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Karmacharya I, Janssen LM, Brekke B. "Let Them Know That They're Appreciated": The Importance of Work Culture on Direct Care Worker Retention. J Gerontol Nurs 2023; 49:7-13. [PMID: 37523340 DOI: 10.3928/00989134-20230706-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Retaining direct care workers (DCWs) in all areas of long-term services and supports (LTSS) remains an unending challenge. The current study purposively selected 12 high-performing LTSS communities (e.g., nursing homes, assisted living, home care agencies) in Ohio with high family satisfaction and staff retention. Qualitative interviews were conducted in 2022 with 21 personnel in leadership positions and 16 DCWs (e.g., certified nursing assistants, personal care aides). Interviews were audio recorded, transcribed, and a team of two coders conducted the thematic analysis. Three themes of work culture emerged as important for retention: (1) Family-Like Organizational Approach, (2) Supportive Working Conditions, and (3) Worker Empowerment. DCWs valued empathic relationships with their clients and supervisors. Favorable working conditions consisted of choice, participative leadership, and effective communication. DCWs experienced empowerment through appreciation, financial incentives, and career advancement opportunities. Findings suggest practical changes for person-centered care practitioners that are feasible across any organizational work culture setting. [Journal of Gerontological Nursing, 49(8), 7-13.].
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Um-E-Rubbab, Farid T, Iqbal S, Saeed I, Irfan S, Akhtar T. Impact of Supportive Leadership During Covid-19 on Nurses' Well-Being: The Mediating Role of Psychological Capital. Front Psychol 2021; 12:695091. [PMID: 34659011 PMCID: PMC8515951 DOI: 10.3389/fpsyg.2021.695091] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/03/2021] [Indexed: 11/13/2022] Open
Abstract
The corona virus disease (Covid-19) has significantly affected the social, physical, and psychological health of workers, specifically the nurses working in the healthcare sectors. Studies have been conducted on the impact of Covid-19 on employees' well-being, organizational structure, and job design; however, limited studies have been conducted focusing on the impact of leadership on employee's well-being during the Covid-19 pandemic. Drawing on job demands resources model and social exchange theory, we examined the impact of supportive leadership on employees' physical, social, and psychological well-being during the Covid-19 pandemic. In addition, we examined the mediating role of psychological capital in examining the relationship between supportive leadership and employees' physical, social, and psychological well-being. Based on three wave time-lagged design, the data were collected from 214 nurses' linear regression analysis and Hayes Process for mediation to test the proposed hypothesis. As hypothesized, supportive leadership predicted employees' physical, social, and psychological well-being. In addition, psychological capital mediated the relationship between supportive leadership and employees' physical, social, and psychological well-being. Implications for research, theory, and practice are discussed.
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Affiliation(s)
- Um-E-Rubbab
- Department of Business Administration, Fatima Jinnah Women University, Rawalpindi, Pakistan
| | - Tahir Farid
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China.,Department of Psychology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Sadaf Iqbal
- Department of Psychology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Imran Saeed
- Institute of Business and Management Science, The University of Agriculture, Peshawar, Pakistan
| | - Shahid Irfan
- Department of Psychology, Foundation University, Islamabad, Pakistan
| | - Tanvir Akhtar
- Department of Psychology, Foundation University, Islamabad, Pakistan
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Places of living and places of dying: the case for preventing suicide in residential long-term care. AGEING & SOCIETY 2021; 41:1945-1960. [PMID: 34621099 DOI: 10.1017/s0144686x20000173] [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: 11/05/2022]
Abstract
This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders - societal, organisational and individual - considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.
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Zhao Y, Liu L, Chan HYL. Dementia care education interventions on healthcare providers' outcomes in the nursing home setting: A systematic review. Res Nurs Health 2021; 44:891-905. [PMID: 34431120 DOI: 10.1002/nur.22180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/20/2021] [Accepted: 08/13/2021] [Indexed: 11/09/2022]
Abstract
Given the increasing prevalence of people with dementia in long-term care, various educational interventions have been developed to enhance the dementia care competence of healthcare providers. The study aim was to appraise the evidence of the effects of dementia care educational programs on improving the preparedness of nursing home staff. Articles on dementia care education interventions for nursing home staff were searched from eight databases. The primary outcomes were staff knowledge, attitude, competence, and sense of competence or self-efficacy related to dementia. The secondary outcomes were psychological outcomes, including burnout, caregiving stress, well-being, and job satisfaction. The quality of evidence was appraised using the Joanna Briggs Institute Critical Appraisal tool. Out of the 3269 articles identified, 19 randomized controlled trials comprising 3947 participants from eight countries were included. The methodological quality of included studies was fair. A significant improvement in staff knowledge regarding dementia was reported. The intervention effects on attitudes and competence were insignificant, and the effects on the sense of competence or self-efficacy related to dementia care were inconsistent. The effects on psychological outcomes seem limited because few significant changes were found. Multiple teaching methods, peer support, qualified trainers, and post-training support were effective components in designing the educational interventions. However, given the variations in content and dose and the methodological limitations of the included studies, the effects of educational programs were inconclusive. The findings highlight the necessity of high-quality studies on dementia-care educational interventions, especially in other cultures than Western countries, such as in Asia.
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Affiliation(s)
- Yayi Zhao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,School of Nursing, Nanjing University of Chinese Medicine, Xianlin, Nanjing, Jiangsu, China
| | - Li Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Helen Yue-Lai Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Lood Q, Kirkevold M, Edvardsson D. Becoming part of an upwards spiral: Meanings of being person-centred in nursing homes. Int J Older People Nurs 2021; 17:e12420. [PMID: 34423910 DOI: 10.1111/opn.12420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/23/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Previous research suggests that person-centred care is positive for people living in nursing homes, but less is known on what motivates people working in nursing homes to be person-centred. Previous research has focused on person-centred care in relation to people in need of care, which may lead to a risk of viewing person-centred care as a means to achieve quality of care, and not as a means in itself. Therefore, this study aimed to illuminate meanings of being person-centred as narrated by people working in nursing homes. METHODS A total of 23 persons working in a nursing home in rural Australia participated in group and individual interviews, conducted and interpreted in respect to a phenomenological hermeneutic approach. RESULTS The thematic structure as emerging from structural analyses of the text indicated that being person-centred involved a joint effort to think differently on what you do and why you do it interpreted as; Doing what you know and feel is the right thing to do, Being a person with and for another person, and Striving to do and be better together. The comprehensive understanding of these findings was that being person-centred means becoming part of an upwards spiral of doing person-centred actions and being person-centred to become even more person-centred and to feel a sense of belonging to a person-centred culture. CONCLUSIONS Denoting the importance of being more of a person in one's professional role, this study highlights health aspects of being person-centred from the perspective of people working in nursing homes, and complements previous research that describes the impact of person-centred care on people in need of care. The findings could be applied to facilitate person-centred care in nursing home contexts, and to develop prevention strategies to diminish negative impacts on person-centred doing, being, becoming and belonging.
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Affiliation(s)
- Qarin Lood
- Institute of neuroscience and physiology, Department of health and rehabilitation, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.,Department of Nursing, Umeå University, Umeå, Sweden.,College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Marit Kirkevold
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden.,College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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Tian L, Li H, Dong B, Xie C, Wang H, Lin L. The supportive supervisory scale: psychometric properties in Chinese health care aides samples. Health Qual Life Outcomes 2021; 19:60. [PMID: 33622357 PMCID: PMC7903650 DOI: 10.1186/s12955-021-01706-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To sinicize the Supportive Supervisory Scale (SSS) and analyze the psychometric properties of the Chinese version of SSS (SSS-C). Methods The SSS (the original English version) was firstly sinicized and adjusted, then its psychometric properties were examined in 300 health care aides from four long-term care (LTC) facilities. SPSS 22.0 was used to process the data and calculate the reliability and validity. Results The 15-item SSS-C had satisfactory internal consistency (Cronbach’s α coefficient = 0.852), split half reliability (Spearman-Brown coefficient = 0.834) and test–retest reliability (Pearson correlation coefficient = 0.784), and three factors were extracted. If the four items with their communality < 0.4 were deleted, the remaining 11 items could explain 55.654% of the total variance. The discriminant validity of the SSS-C varied significantly between sites. Conclusions The Chinese version of SSS can be used to effectively measure the supervisory support of the nurses within the LTC settings.
