Conflict between Family Caregivers and Staff in Nursing Homes: Feasibility of the Daily Diary Method.

Objective: The purpose of this study was to investigate the daily diary method (DDM) for assessing family-staff conflicts in nursing homes, to provide descriptive information on conflict, and to examine the relationship between conflict and mood among family caregivers.

Methods: Participants were nine caregivers that experienced conflict with staff on an ongoing basis. They were contacted daily by telephone for 14 days and were asked (1) whether a conflict had occurred, (2) to describe the severity and type of conflict, and (3) to rate their positive and negative affect.

Results: Compliance was excellent with no attrition, and there were only 2 missing data points over 126 potential observations. Conflicts occurred on 22% of the days, were rated as moderately severe, and were related to poor resident care, lack of information, and staff attitudes. Participants reported significantly lower positive affect (p < .05) and higher negative affect (p < .001) on conflict versus no-conflict days. Exit interviews indicated positive attitudes towards the DDM.

Conclusions: These results support the feasibility of the DDM for providing an in-depth understanding of family-staff conflict and its relationship to caregivers' mood.

Clinical Implications: The DDM would ideally be used as an outcome measure in studies that assess interventions that target high-conflict family-staff relationships.