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Nigg JK, Arendt SW, Sapp SG. Development of the Food-Related Control Scale for Long-Term Care. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00350-6. [PMID: 38912984 DOI: 10.1016/j.jneb.2024.05.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE Develop and test a Food-Related Control Scale (FRCS) measuring resident-perceived control in long-term care food service. DESIGN A bank of 15 initial items based on a multidimensional locus of control construct was developed initially. Expert review, cognitive interviews, a pilot study, and factor analysis were used to validate the instrument and assess reliability. SETTING Individual phone-based cognitive interviews and 16 skilled nursing facilities in the US. PARTICIPANTS Cognitive interviews included a convenience sample of independently living adults aged ≥ 65 (n = 13), whereas the pilot study included skilled nursing facility-residing adults (n = 166). VARIABLES MEASURED Perception of food-related control in a long-term care setting. ANALYSIS Cognitive interviews were analyzed to develop items. Quantitative data from skilled nursing facility residents were analyzed using SAS software for structural equation modeling and factor analysis. RESULTS A 2-dimensional construct (9 items) of the FRCS demonstrated reliability with factor analysis. Concurrent validity within the locus of control construct was demonstrated with the Multidimensional Health Locus of Control Scale (standardized estimate of 0.430; P < 0.1). CONCLUSIONS AND IMPLICATIONS The FRCS may be used to determine how residents in long-term care perceive control over their food experiences. Further testing is necessary to determine the appropriateness of the FRCS for different population uses.
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Affiliation(s)
- Jessica K Nigg
- Department of Family and Consumer Sciences, Bradley University, Peoria, IL.
| | - Susan W Arendt
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, IA
| | - Stephen G Sapp
- Department of Sociology, Iowa State University, Ames, IA
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Shrestha S, Cummings G, Knopp-Sihota J, Devkota R, Hoben M. Factors influencing health-related quality of life among long-term care residents experiencing pain: a systematic review protocol. Syst Rev 2024; 13:49. [PMID: 38303055 PMCID: PMC10832087 DOI: 10.1186/s13643-024-02459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Pain is highly burdensome, affecting over 30% of long-term care (LTC) residents. Pain significantly reduces residents' health-related quality of life (HRQoL), limits their ability to perform activities of daily living (ADLs), restricts their social activities, and can lead to hopelessness, depression, and unnecessary healthcare costs. Although pain can generally be prevented or treated, eliminating pain may not always be possible, especially when residents have multiple chronic conditions. Therefore, improving the HRQoL of LTC residents with pain is a priority goal. Understanding factors influencing HRQoL of LTC residents with pain is imperative to designing and evaluating targeted interventions that complement pain management to improve residents' HRQoL. However, these factors are poorly understood, and we lack syntheses of available research on this topic. This systematic review protocol outlines the methods to identify, synthesize, and evaluate the available evidence on these factors. METHODS This mixed methods review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We will systematically search Medline, EMBASE, PsycINFO, CINAHL, Scopus, Cochrane Database of Systematic Reviews and ProQuest Dissertation and Thesis Global from database inception. We will include primary studies and systematically conducted reviews without restrictions to language, publication date, and study design. We will also include gray literature (dissertation and reports) and search relevant reviews and reference lists of all included studies. Two reviewers will independently screen articles, conduct quality appraisal, and extract data. We will synthesize results thematically and conduct meta-analyses if statistical pooling is possible. Residents and family/friend caregivers will assist with interpreting the findings. DISCUSSION This proposed systematic review will address an important knowledge gap related to the available evidence on factors influencing HRQoL of LTC residents with pain. Findings will be crucial for researchers, LTC administrators, and policy makers in uncovering research needs and in planning, developing, and evaluating strategies in addition to and complementary with pain management to help improve HRQoL among LTC residents with pain. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023405425.