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Affiliation(s)
- Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China. .,School of Nursing, Medical College of Soochow University, No. 1 Shizi Street, 215006, Suzhou, People's Republic of China.
| | - Haixia Li
- School of Nursing, Medical College of Soochow University, No. 1 Shizi Street, 215006, Suzhou, People's Republic of China.,Suzhou Jiulong Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, People's Republic of China
| | - Bei Dong
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.,School of Nursing, Medical College of Soochow University, No. 1 Shizi Street, 215006, Suzhou, People's Republic of China
| | - Congyan Xie
- School of Nursing, Medical College of Soochow University, No. 1 Shizi Street, 215006, Suzhou, People's Republic of China
| | - Hong Wang
- School of Nursing, Medical College of Soochow University, No. 1 Shizi Street, 215006, Suzhou, People's Republic of China.,Suzhou Jiulong Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, People's Republic of China
| | - Lu Lin
- The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China. .,School of Nursing, Medical College of Soochow University, No. 1 Shizi Street, 215006, Suzhou, People's Republic of China.
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Prentice J, Weatherall M, Grainger R, Levack W. 'Tell someone who cares': Participation action research on workplace engagement of caregivers in aged residential care, NZ. Australas J Ageing 2020; 40:e109-e115. [PMID: 33124147 DOI: 10.1111/ajag.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 09/12/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To use participatory action research (PAR) to understand workplace engagement of caregivers in aged residential care (ARC) in New Zealand. METHODS A PAR study was conducted in a 40-bed ARC facility providing rest home- and hospital-level care in rural New Zealand. The four-step study included an advisory group of caregivers (N = 6) who co-designed the process. Data were collected via verbatim transcripts of four advisory group meetings, five interviews with staff and field notes over a period of six months. The data were analysed using thematic analysis. RESULTS A model was developed to describe factors that encouraged caregivers' engagement in their work. Caregivers were more engaged in their workplace when the influencers of 'Communication', 'Contributing to the workplace' and 'Caring for oneself' were present and when they experienced 'feeling valued', 'being heard' and 'being listened to'. CONCLUSION Factors influencing positive changes in workplace engagement were identified that could be considered when implementing organisational change or service development in other ARC facilities. These factors could potentially increase productivity and quality of care at little cost, as well as improve workplace satisfaction.
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Affiliation(s)
| | - Mark Weatherall
- Department of Medicine, Otago University, Wellington, New Zealand
| | - Rebecca Grainger
- Department of Medicine, Otago University, Wellington, New Zealand
| | - William Levack
- Department of Medicine, Otago University, Wellington, New Zealand
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Vassbø TK, Bergland Å, Kirkevold M, Lindkvist M, Lood Q, Sandman P, Sjögren K, Edvardsson D. Effects of a person-centred and thriving-promoting intervention on nursing home staff job satisfaction: A multi-centre, non-equivalent controlled before-after study. Nurs Open 2020; 7:1787-1797. [PMID: 33072363 PMCID: PMC7544881 DOI: 10.1002/nop2.565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/03/2020] [Accepted: 06/26/2020] [Indexed: 12/02/2022] Open
Abstract
Aim To evaluate the effects of a person‐centred and thriving‐promoting intervention in nursing homes on staff job satisfaction, stress of conscience and the person‐centredness of care and of the environment. Design A multi‐centre, non‐equivalent control group, before–after trial design. Methods Staff (N = 341) from six nursing homes in Australia, Norway and Sweden were assigned to the intervention or the control group and both groups were evaluated before the intervention, immediately after and by 6 months follow‐up. Staff completed a questionnaire about job satisfaction (primary endpoint), stress of conscience and the person‐centredness of care and of the environment (secondary endpoints). Linear regression models were used to identify the mean scores and to analyse group differences to test the effects of the intervention. Results The intervention had no statistically significant effects on staff job satisfaction, level of stress of conscience or the perceived person‐centredness of care and of the environment.
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Affiliation(s)
- Tove Karin Vassbø
- Faculty of MedicineInstitute of Health and SocietyOslo UniversityOsloNorway
- Lovisenberg Diaconal University CollegeOsloNorway
| | | | - Marit Kirkevold
- Faculty of MedicineInstitute of Health and SocietyOslo UniversityOsloNorway
- Institute of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
| | - Marie Lindkvist
- Department of Epidemiology and Global HealthUmeå UniversityUmeåSweden
| | - Qarin Lood
- Department of Health and RehabilitationInstitute of Neuroscience and PhysiologySahlgrenska AcademyCentre for Ageing and Health (AgeCap)University of GothenburgGothenburgSweden
- Department of NursingUmeå UniversityUmeåSweden
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVic.Australia
| | - Per‐Olof Sandman
- Department of NursingUmeå UniversityUmeåSweden
- NVSDepartment of NursingKarolinska InstitutetStockholmSweden
| | | | - David Edvardsson
- Department of NursingUmeå UniversityUmeåSweden
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVic.Australia
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Haugan G, Kuven BM, Eide WM, Taasen SE, Rinnan E, Xi Wu V, Drageset J, André B. Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents? BMC Geriatr 2020; 20:168. [PMID: 32381032 PMCID: PMC7203905 DOI: 10.1186/s12877-020-01555-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022] Open
Abstract
Background Due to the shift to an older population worldwide and an increased need for 24-h care, finding new and alternative approaches to increase wellbeing among nursing home (NH) residents is highly warranted. To guide clinical practice in boosting wellbeing among NH residents, knowledge about nurse-patient interaction (NPI), inter- (ST1) and intra-personal (ST2) self-transcendence and meaning-in-life (PIL) seems vital. This study tests six hypotheses of the relationships between NPI, ST1, ST2 and PIL among cognitively intact NH residents. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH residents representing 27 NHs responded to NPI, ST, and the PIL scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations between the latent constructs were tested through structural equation modeling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2 = 146.824, p = 0.021, df = 114, χ2/df = 1.29 RMSEA = 0.040, p-close 0.811, CFI = 0.97, TLI = 0.96, and SRMR = 0.063), supporting five of the six hypothesized relationships between the constructs of NPI, ST1, ST2 and PIL. Conclusion NPI significantly relates to both ST1, ST2 and PIL in NH residents. ST revealed a fundamental influence on perceived PIL, while NPI demonstrated a significant indirect influence on PIL, mediated by ST.
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Affiliation(s)
- Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway. .,NORD University, Faculty of Nursing and Health Science, Levanger, Norway.
| | - Britt Moene Kuven
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Eva Rinnan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Trondheim Municiaplity, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, The National University of Singapore, Singapore, Singapore
| | - Jorunn Drageset
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway.,Department of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Beate André
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Smith-MacDonald L, Venturato L, Hunter P, Kaasalainen S, Sussman T, McCleary L, Thompson G, Wickson-Griffiths A, Sinclair S. Perspectives and experiences of compassion in long-term care facilities within Canada: a qualitative study of patients, family members and health care providers. BMC Geriatr 2019; 19:128. [PMID: 31060500 PMCID: PMC6503362 DOI: 10.1186/s12877-019-1135-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/11/2019] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION This paper details a subset of the findings from a participatory action research project exploring a palliative intervention in long-term care sites across Canada. The findings presented in this paper relate to understanding compassion within the context of a palliative approach to long-term care. METHODS Findings presented are drawn from qualitative interviews and focus groups with residents, family members, healthcare providers, and managers from 4 long-term care sites across 4 provinces in Canada. In total, there were 117 individuals (20 residents, 16 family members, 72 healthcare providers, and 9 managers) who participated in one of 19 focus groups. Data was analyzed by multiple members of the research team in accordance with thematic analysis. Individual concepts were organized into themes across the different focus groups and the results were used to build a conceptual understanding of compassion within Long Term Care . FINDINGS Two themes, each comprised of 5 sub-themes, emerged from the data. The first theme 'Conceptualizing Compassion in Long-Term Care generated a multidimensional understanding of compassion that was congruent with previous theoretical models. 'Organizational Compassion: resources and staffing', the second major theme, focused on the operationalization of compassion within the practice setting and organizational culture. Organizational Compassion subthemes focused on how compassion could support staff to enact care for the residents, the families, one another, and at times, recognizing their pain and supporting it through grief and mourning. CONCLUSIONS Results suggest that compassion is an essential part of care and relationships within long-term care, though it is shaped by personal and professional relational aspects of care and bound by organizational and systemic issues. Findings suggest that compassion may be an under-recognised, but essential element in meeting the promise of person-centred care within long-term care environments.
