in a different sub-sample. The Family Caregiver's Communication Needs Questionnaire's construct was tested using a factor analysis. Results: Both tools' internal consistency reliabilities were high (Family Caregiver's Communication Needs Questionnaire, Cronbach's α = 0.92, 23 items; Staff-Family Quality of Communication Questionnaire, α = 0.86, 8 items). Exploratory factor analysis for the Family Caregiver's Communication Needs Questionnaire reinforced the four factors that emerged in a prior study (staff's availability and attitude, relating to family caregivers' caregiving experience, clarity and reliability of information, and language barriers), accounting together for 63.3 % of the variance. Both tools demonstrated good convergent validity. Conclusions: The Family Caregiver's Communication Needs Questionnaire and Staff-Family Quality of Communication Questionnaire are valid and reliable tools for assessing the quality of staff-family communication, assisting in identifying communication strengths and weaknesses, suggesting potential interventions for improved communication, and providing outcome measures for such interventions.