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Affiliation(s)
- Shovana Shrestha
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
| | - Greta Cummings
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer Knopp-Sihota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Health Disciplines, Athabasca University, Edmonton, Alberta, Canada
| | - Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada
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Keefe JM, Taylor D, Irwin P, Hande MJ, Hubley E. Do Residential Long-Term Care Policies Support Family Involvement in Residents' Quality of Life in Four Canadian Provinces? J Aging Soc Policy 2024; 36:43-68. [PMID: 36367098 DOI: 10.1080/08959420.2022.2138066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022]
Abstract
Family members are essential contributors to the quality of life (QoL) of persons living in residential long-term care (RLTC). This paper analyzes how the system enables or inhibits family involvement with residents in RLTC. Our analysis of 21 policies that regulate long-term care in four Canadian Provinces reveal differences in their portrayal of residents' families. Family roles are characterized procedurally (task-oriented) or relationally (interactive). Operational standards linked to licensing of RLTC homes employ more formal terminology, while RLTC program guidelines, use facilitative language to engage families and build relationships. Examples of orientation procedures, care protocols, living at risk, and end-of-life care reveal inter-provincial variations. We argue that there are opportunities to further engage families within the current regulatory framework and improve their continued contributions in the post-pandemic era.
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Affiliation(s)
- Janice M Keefe
- Department Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Deanne Taylor
- Interior Health Authority, Kelowna, British Columbia, Canada
- Rural Coordination Centre of British Columbia
| | - Pamela Irwin
- Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Mary Jean Hande
- Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Department of Sociology Trent University
| | - Emily Hubley
- Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Irwin P, Taylor D, Keefe JM. Provincial policies affecting resident quality of life in Canadian residential long-term care. BMC Geriatr 2023; 23:362. [PMID: 37296381 PMCID: PMC10252178 DOI: 10.1186/s12877-023-04074-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The precautions and restrictions imposed by the recent Covid-19 pandemic drew attention to the criticality of quality of care in long-term care facilities internationally, and in Canada. They also underscored the importance of residents' quality of life. In deference to the risk mitigation measures in Canadian long-term care settings during Covid-19, some person-centred, quality of life policies were paused, unused, or under-utilised. This study aimed to interrogate these existing but latent policies, to capture their potentiality in terms of positively influencing the quality of life of residents in long-term care in Canada. METHODS The study analysed policies related to quality of life of long-term care residents in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia). Three policy orientations were framed utilising a comparative approach: situational (environmental conditions), structural (organisational content), and temporal (developmental trajectories). 84 long term care policies were reviewed, relating to different policy jurisdictions, policy types, and quality of life domains. RESULTS Overall, the intersection of jurisdiction, policy types, and quality of life domains confirms that some policies, particularly safety, security and order, may be prioritised in different types of policy documents, and over other quality of life domains. Alternatively, the presence of a resident focused quality of life in many policies affirms the cultural shift towards greater person-centredness. These findings are both explicit and implicit, and mediated through the expression of individual policy excerpts. CONCLUSION The analysis provides substantive evidence of three key policy levers: situations-providing specific examples of resident focused quality of life policy overshadowing in each jurisdiction; structures-identifying which types of policy and quality of life expressions are more vulnerable to dominance by others; and trajectories-confirming the cultural shift towards more person-centredness in Canadian long-term care related policies over time. It also demonstrates and contextualises examples of policy slippage, differential policy weights, and cultural shifts across existing policies. When applied within a resident focused, quality of life lens, these policies can be leveraged to improve extant resource utilisation. Consequently, the study provides a timely, positive, forward-facing roadmap upon which to enhance and build policies that capitalise and enable person-centredness in the provision of long-term care in Canada.
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Affiliation(s)
- Pamela Irwin
- Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, NS Canada
| | - Deanne Taylor
- Interior Health Authority, Kelowna, BC Canada
- Rural Coordination Centre of British Columbia, Vancouver, BC Canada
| | - Janice M. Keefe
- Nova Scotia Centre on Aging, Mount Saint Vincent University, Halifax, NS Canada
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS Canada
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Exploring what matters to residents of Australian aged care facilities with the Happy Life Index: comparison of qualitative responses between pre- and mid-Covid-19 pandemic time points. Qual Life Res 2023:10.1007/s11136-023-03387-0. [PMID: 36928652 PMCID: PMC10019411 DOI: 10.1007/s11136-023-03387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE This study analysed data from a national survey of people living in Australian Residential Aged Care Facilities (RACFs) reporting on what is the best thing about where they live and suggestions for improvement. Data from prior to the Covid-19 pandemic were compared with data during the Covid-19 pandemic. METHODS Qualitative data from the Happy Life Index Survey were analysed using summative content analysis to code the responses in the data sets and then organise them into categories. Once categorised, the pre-Covid-19 and mid-Covid-19 data sets were compared using descriptive statistics. RESULTS A total of 4745 residents, from over 100 RACFs, provided 8512 open-text responses to at least one of the two survey questions. Pre-Covid-19 responses were compared with mid-Covid-19 responses and those trending towards relevance (5-10% change) were identified. There were both positive and negative relevant percent changes for staff number, food (general comments), and friendliness. A trending positive percentage change was observed for staff quality and the internal environment. There was a trending negative relevant percentage change for lifestyle activities, staff generally, level of contentedness, the general environment, general choice, and general views about the service. CONCLUSION People living in RACFs notice the changes in staffing levels and visitors during restrictions imposed during infectious outbreaks. During these times, they appreciate the quality of the staff attending to their needs and the quality of their food. Further exploration is needed of the value of lifestyle activities and strategies to promote feelings of contentedness and general wellbeing during times of restriction.