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Affiliation(s)
- Lorraine Smith-MacDonald
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Lorraine Venturato
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.,Dementia and Cognitive Impairment NeuroTeam, Hotchkiss Brain Institute, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Paulette Hunter
- St. Thomas More College, University of Saskatchewan, 1437 College Drive, Saskatoon, SK, S7N 0W6, Canada
| | - Sharon Kaasalainen
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Tamara Sussman
- School of Social Work, McGill University, 845 Sherbrooke Street West, Montreal, QC, H3A 0G4, Canada
| | - Lynn McCleary
- Department of Nursing, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Genevieve Thompson
- College of Nursing, Max Rady Faculty of Health Sciences, University of Manitoba, Helen Glass Centre for Nursing, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
| | | | - Shane Sinclair
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. .,Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. .,Compassion Research Lab, Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N1N4, Canada.
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11
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Danaci E, Koç Z. The association of job satisfaction and burnout with individualized care perceptions in nurses. Nurs Ethics 2019; 27:301-315. [DOI: 10.1177/0969733019836151] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Individualized care is closely related to the fulfillment of nurses’ ethical responsibilities regarding the provision of healthcare as well as having a strong foundation in the philosophy of nursing. Objective: This study aimed to determine the association of job satisfaction and burnout with individualized care perceptions in nurses working at a university hospital located in the Central Black Sea region of northern Turkey. Research design: A cross-sectional correlational survey design. Participants and research context: The study was conducted between 15 February 2017 and 15 August 2017 with 419 nurses working at a public university hospital located in Samsun. Data were collected using an information form, the Individualized Care Scale-Nurse Version, the Minnesota Job Satisfaction Scale, and the Maslach Burnout Inventory. The Mann–Whitney U test, Kruskal–Wallis test and Spearman Correlation were used. Ethical considerations: Ethical approval for the study was obtained from the Ondokuz Mayıs University Clinical Studies Board of Ethics. Oral informed consent was taken from the participants. Findings: There was a significant positive relationship between the total Individualized Care Scale-A Nurse Version score and the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale (r = 0.121, p < 0.05). The total Individualized Care Scale-A Nurse Version score increased as the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale increased. There was a significant negative relationship between the total Individualized Care Scale-B Nurse Version score and the Desensitization (r = –0.143, p < 0.01) and Personal Achievement subscale scores of the Maslach Burnout Inventory (r = –0.182, p < 0.01). The Desensitization and Personal Achievement subscale scores of the Maslach Burnout Inventory increased as the total Individualized Care Scale-B Nurse Version score decreased. Discussion: Factors associated with the individualized care perceptions of nurses, such as job satisfaction and burnout levels and factors related to personal life and worklife should be taken into consideration. Also in order to increase job satisfaction and motivation in nurses, personal preferences regarding the service they want to work at should be taken into account. Conclusion: Nurses with lower burnout and higher job satisfaction were found to have higher individualized care perceptions and to support the individuality of patients in care applications. It is important to consider work-related factors associated with individualized care perceptions, job satisfaction, and burnout in nurses.
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12
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Zhang N, Gong ZX, Xu Z, Gilal FG. Ethical climate and service behaviours in nurses: The moderating role of employment type. J Adv Nurs 2019; 75:1868-1876. [PMID: 30697786 DOI: 10.1111/jan.13961] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/09/2018] [Accepted: 12/19/2018] [Indexed: 11/27/2022]
Abstract
AIM To explore the relationship between ethical climate (EC) and nurses' service behaviours (SB) and examine the moderating effect of nurses' employment type. BACKGROUND As most public hospitals in China implement the "dual-track system" of nurses' employment, the two different types of nurses, contract-employed nurses and state-employed nurses, receive the different pay for the same work, which results in they providing different SB. It has become critical for hospital administrators and nursing managers to understand better the state of two groups of nurses and to find an effective method to improve the service level of the nursing workforce. DESIGN Stepwise multiple regression analyses of survey data collected in June and July 2017 from Chinese nurses employed in three tertiary hospitals. METHODS Chinese nurses (298 of 350 [85.1%]) were interviewed using the Ethical Climate Scale and Nurses' Service Behaviour Scale. Data were analysed statistically using descriptive statistics, confirmatory factor analysis, correlation coefficients (Pearson), two-tailed t-test and stepwise multiple regression analyses were conducted to test the proposed hypotheses. Data were analysed using SPSS and AMOS. RESULTS There were statistically significant correlations between EC and nurses' extra-role service behaviour (ERSB) and overall service behaviour and nurses' employment type moderated the proposed relationships. CONCLUSION Healthcare institutions should pay more attention to cultivate EC and implement new incentive mechanism to better stimulate nurses to provide ERSB.
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Affiliation(s)
- Na Zhang
- School of Economics and Management, Beijing Information Science & Technology University, Beijing, China
| | - Zhen-Xing Gong
- School of Business, Liaocheng University, Liaocheng, China
| | - Zhen Xu
- Medical School, Hebei University of Engineering, Handan, China
| | - Faheem Gul Gilal
- Department of Business Administration, Sukkur IBA University, Sukkur, Pakistan
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Nordlander M, Isaksson U, Hörnsten Å. Perceptions of What Is Important for Appetite-An Interview Study With Older People Having Food Distribution. SAGE Open Nurs 2019; 5:2377960818817126. [PMID: 33415215 PMCID: PMC7774383 DOI: 10.1177/2377960818817126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/02/2018] [Accepted: 11/03/2018] [Indexed: 12/11/2022] Open
Abstract
The proportion of older people in the population increases and more and more continue living in their own homes. Appetite among the elderly people is important to their nutrition and health. The increased risk of unintended weight loss and malnutrition is linked to food distribution among home-living elderly people. The aim was to describe experiences and perceptions of what matters to appetite among home-living elderly people having food distribution. The design was qualitative where interview data were collected among 13 interviewees in 2017 to 2018. Data were analyzed using qualitative content analysis. The results are presented in three domains: the food, the meal situation, and the adaptation to meal service with categories and themes responding to each domain. The six themes related to appetite among the elderly people concerned the following: eating tasty, savory, and culturally adapted food; eating healthy and sustainable food; eating alone or together with others; eating in a pleasant meal environment; having choices to make about the meal; and last, accepting disabilities and increased dependency. One conclusion is that many aspects should be taken into consideration when promoting appetites of people who also get food distribution. It is highly individual and an understanding of which aspects are relevant must be considered; consequently, person-centered care is suggested to promote appetite.
