Assessing family members' satisfaction with information sharing and communication during Hospital care at the end of life

Context: Despite the fact that most deaths occur in hospital, problems remain with how patients and families experience care at the end of life when a death occurs in a hospital. Objectives: (1) assess family member satisfaction with information sharing and communication, and (2) examine how satisfaction with information sharing and communication is associated with patient factors. Methods: Using a cross-sectional survey, data were collected from family members of adult patients who died in an acute care organization. Correlation and factor analysis were conducted, and internal consistency assessed using Cronbach's alpha. Linear regression was performed to determine the relationship among patient variables and satisfaction on the Information Sharing and Communication (ISC) scale. Results: There were 529 questionnaires available for analysis. Following correlation analysis and the dropping of redundant and conceptually irrelevant items, seven items remained for factor analysis. One factor was identified, described as information sharing and communication, that explained 76.3% of the variance. The questionnaire demonstrated good content and reliability (Cronbach's alpha 0.96). Overall, family members were satisfied with information sharing and communication (mean total satisfaction score 3.9, SD 1.1). The ISC total score was significantly associated with patient gender, the number of days in hospital before death, and the hospital program where the patient died. Conclusions: The ISC scale demonstrated good content validity and reliability. The ISC scale offers acute care organizations a means to assess the quality of information sharing and communication that transpires in care at the end of life. © Copyright 2013, Mary Ann Liebert, Inc.

Mitigating Cross-Network Interference in Cognitive Spectrum Sharing with Opportunistic Relaying

We examine the impact of primary and secondary interference on opportunistic relaying in cognitive spectrum sharing networks. In particular, new closed-form exact and asymptotic expressions for the outage probability of cognitive opportunistic relaying are derived over Rayleigh and Nakagami-m fading channels. Our analysis presents revealing insights into the diversity and array gains, diversity-multiplexing tradeoff, impact of primary transceivers' positions, and the optimal position of relays. We highlight that cognitive opportunistic relaying achieves the full diversity gain which is a product of the number of relays and the minimum Nakagami-m fading parameter in the secondary network. Furthermore, we confirm that the diversity gain reduces to zero when the peak interference constraint in the secondary network is proportional to the interference power from the primary network.