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Burgess EO, Kemp CL, Bender AA. "It's Going to be Different for Everyone": Negotiating Quality of Life and Care Priorities Within Care Convoys. J Aging Health 2021; 34:602-613. [PMID: 34866447 DOI: 10.1177/08982643211052367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The overall goal of this analysis was to learn about residents' quality of life and quality of care in assisted living over time and from multiple viewpoints within support networks. Method: This grounded theory analysis examined qualitative data collected from 50 residents and 169 of their care network members followed over two consecutive 2-year periods in 8 diverse settings. Results: Quality involved a dynamic process of "negotiating priorities," which refers to working out what is most important for residents' quality of life and care. Resident and care partner priorities were not always consistent or shared, in part because quality is personal, subjective, dynamic, and situational. Discussion: Communication and collaboration among formal and informal care partners are vital to residents' ability to age in place with a high quality of life and quality care.
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Affiliation(s)
| | - Candace L Kemp
- The Gerontology Institute, Georgia State University, Atlanta, GA, USA
| | - Alexis A Bender
- Emory University School of Medicine, Division of Geriatrics and Gerontology, Atlanta, GA, USA
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Nygaard A, Halvorsrud L, Grov EK, Bergland A. What matters to you when the nursing is your home: a qualitative study on the views of residents with dementia living in nursing homes. BMC Geriatr 2020; 20:227. [PMID: 32600264 PMCID: PMC7325251 DOI: 10.1186/s12877-020-01612-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dementia is recognised as one of the greatest global public health challenges. A central tenet of national health and social care policy is to ensure that services support people in achieving their personal well-being and outcomes, defined as the things important to people in their lives, also people with dementia. The aim of this study is to explore what matters to nursing home residents with dementia based on their perceptions of nursing homes as home. METHODS There were conducted 35 interviews with people with dementia in nursing homes. We conducted the in-depth unstructured qualitative interviews. Thematic analysis was applied to analyse the data. RESULTS The analysis resulted in one over-arching theme "tension between the experiences of a nursing home being a home and an institution" and five themes; "myself and my relationships with fellow residents", "creation of individualised living spaces", "single rooms with personal decor that enhances a sense of connectedness", "transition between the old home and the new home" and "significant activities providing meaning". The participants stated that the transition to the supported, structured living environment in nursing homes to be a clear need based on immediate, serious safety concerns. They went from being masters of their own lives to adhering to nursing home routines. Fellow residents could be both resources and burdens, creating feelings of security and insecurity. A home-like environment was created by allowing the participants to bring their important personal belongings into private spaces. The participants said they needed to be able to decorate their rooms to their own specifications. They wanted involvement in meaningful activities. CONCLUSIONS The findings showed that 'home' was an emotive word that awakened many associations. The participants reported mixed feelings and stated that they could thrive even if they missed their old homes. What mattered was that the participants felt safe, had single rooms where they could retire from the community, their own belongings and did activities. The participants wanted greater possibilities for meaningful relations. They appreciate that nursing home were similar to their previous homes. They desired opportunities to continue some activities they did in their former home.
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Affiliation(s)
- Agnete Nygaard
- OsloMet-Metropolitan University, Faculty of Health Sciences, 0130, Oslo, Norway.
- Lørenskog Municipality, Centre for Development of Institutional and Home Care Services, Lørenskog, Akershus, Norway.
| | - Liv Halvorsrud
- OsloMet-Metropolitan University, Faculty of Health Sciences, 0130, Oslo, Norway
| | - Ellen Karine Grov
- OsloMet-Metropolitan University, Faculty of Health Sciences, 0130, Oslo, Norway
| | - Astrid Bergland
- OsloMet-Metropolitan University, Faculty of Health Sciences, 0130, Oslo, Norway
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