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Affiliation(s)
| | - Ulf Isaksson
- Department of Nursing, Umeå University, Sweden.,Arctic Research Centre at Umeå University, Sweden
| | - Åsa Hörnsten
- Department of Nursing, Umeå University, Sweden.,Arctic Research Centre at Umeå University, Sweden
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Vassbø TK, Kirkevold M, Edvardsson D, Sjögren K, Lood Q, Sandman PO, Bergland Å. Associations between job satisfaction, person‐centredness, and ethically difficult situations in nursing homes—A cross‐sectional study. J Adv Nurs 2018; 75:979-988. [DOI: 10.1111/jan.13890] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 08/20/2018] [Accepted: 08/29/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Tove K. Vassbø
- Lovisenberg Diaconal University College Oslo Norway
- Oslo University Oslo Norway
| | | | - David Edvardsson
- Umeå University Umeå Sweden
- La Trobe University Melbourne Vic. Australia
| | | | - Qarin Lood
- Umeå University Umeå Sweden
- La Trobe University Melbourne Vic. Australia
- University of Gothenburg Gothenburg Sweden
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15
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Hartmann CW, Palmer JA, Mills WL, Pimentel CB, Allen RS, Wewiorski NJ, Dillon KR, Snow AL. Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use. Psychol Serv 2018; 14:337-346. [PMID: 28805418 DOI: 10.1037/ser0000137] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care. (PsycINFO Database Record
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Affiliation(s)
- Christine W Hartmann
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital
| | - Jennifer A Palmer
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital
| | - Whitney L Mills
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center
| | - Camilla B Pimentel
- Department of Quantitative Health Sciences, University of Massachusetts Medical School
| | | | - Nancy J Wewiorski
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital
| | - Kristen R Dillon
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital
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16
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Snow AL, Jacobs ML, Palmer JA, Parmelee PA, Allen RS, Wewiorski NJ, Hilgeman MM, Vinson LD, Berlowitz DR, Halli-Tierney AD, Hartmann CW. Development of a New Tool for Systematic Observation of Nursing Home Resident and Staff Engagement and Relationship. THE GERONTOLOGIST 2018; 58:e15-e24. [PMID: 28499032 PMCID: PMC6281332 DOI: 10.1093/geront/gnw255] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 01/13/2017] [Indexed: 11/12/2022] Open
Abstract
Purpose of Study To develop a structured observational tool, the Resident-centered Assessment of Interactions with Staff and Engagement tool (RAISE), to measure 2 critical, multi-faceted, organizational-level aspects of person-centered care (PCC) in nursing homes: (a) resident engagement and (b) the quality and frequency of staff-resident interactions. Design and Methods In this multi-method psychometric development study, we conducted (a) 120 hr of ethnographic observations in one nursing home and (b) a targeted literature review to enable construct development. Two constructs for which no current structured observation measures existed emerged from this phase: nursing home resident-staff engagement and interaction. We developed the preliminary RAISE to measure these constructs and used the tool in 8 nursing homes at an average of 16 times. We conducted 8 iterative psychometric testing and refinement cycles with multi-disciplinary research team members. Each cycle consisted of observations using the draft tool, results review, and tool modification. Results The final RAISE included a set of coding rules and procedures enabling simultaneously efficient, non-reactive, and representative quantitative measurement of the interaction and engagement components of nursing home life for staff and residents. It comprised 8 observational variables, each represented by extensive numeric codes. Raters achieved adequate to high reliability with all variables. There is preliminary evidence of face and construct validity via expert panel review. Implications The RAISE represents a valuable step forward in the measurement of PCC, providing objective, reliable data based on systematic observation.
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Affiliation(s)
- A Lynn Snow
- Research & Development, Tuscaloosa VA Medical Center, Alabama
- Alabama Research Institute on Aging and Psychology Department, The University of Alabama, Tuscaloosa
| | - M Lindsey Jacobs
- Mental Health Service, VA Boston Healthcare System Brockton Division, Massachusetts
| | - Jennifer A Palmer
- Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts
| | - Patricia A Parmelee
- Alabama Research Institute on Aging and Psychology Department, The University of Alabama, Tuscaloosa
| | - Rebecca S Allen
- Alabama Research Institute on Aging and Psychology Department, The University of Alabama, Tuscaloosa
| | - Nancy J Wewiorski
- Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts
| | - Michelle M Hilgeman
- Research & Development, Tuscaloosa VA Medical Center, Alabama
- Alabama Research Institute on Aging and Psychology Department, The University of Alabama, Tuscaloosa
| | - Latrice D Vinson
- Mental Illness Research, Education & Clinical Center, VA Maryland Health Care System, Baltimore
| | - Dan R Berlowitz
- Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts
- Health Law, Policy, & Management, Boston University School of Public Health, Massachusetts
| | - Anne D Halli-Tierney
- Alabama Research Institute on Aging and College of Community Health Sciences, The University of Alabama, Tuscaloosa
| | - Christine W Hartmann
- Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts
- Health Law, Policy, & Management, Boston University School of Public Health, Massachusetts
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17
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Cooke HA. Staff personhood in dementia care settings: "Do they care about me?". Int J Older People Nurs 2018; 13:e12184. [PMID: 29363270 DOI: 10.1111/opn.12184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 12/22/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This article aims to examine RCAs' own experiences of personhood in dementia care settings. BACKGROUND Conceptually, person-centred care entails fostering the personhood of residents and the residential care aides (RCAs) who provide much of their hands-on care. To date, however, staff personhood has been overlooked in the empirical literature. DESIGN The study was part of a larger focused ethnographic project exploring how the organisational care environment impedes or facilitates the provision of quality dementia care. METHODS Semi-structured interviews with 23 RCAs and more than 230 hours of participant observation were conducted in two nursing homes with specialised dementia units in British Columbia, Canada. RESULTS Two overarching themes, "personhood undermined-management-staff relations" and "personhood undermined-workplace policies and practices" emerged, illustrating how, despite exposure to features believed beneficial to their working environment (e.g., favourable staffing ratios, relatively good remuneration), RCAs encountered repeated affronts to their personhood. The first theme encompasses the importance of being known (i.e., as persons and of their job demands) and valued (i.e., appreciated for their work in non-monetary terms). The second highlights the salience of work-life balance, full-staffing coverage and supportive human resource practices. CONCLUSIONS RCAs' experiences reveal how the ongoing search for cost-efficiencies, cost-containment and cost-accountability overshadows their individuality, indicating a key disconnect between conceptual ideals and workplace realities. IMPLICATIONS FOR PRACTICE Organisations are encouraged to consider creating person-centred management and workplace practices that provide tangible evidence that RCAs, and their work, matter.
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Affiliation(s)
- Heather A Cooke
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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18
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Steinberg KE. Person-Centered Care Planning: Preferences Are a Priority. J Am Med Dir Assoc 2017; 19:100-101. [PMID: 29208446 DOI: 10.1016/j.jamda.2017.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Karl E Steinberg
- California State University Institute for Palliative Care, San Marcos, CA.
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19
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Villar F, Celdrán M, Vila-Miravent J, Serrat R. Involving institutionalised people with dementia in their care-planning meetings: lessons learnt by the staff. Scand J Caring Sci 2017; 32:567-574. [PMID: 28901562 DOI: 10.1111/scs.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 04/23/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Applying a person-centred care (PCC) approach is an aspiration for many services attending people with dementia (PwD). However, the implementation and assessment of PCC practices represent a challenge to health professionals. AIM To evaluate the impact on staff of a programme aiming to involve people with dementia (PwD) in their individualised care-planning (ICP) meetings in long-term residential settings; specifically, to explore the lessons that staff perceived they had learned from the experience. METHODS Twenty-one staff members working in residential facilities for older people were interviewed after the programme. Responses to two questions ('Do you think that your work has been affected in any way by the attendance of PwD at ICP meetings?' and 'Have you learnt something new as a result of these meetings?') were submitted to thematic analysis. RESULTS Eighteen of the 21 participants identified at least one lesson they had learned from the experience. The lessons could be grouped under three main headings: (i) an increase in their understanding of PwD, (ii) questioning of their own care practices, and (iii) an improvement in teamwork. CONCLUSION The involvement of PwD in ICP meetings had a positive impact on staff. They stated that the experience encouraged them to develop PCC-compatible attitudes and modify the way they treat PwD, thus improving the quality of care they deliver. The experience also seemed to empower staff (particularly the lesser trained members) and increase the cohesion of working teams.
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Affiliation(s)
- Feliciano Villar
- Department of Cognition, Development, and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Montserrat Celdrán
- Department of Cognition, Development, and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Josep Vila-Miravent
- Department of Cognition, Development, and Educational Psychology, University of Barcelona, Barcelona, Spain.,Alzheimer Catalonia Foundation, Barcelona, Spain
| | - Rodrigo Serrat
- Department of Cognition, Development, and Educational Psychology, University of Barcelona, Barcelona, Spain
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20
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Kazemi A, Kajonius P. Variations in user-oriented elderly care: a multilevel approach. INTERNATIONAL JOURNAL OF QUALITY AND SERVICE SCIENCES 2017. [DOI: 10.1108/ijqss-06-2016-0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
National Board of Health and Welfare claims that the quality of elderly care services differ considerably between municipalities in Sweden. This study aims to analyze to what extent these variations can be accounted for by the older person’s municipality affiliation (i.e. receiving elderly care in a certain municipality).
Design/methodology/approach
Addressing this issue, national survey data from 78,538 older respondents receiving elderly care services in Sweden were analyzed using multilevel modeling (MLM).
Findings
The results showed that municipality affiliation only marginally explained the variance in satisfaction with care, i.e. its variations were larger within than between municipalities. Instead, user-oriented care accounted for the variation in satisfaction with care. Specifically, the way the care workers behave toward the older person proved to be much more crucial for satisfaction with care than municipality affiliation. Moreover, random effects analyses revealed that the effects of user-oriented care on satisfaction with care varied across municipalities. Care setting (i.e. home care or nursing home) only marginally accounted for its variance.
Practical implications
Developing care quality should start and primarily be discussed at the interpersonal care level, and not, as is customary, at the municipality level.
Originality/value
The present research is the first in its kind to quantitatively investigate the sources of variation in perceived quality of Swedish elderly care using MLM.
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21
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Perspectives on caregiving: A qualitative evaluation of certified nursing assistants. Geriatr Nurs 2017; 38:146-151. [DOI: 10.1016/j.gerinurse.2016.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 11/18/2022]
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22
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Edvardsson D, Sjögren K, Lood Q, Bergland Å, Kirkevold M, Sandman PO. A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial. BMC Geriatr 2017; 17:22. [PMID: 28095791 PMCID: PMC5240428 DOI: 10.1186/s12877-016-0404-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this. METHODS The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents' thriving, relatives' satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives' experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention. DISCUSSION The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452 .
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Affiliation(s)
- David Edvardsson
- The Medical Faculty, Department of Nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, SE-90187, Umeå, Sweden. .,College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg, 3084, VIC, Australia.
| | - Karin Sjögren
- The Medical Faculty, Department of Nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, SE-90187, Umeå, Sweden
| | - Qarin Lood
- The Medical Faculty, Department of Nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, SE-90187, Umeå, Sweden.,College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg, 3084, VIC, Australia
| | - Ådel Bergland
- Lovisenberg Diaconal University College, Lovisenberggt. 15b, 0456, Oslo, Norway.,Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Postboks 1130, Blindern, 0318, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Postboks 1130, Blindern, 0318, Oslo, Norway
| | - Per-Olof Sandman
- The Medical Faculty, Department of Nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, SE-90187, Umeå, Sweden.,Division of Caring Sciences, Depart Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Department of Health Sciences, University of Technology, Luleå, Sweden
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Abstract
OBJECTIVES Describe the development of a competent workforce committed to providing patient-centered care to persons with dementia and/or depression and their caregivers; to report on qualitative analyses of our workforce's case reports about their experiences; and to present lessons learned about developing and implementing a collaborative care community-based model using our new workforce that we call care coordinator assistants (CCAs). METHOD Sixteen CCAs were recruited and trained in person-centered care, use of mobile office, electronic medical record system, community resources, and team member support. CCAs wrote case reports quarterly that were analyzed for patient-centered care themes. RESULTS Qualitative analysis of 73 cases using NVivo software identified six patient-centered care themes: (1) patient familiarity/understanding; (2) patient interest/engagement encouraged; (3) flexibility and continuity of care; (4) caregiver support/engagement; (5) effective utilization/integration of training; and (6) teamwork. Most frequently reported themes were patient familiarity - 91.8% of case reports included reference to patient familiarity, 67.1% included references to teamwork and 61.6% of case reports included the theme flexibility/continuity of care. CCAs made a mean number of 15.7 (SD = 15.6) visits, with most visits for coordination of care services, followed by home visits and phone visits to over 1200 patients in 12 months. DISCUSSION Person-centered care can be effectively implemented by well-trained CCAs in the community.
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Affiliation(s)
- Mary Guerriero Austrom
- Department of Psychiatry, Indiana University School of Medicine (IUSM), Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, IUSM, Indianapolis, IN, USA
- Office for Diversity and Inclusion, IUSM, Indianapolis, IN, USA
| | - Carly A. Carvell
- Department of Psychiatry, Indiana University School of Medicine (IUSM), Indianapolis, IN, USA
| | | | - Sujuan Gao
- Indiana Alzheimer Disease Center, IUSM, Indianapolis, IN, USA
- Department of Biostatistics, IUSM, Indianapolis, IN, USA
| | - Malaz Boustani
- Michael LaMantia, Eskenazi Health, Indianapolis, IN, USA
- Michael LaMantia, IUSM, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Innovation and Implementation, IUSM, Indianapolis, IN, USA
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Kajonius P, Kazemi A. Advancing the Big Five of user-oriented care and accounting for its variations. Int J Health Care Qual Assur 2016; 29:162-76. [DOI: 10.1108/ijhcqa-03-2015-0040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care.
Design/methodology/approach
– Two municipalities were selected for in-depth field studies. First, in each municipality, the authors interviewed and observed care workers’ interactions with the older persons in both home care and nursing homes during two weeks (Study 1). Second, in an attempt to gain a deeper understanding of why process quality in terms of user-oriented care varies, the authors conducted interviews with care workers and care unit managers (Study 2).
Findings
– A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level).
Originality/value
– The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.
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Abstract
Client-responsive behaviours occur commonly among residents in long-term care (LTC) settings; direct-care staff, however, receive little education, support, or opportunities to discuss and collaborate on managing such behaviours. Our participatory action project introduced mental health huddles to support staff in discussing and managing client-responsive behaviours in long-term care. This research project engaged direct-care staff (e.g., personal support workers, registered practical nurses, housekeeping staff, and registered nurses) in learning how to use these huddles. Staff workers used huddles as a forum to stay informed, review work, problem solve, and develop person-centered action plans. Fifty-six huddles occurred over a 12-week period; two to seven direct-care staff participated in each huddle. Focus groups indicated improved staff collaboration, teamwork, support, and communication when discussing specific responsive behaviours. Huddles provided LTC staff with the opportunity to collaborate and discuss strategies to optimize resident care. Further research on how huddles affect resident care outcomes is needed.
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26
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Kazemi A, Kajonius PJ. User-oriented elderly care: a validation study in two different settings using observational data. QUALITY IN AGEING AND OLDER ADULTS 2015. [DOI: 10.1108/qaoa-08-2014-0013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– User-oriented care, defined as individualized assisting behaviors, is the dominant approach within elderly care today. Yet, there is little known about its conceptual structure. This paper proposes that user-oriented care has a bi-partite structure which may be decomposed into the two dimensions of task and relation.
Design/methodology/approach
– Care workers were “shadowed” (i.e. observed) at their work (n=391 rated interactions). User-oriented care was assessed along ten process quality indicators targeting the acts of caregiving (i.e. task focus, relation focus, involvement, time-use, body language, autonomy, respect, warmth, encouragement, and information) in two elderly care settings, i.e. home care and nursing home. Observations added up to 45 hours.
Findings
– Principal component analyses confirmed the proposed two-factor structure of user-oriented care. Specifically, the user-oriented care indicators loaded on two distinct factors, i.e. task and relation. The underlying structure of user-oriented care revealed to be invariant across the two settings. However, the results revealed interesting structural differences in terms of explained variance and the magnitude of factor loadings in the home care and nursing home settings. Differences also emerged specifically pertaining to the indicators of autonomy and time-use. These findings suggest that user-oriented behavior may to some extent denote different acts of caregiving and what may be called task- and relation-orientation may be loaded with different meanings in these two care settings.
Originality/value
– This is the first study investigating user-oriented behavior in the context of elderly care using a quantitative observational approach. The authors propose that the observed differences between the two care settings are primarily not due to better elderly care work in home care, but due to some inherent differences between these two contexts of care (e.g. better health and living at home).
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27
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Ericson-Lidman E, Strandberg G. ‘Troubled conscience related to deficiencies in providing individualised meal schedule in residential care for older people - a participatory action research study’. Scand J Caring Sci 2015; 29:688-96. [DOI: 10.1111/scs.12197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 10/25/2014] [Indexed: 12/01/2022]
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Shield RR, Tyler D, Lepore M, Looze J, Miller SC. "Would You Do That in Your Home?" Making Nursing Homes Home-like in Culture Change Implementation. ACTA ACUST UNITED AC 2014; 28:383-398. [PMID: 28344379 PMCID: PMC5363857 DOI: 10.1080/02763893.2014.930369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Qualitative interviews with nursing home administrators reveal innovative and cost-conscious ways to physically modify facilities that help institute culture change practices. Telephone interviews were conducted following a national survey of nursing home nursing directors and administrators. In this cross-sectional snapshot of administrator experiences, motivations for making facilities more home-like and less institutional and creative responses to challenges are described. State and corporate support and regulator encouragement are noted that help their reform efforts. Administrators note that small steps to create a more home-like environment can result in a positive impact that minimizes disruption to existing care processes. They describe how they respond to challenges, such as the physical plant and high costs, and note how comparative shopping, cost-conscious physical improvements, and continuous involvement of staff and residents contribute to successful efforts. Their examples illustrate novel ways to humanize long-term care facilities that other nursing homes can emulate.
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Affiliation(s)
| | | | - Michael Lepore
- RTI International, Washington, DC, USA, and Brown University, Providence, Rhode Island, USA
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Shield RR, Looze J, Tyler D, Lepore M, Miller SC. Why and how do nursing homes implement culture change practices? Insights from qualitative interviews in a mixed methods study. J Appl Gerontol 2014; 33:737-63. [PMID: 24652888 PMCID: PMC4385266 DOI: 10.1177/0733464813491141] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED To understand the process of instituting culture change (CC) practices in nursing homes (NHs). NH Directors of Nursing (DONs) and Administrators (NHAs) at 4,149 United States NHs were surveyed about CC practices. Follow-up interviews with 64 NHAs were conducted and analyzed by a multidisciplinary team which reconciled interpretations recorded in an audit trail. RESULTS The themes include: (a) Reasons for implementing CC practices vary; (b) NH approaches to implementing CC practices are diverse; (c) NHs consider resident mix in deciding to implement practices; (d) NHAs note benefits and few costs to implementing CC practices; (e) Implementation of changes is challenging and strategies for change are tailored to the challenges encountered; (f) Education and communication efforts are vital ways to institute change; and (g) NHA and other staff leadership is key to implementing changes. Diverse strategies and leadership skills appear to help NHs implement reform practices, including CC innovations.
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Affiliation(s)
| | | | | | - Michael Lepore
- Brown University, Providence, RI, USA Planetree, Inc., Derby, CT, USA
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Certified nursing assistants: a key to resident quality of life. J Am Med Dir Assoc 2014; 15:610-2. [PMID: 25086690 DOI: 10.1016/j.jamda.2014.06.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 06/27/2014] [Indexed: 11/20/2022]
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Papastavrou E, Acaroglu R, Sendir M, Berg A, Efstathiou G, Idvall E, Kalafati M, Katajisto J, Leino-Kilpi H, Lemonidou C, da Luz MDA, Suhonen R. The relationship between individualized care and the practice environment: an international study. Int J Nurs Stud 2014; 52:121-33. [PMID: 24947755 DOI: 10.1016/j.ijnurstu.2014.05.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 05/13/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses' ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies. OBJECTIVES The aim of this study was to determine whether nurses' views of their professional practice environment associate with their views of the level of care individualization in seven countries. DESIGN This study had an international, multisite, prospective, cross-sectional, exploratory survey design. SETTINGS The study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey. PARTICIPANTS Nurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study. METHODS Self-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model. RESULTS Two regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care. CONCLUSIONS The results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse-patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes.
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Affiliation(s)
- Evridiki Papastavrou
- Cyprus University of Technology, Department of Nursing, School of Health Studies, Limassol, Cyprus.
| | - Rengin Acaroglu
- Istanbul University, Florence Nightingale School Faculty of Nursing, Istanbul, Turkey.
| | - Merdiye Sendir
- Istanbul University, Florence Nightingale School Faculty of Nursing, Istanbul, Turkey.
| | - Agneta Berg
- Kristianstad University, Kristianstad, Sweden; University West, Sweden.
| | | | - Ewa Idvall
- Malmö University, Department of Care Science, Malmö, Sweden; Skåne University Hospital, Department of Intensive Care and Perioperative Medicine, Malmö, Sweden.
| | - Maria Kalafati
- National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
| | - Jouko Katajisto
- University of Turku, Department of Mathematics and Statistics, Turku, Finland.
| | - Helena Leino-Kilpi
- University of Turku, Department of Nursing Science, Turku, Finland; Turku University Hospital, Turku, Finland.
| | - Chryssoula Lemonidou
- National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
| | - Maria Deolinda Antunes da Luz
- Unidade de Investigacão e Desenvolvimento em Enfermagem (UI&DE), Escola Superior de Enfermagem de Lisboa (Nursing Research and Development Unit UI&DE), Portugal.
| | - Riitta Suhonen
- University of Turku, Department of Nursing Science, Turku, Finland.
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Siegel EO, Young HM, Zysberg L, Santillan V. Securing and Managing Nursing Home Resources: Director of Nursing Tactics. THE GERONTOLOGIST 2014; 55:748-59. [PMID: 24534608 DOI: 10.1093/geront/gnu003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 01/16/2014] [Indexed: 11/12/2022] Open
Abstract
PURPOSE OF THE STUDY Shrinking resources and increasing demands pose managerial challenges to nursing homes. Little is known about how directors of nursing (DON) navigate resource conditions and potential budget-related challenges. This paper describes the demands-resources tensions that DONs face on a day-to-day basis and the tactics they use to secure and manage resources for the nursing department. DESIGN AND METHODS We conducted a secondary analysis of data from a parent study that used a qualitative approach to understand the DON position. A convenience sample of 29 current and previous DONs and administrators from more than 15 states participated in semistructured interviews for the parent study. Data analysis included open coding and thematic analysis. RESULTS DONs address nursing service demands-resources tensions in various ways, including tactics to generate new sources of revenue, increase budget allocations, and enhance cost efficiencies. IMPLICATIONS The findings provide a rare glimpse into the operational tensions that can arise between resource allocations and demands for nursing services and the tactics some DONs employ to address these tensions. This study highlights the DON's critical role, at the daily, tactical level of adjusting and problem-solving within existing resource conditions. How DONs develop these skills and the extent to which these skills may improve nursing home quality and value are important questions for further practice-, education-, and policy-level investigation.
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Affiliation(s)
- Elena O Siegel
- Betty Irene Moore School of Nursing at UC Davis, Sacramento, California.
| | - Heather M Young
- Betty Irene Moore School of Nursing at UC Davis, Sacramento, California
| | - Leehu Zysberg
- Betty Irene Moore School of Nursing at UC Davis, Sacramento, California. Department of Psychology, Tel Hai College, Upper Galilee, Israel
| | - Vanessa Santillan
- Betty Irene Moore School of Nursing at UC Davis, Sacramento, California
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Beeber AS, Cohen LW, Zimmerman S, Gwyther LP, Washington T, Cagle JC, Reed D. Differences in assisted living staff perceptions, experiences, and attitudes. J Gerontol Nurs 2014; 40:41-9. [PMID: 23937102 PMCID: PMC4121260 DOI: 10.3928/00989134-20130731-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/22/2013] [Indexed: 11/20/2022]
Abstract
Research within residential care/assisted living (RC/AL) settings has shown that the attitudes of personal care (PC) staff toward their organization and its residents and families can affect the quality of resident care. This article describes the perceptions, experiences, and attitudes of PC staff and their supervisors, and considers these data in the context of non-hierarchical staffing patterns-a philosophically expected, yet unproven tenet of RC/AL. Using data collected from 18 RC/AL communities, these analyses compared the characteristics, perceptions, experiences, and attitudes of PC staff (N = 250) and supervisors (N = 30). Compared to supervisors, PC staff reported greater burden, frustration, depersonalization, hassles, and feeling significantly more controlling of, and less in partnership with, families (p < 0.05). Because the PC staff experience is crucial for resident outcomes, more work is needed to create an environment where PC staff are less burdened and have better attitudes toward work and families.
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Affiliation(s)
- Anna S. Beeber
- Assistant Professor - School of Nursing, Research Fellow - Cecil G. Sheps Center for Health Services Research, Robert Wood Johnson Nurse Faculty Scholar, University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall CB #7460, Chapel Hill, NC 27599-7460, Telephone: 919-843-9489
| | - Lauren W. Cohen
- Associate Director, Collaborative Studies of Long-term Care, Research Associate, Program on Aging, Disability, and Long-term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Boulevard, Campus Box 7590, Chapel Hill, NC 27599-7590, Telephone: 919-843-8874
| | - Sheryl Zimmerman
- Mary Lily Kenan Flagler Bingham Distinguished Professor & Associate Dean for Doctoral Education - School of Social Work, Co-Director and Senior Research Scientist, Program on Aging, Disability and Long-Term Care - the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Boulevard, Campus Box 7590, Chapel Hill, NC 27599-7590, Telephone: 919-962-6417
| | - Lisa P. Gwyther
- Director, Duke Center for the Study of Aging and Human Development, 3600 Duke University Medical Center, Rm. 3508, Blue Zone, Duke Clinic, 200 Trent Drive, Durham, NC 27710, Telephone: 919-660-7508
| | - Tiffany Washington
- Doctoral Candidate, School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Campus Box 3550, Chapel Hill, NC 27599-3550, Telephone: 919-962-1225
| | - John C. Cagle
- Assistant Professor, School of Social Work, University of Maryland - Baltimore, 525 West Redwood Street, Baltimore, MD 21201, Telephone: (804) 248-2748
| | - David Reed
- Research Associate, Analyst, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Boulevard, Campus Box 7590, Chapel Hill, NC 27599-7590, Telephone: 919-843-8876
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Suhonen R, Stolt M, Gustafsson ML, Katajisto J, Charalambous A. The associations among the ethical climate, the professional practice environment and individualized care in care settings for older people. J Adv Nurs 2013; 70:1356-68. [DOI: 10.1111/jan.12297] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Riitta Suhonen
- Department of Nursing Science; University of Turku; Finland
| | - Minna Stolt
- Department of Nursing Science; University of Turku; Finland
| | | | - Jouko Katajisto
- Department of Mathematics and Statistics; University of Turku; Finland
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Béliveau J. Middle managers' role in transferring person-centered management and care. SERVICE INDUSTRIES JOURNAL 2013. [DOI: 10.1080/02642069.2013.815738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Palmer JA, Meterko M, Zhao S, Berlowitz D, Mobley E, Hartmann CW. Nursing Home Employee Perceptions of Culture Change. Res Gerontol Nurs 2013; 6:152-60. [DOI: 10.3928/19404921-20130610-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 05/13/2013] [Indexed: 11/20/2022]
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Haugan G, Innstrand ST, Moksnes UK. The effect of nurse-patient interaction on anxiety and depression in cognitively intact nursing home patients. J Clin Nurs 2013; 22:2192-205. [DOI: 10.1111/jocn.12072] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Sør-Trøndelag University College, HIST; Trondheim Norway
| | - Siw T Innstrand
- Research Centre for Health Promotion and Resources ; Norwegian University of Science and Technology, NTNU; Trondheim Norway
| | - Unni K Moksnes
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Sør-Trøndelag University College, HIST; Trondheim Norway
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Haugan G. Nurse-patient interaction is a resource for hope, meaning in life and self-transcendence in nursing home patients. Scand J Caring Sci 2013; 28:74-88. [PMID: 23461626 DOI: 10.1111/scs.12028] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/06/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Spiritual dimensions such as hope, meaning in life and self-transcendence have been found to be predictors of successful ageing, life satisfaction and well-being in older individuals. Connectedness and communicating with others have been seen to facilitate hope, meaning in life and self-transcendence among nursing home patients. AIMS This study aimed to investigate the associations between hope, meaning in life, self-transcendence and nurse-patient interaction in a nursing home population. DESIGN AND METHODS A cross-sectional design was employed, collecting data in 44 different Norwegian nursing homes (NHs) from 250 patients who met the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 NHs was obtained. A sample of 202 cognitively intact nursing home patients responded to the Herth Hope Index, the Purpose in Life test, the Self-Transcendence Scale and the Nurse-Patient Interaction Scale. A structural equation model (SEM) of the hypothesized relationships between the constructs was tested. RESULTS The SEM model fit well with the present data. Significant direct relationships of nurse-patient interaction on hope, meaning in life and self-transcendence were displayed. Meaning and the interconnectedness dimension of hope appeared to be particularly dynamic resources, revealing significant influences on all the constructs in the SEM model tested. CONCLUSION Nurse-patient interaction influences hope, meaning in life and self-transcendence in cognitively intact nursing home patients and might be an important resource in relation to patients' health and global well-being. Thus, care providers are above all fundamental for nursing home patients. Advancing caregivers' interacting and communicating skills might facilitate patients' health and global well-being and inspire professional caregivers as they perform their daily care practices. More research of the effectiveness of such strategies is greatly needed. LIMITATIONS The SEM model tested comprised 20 variables, indicating a desirable sample size of n = 200, while the present effective sample was n = 187. Also, cross-sectional data do not allow making conclusion on the causality.
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Affiliation(s)
- Gørill Haugan
- Research Centre for Health Promotion and Resources HIST/NTNU, Faculty of Nursing, Sør-Trøndelag University College, Trondheim, Norway
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Abstract
BACKGROUND While the work situation for nurse assistants in residential care is strenuous, they themselves often state that they are satisfied with their job. More knowledge is clearly needed of the interrelationship of variables associated with job satisfaction. This study aims to investigate job satisfaction and explore associated variables among nurse assistants working in residential care. METHODS A total of 225 respondents completed a questionnaire measuring general job satisfaction, satisfaction with nursing-care provision and measures concerning person-centered care, work climate, leadership, and health complaints. Job satisfaction was the outcome measure and comparisons were made among those reporting low, moderate, and high levels of job satisfaction; multiple regression analyses were used to explore associated variables. RESULTS The caring climate and personalized care provision were associated with general job satisfaction. High levels of satisfaction with nursing-care provision were also associated with the general work climate, organizational and environmental support, and leadership. Low job satisfaction was mainly associated with health complaints. CONCLUSIONS Nurse assistants working in a positive work climate, caring climate, with a positive attitude to their leaders, who receive organizational and environmental support, provide person-centered care and experience a higher degree of job satisfaction. It seems essential, however, to include both general and context-specific measures when investigating job satisfaction in this field as they reveal different aspects of the nurse assistant's work situation.
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Choi J, Flynn L, Aiken LH. Nursing practice environment and registered nurses' job satisfaction in nursing homes. THE GERONTOLOGIST 2012; 52:484-92. [PMID: 21908803 PMCID: PMC3409799 DOI: 10.1093/geront/gnr101] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Accepted: 08/03/2011] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. DESIGN AND METHODS The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes. RESULTS Controlling for individual and nursing home characteristics, staff RNs' participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs' job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied. IMPLICATIONS A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction.
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Affiliation(s)
- JiSun Choi
- National Database of Nursing Quality Indicators, School of Nursing, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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Suhonen R, Charalambous A, Stolt M, Katajisto J, Puro M. Caregivers' work satisfaction and individualised care in care settings for older people. J Clin Nurs 2012; 22:479-90. [PMID: 22564089 DOI: 10.1111/j.1365-2702.2011.04052.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES To examine the association between caregivers' work satisfaction and individualised care in different care settings for older people. BACKGROUND Work satisfaction in older people care settings has been associated with absenteeism, staff turnover and the quality of care delivered. The management of individuality is an important quality of care issue. Although these two issues are important there is little evidence about the possible association between them. DESIGN An exploratory and correlational survey design. METHODS Data were collected using three questionnaires, the Individualised Care Instrument the Individualised Care Scale-Nurse and the Index of Work Satisfaction from a sample of professional nursing caregivers (n=263, response rate 71%) in care settings for older people in one health care area in Finland in 2010. Statistical analysis included descriptive statistics, correlations, analysis of variance and multiple regression analysis. RESULTS Caregivers support the patient's individuality through specific activities, perceiving that they maintain individuality in care provision whilst reporting moderate work satisfaction. The ratings of individuality assessments were the lowest in nursing homes followed by long-term care in in-patient wards. There were statistically significant correlations between work satisfaction and specific perceptions in the support of individuality. The sub-scales of the instruments used were: the Support of Individuality in general, Individuality in the Care Provided, Knowing the Person, Staff-to-Resident Communication and Staff-to-Staff Communication. Significant statistical differences in the results were found between staff working in home care, primary health care, in-patient wards and nursing homes. CONCLUSIONS Low job satisfaction can affect the provision of individualised care emphasising the need to promote individualised care at an organisational level as a means of improving work satisfaction. RELEVANCE TO CLINICAL PRACTICE Instruments to measure work satisfaction and individualised care can be used to improve care quality.
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Affiliation(s)
- Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland. ;
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Finnbakk E, Skovdahl K, Blix ES, Fagerström L. Top-level managers’ and politicians’ worries about future care for older people with complex and acute illnesses - a Nordic study. Int J Older People Nurs 2012; 7:163-72. [DOI: 10.1111/j.1748-3743.2012.00312.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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White HK, Corazzini K, Twersky J, Buhr G, McConnell E, Weiner M, Colón‐Emeric CS. Prioritizing Culture Change in Nursing Homes: Perspectives of Residents, Staff, and Family Members. J Am Geriatr Soc 2012; 60:525-31. [DOI: 10.1111/j.1532-5415.2011.03840.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Heidi K. White
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
| | - Kirsten Corazzini
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
- School of Nursing Duke University Durham North Carolina
| | - Jack Twersky
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
- Geriatric Research, Education and Clinical Center Durham Veterans Affairs Medical Center Durham North Carolina
| | - Gwendolen Buhr
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
| | - Eleanor McConnell
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
- School of Nursing Duke University Durham North Carolina
- Geriatric Research, Education and Clinical Center Durham Veterans Affairs Medical Center Durham North Carolina
| | - Madeline Weiner
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
- Geriatric Research, Education and Clinical Center Durham Veterans Affairs Medical Center Durham North Carolina
| | - Cathleen S. Colón‐Emeric
- School of Medicine Center for the Study of Aging and Human Development Duke University Durham North Carolina
- Geriatric Research, Education and Clinical Center Durham Veterans Affairs Medical Center Durham North Carolina
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Kuhn DR, Forrest JM. Palliative care for advanced dementia: a pilot project in 2 nursing homes. Am J Alzheimers Dis Other Demen 2012; 27:33-40. [PMID: 22296910 PMCID: PMC10697225 DOI: 10.1177/1533317511432732] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This article describes a pilot project involving training, case consultations, and administrative coaching over a period of 1 year aimed at introducing palliative care in 2 nursing homes among 31 residents with advanced dementia. Resident outcomes that examined numerous clinical measures were assessed at 3 points in time. Changes in the knowledge and attitudes of 80 staff members and 33 family members who participated in the multimodal intervention were also assessed at 3 points in time. Limited improvements were demonstrated on measures for residents, staff members, and family members at the first nursing home (site 1) and significant improvements were demonstrated at the other nursing home (site 2). Top leadership turned over 3 times at site 1 which limited the integration of palliative care, whereas leadership of site 2 remained stable. Implications for implementing a program of palliative care in nursing homes are discussed.
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Affiliation(s)
- Daniel R Kuhn
- Rainbow Hospice and Palliative Care, Mount Prospect, IL 60056, USA.
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Staff outcomes from the caring for aged dementia care resident study (CADRES): a cluster randomised trial. Int J Nurs Stud 2011; 49:508-18. [PMID: 22078076 DOI: 10.1016/j.ijnurstu.2011.10.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 10/19/2011] [Accepted: 10/19/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dementia care mapping and person centred care are well-accepted as processes for improving care and well-being for persons with dementia living in the residential setting. However, the impact of dementia care mapping and person centred care on staff has not been well researched. OBJECTIVES The impact of person centred care and dementia care mapping compared to each other and to usual dementia care on staff outcomes was examined in terms of staff burnout, general well-being, attitudes and reactions towards resident behavioural disturbances, perceived managerial support, and quality of care interactions. DESIGN A cluster-randomised, controlled trial. SETTINGS The study was conducted between 2005 and 2007 in 15 residential aged care sites in the Sydney metropolitan area, Australia, with comparable management structures, staffing mix and ratios, and standards of care. PARTICIPANTS 194 consenting managers, nurses, therapists and nurse assistants working in the participating sites. METHODS Intervention care sites received training and support in either person centred care (n=5) or dementia care mapping (n=5); control sites continued with usual dementia care (n=5). Staff outcomes of those three groups were assessed before, directly after the four month intervention (post) and after a further four months (follow-up). The primary outcome measures were the Maslach Burnout Inventory-Human Services Survey and the 12-item General Health Questionnaire. Analysis involved repeated measures analyses of variance for each of the outcome measures and adjustment for potential confounders to limit bias. RESULTS The Maslach Burnout Inventory-Human Services Survey results showed that change over time in emotional exhaustion scores differed between the three groups. Post-hoc analyses for each group separately revealed that the only significant time effect was in the dementia care mapping group (p=0.006), with emotional exhaustion scores declining over time. At baseline, more perceived support from management was associated with less emotional exhaustion (r(s)=0.26, p=0.004, n=122) and less depersonalisation (r(s)=0.21, p=0.023, n=122), but not for any of the other outcome measures. CONCLUSIONS This study has shown that person centred approaches of care, in particular with dementia care mapping, may contribute to reducing staff job related burnout. The findings also highlight a potentially important role of managerial support and a whole of system approach.
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Suhonen R, Alikleemola P, Katajisto J, Leino-Kilpi H. Nurses’ assessments of individualised care in long-term care institutions. J Clin Nurs 2011; 21:1178-88. [DOI: 10.1111/j.1365-2702.2011.03855.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Suhonen R, Efstathiou G, Tsangari H, Jarosova D, Leino-Kilpi H, Patiraki E, Karlou C, Balogh Z, Papastavrou E. Patients’ and nurses’ perceptions of individualised care: an international comparative study. J Clin Nurs 2011; 21:1155-67. [DOI: 10.1111/j.1365-2702.2011.03833.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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SUHONEN RIITTA, STOLT MINNA, PURO MARKKU, LEINO-KILPI HELENA. Individuality in older people’s care - challenges for the development of nursing and nursing management. J Nurs Manag 2011; 19:883-96. [DOI: 10.1111/j.1365-2834.2011.01243.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pillemer K, Meador RH, Teresi JA, Chen EK, Henderson CR, Lachs MS, Boratgis G, Silver S, Eimicke JP. Effects of electronic health information technology implementation on nursing home resident outcomes. J Aging Health 2011; 24:92-112. [PMID: 21646551 DOI: 10.1177/0898264311408899] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the effects of electronic health information technology (HIT) on nursing home residents. METHODS The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. RESULTS No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. DISCUSSION The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior.
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Affiliation(s)
- Karl Pillemer
- Department of Human Development, MVR Hall, Cornell University, Ithaca, NY 14853, USA.
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