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Rosendal KA, Lehn S, Overgaard D. Body care of older people in different institutionalized settings: A systematic mapping review of international nursing research from a Scandinavian perspective. Nurs Inq 2023; 30:e12503. [PMID: 35666581 PMCID: PMC10078501 DOI: 10.1111/nin.12503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023]
Abstract
Body care is considered a key aspect of nursing and imperative for the health, wellbeing, and dignity of older people. In Scandinavian countries, body care as a professional practice has undergone considerable changes, bringing new understandings, values, and dilemmas into nursing. A systematic mapping review was conducted with the aims of identifying and mapping international nursing research on body care of older people in different institutionalized settings in the healthcare system and to critically discuss the dominant assumptions within the research by adapting a problematization approach. Most identified papers reported on empirical research with a biomedical approach focusing on outcome and effectiveness. Conceptual papers, papers with a focus on the perspectives of the older people, or contextual and material aspects were lacking. The research field is dominated by four dominant assumptions: Body care as an evidence-based practice, body care as a relational ethical practice, the body as a body-object and a body-subject, the objects in the body care practices as nonrelational materialities. Given the complexities of professional body care practices, there is a need for other research designs and theoretical perspectives within nursing that expand our understanding of body care taking into consideration the multiple social and material realities.
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Affiliation(s)
- Kirstine A Rosendal
- Department of People and Technology, Research Centre in Health Promotion, University of Roskilde, Roskilde, Denmark
| | - Sine Lehn
- Department of People and Technology, Research Centre in Health Promotion, University of Roskilde, Roskilde, Denmark
| | - Dorthe Overgaard
- Department of Nursing and Nutrition, Faculty of Health, University College Copenhagen, Copenhagen N, Denmark
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Davila H, Ng W, Akosionu O, Thao MS, Skarphol T, Virnig BA, Thorpe RJ, Shippee TP. Why Men Fare Worse: A Mixed-Methods Study Examining Gender Differences in Nursing Home Resident Quality of Life. THE GERONTOLOGIST 2022; 62:1347-1358. [PMID: 35024847 PMCID: PMC9579463 DOI: 10.1093/geront/gnac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Despite research documenting gender differences in numerous outcomes in later life, we know little about gender differences in quality of life (QoL) for nursing home (NH) residents. This study examines the relationship between gender and residents' QoL, including possible reasons for differences observed. RESEARCH DESIGN AND METHODS We used a mixed-methods design including surveys with a random sample of Minnesota NH residents using a multidimensional measure of QoL (n = 9,852), resident clinical data, facility-level characteristics (n = 364), interviews with residents (n = 64), and participant observations. We used linear mixed models and thematic analysis of resident interviews and observations to examine possible gender-related differences in residents' QoL. RESULTS After controlling for individual and facility characteristics, men reported lower overall QoL than women, including significantly lower ratings in several QoL domains. In interviews, men noted being less satisfied with activities than women, having fewer friends, and being less able to rely on family for support. Some women described the NH as a place of respite, but men more often described being dissatisfied with life in the NH and undesirable for long-term living. Our observations were consistent with interview findings but provide additional nuances, such as that some men organized their own social groups. DISCUSSION AND IMPLICATIONS Our findings suggest that men and women experience QoL differently in NHs, with men reporting lower QoL in several domains. Tailoring more activities for men and finding ways to strengthen relationships for men in NHs could help reduce the gender differences in QoL we observed.
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Affiliation(s)
- Heather Davila
- VA Iowa City Healthcare System, Iowa City, Iowa, USA
- University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Weiwen Ng
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Odichinma Akosionu
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mai See Thao
- Anthropology, Global Religions, and Cultures, University of Wisconsin, Oshkosh, Wisconsin, USA
| | - Tricia Skarphol
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Beth A Virnig
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tetyana P Shippee
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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McCabe MP, Beattie E, Karantzas G, Mellor D, Sanders K, Busija L, Goodenough B, Bennett M, von Treuer K, Byers J. Consumer directed care in residential aged care: an evaluation of a staff training program. Aging Ment Health 2020; 24:673-678. [PMID: 30789027 DOI: 10.1080/13607863.2019.1574711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The advent of Consumer-Directed Care (CDC, or individualized care) in Residential Aged Care Facilities (RACFs, or residential care) will require a paradigm shift in service delivery. This article evaluated the six-session Resident at the Centre of Care (RCC) staff training program designed to equip staff to implement a CDC model of care among residents.Method: There were two experimental conditions: RCC training program alone, RCC training program plus support, and a 'care as usual' condition. Outcome measures were resident quality of life (QoL) and resident working relationships with staff at 3-month follow-up. At Time 1, 92 residents from RACFs participated in the program. The RCC is six sessions that focus on the development of staff skills in communicating with residents, as well as the organizational change and transformational leadership that is needed for the implementation of CDC.Results: There were significant improvements in resident QoL. There was no major difference between the RCC Program plus support condition compared to the RCC Program alone condition, but both were associated with more positive changes in resident QoL than the 'care as usual' condition.Conclusion: This study demonstrates that training staff in strategies to implement CDC in RACFs can lead to an improvement in the wellbeing of many residents, and that additional support to assist staff to implement the strategies may not be required to produce such improvements. Longer term follow-up is necessary to determine if the improvements in resident QoL are sustained.
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Affiliation(s)
- Marita P McCabe
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Elizabeth Beattie
- Dementia Centre for Research Collaboration, Queensland University of Technology, Brisbane, Australia
| | - Gery Karantzas
- School of Psychology, Deakin University, Burwood, Australia
| | - David Mellor
- School of Psychology, Deakin University, Burwood, Australia
| | - Kerrie Sanders
- Department of Medicine, University of Melbourne and Western Health, Sunshine Hospital, Melbourne, Australia
| | - Lucy Busija
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Belinda Goodenough
- Dementia Training Australia, University of Wollongong, Wollongong, Australia
| | - Michelle Bennett
- School of Allied Health, Australian Catholic University, Sydney, Australia
| | | | - Jessica Byers
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
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Lindsey Jacobs M, Lynn Snow A, Allen RS, Hartmann CW, Dautovich N, Parmelee PA. Supporting autonomy in long-term care: Lessons from nursing assistants. Geriatr Nurs 2019; 40:129-137. [DOI: 10.1016/j.gerinurse.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 11/29/2022]
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Simmons SF, Coelho CS, Sandler A, Shah AS, Schnelle JF. Managing Person-Centered Dementia Care in an Assisted Living Facility: Staffing and Time Considerations. THE GERONTOLOGIST 2018; 58:e251-e259. [PMID: 28575376 DOI: 10.1093/geront/gnx089] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives To describe (a) the unlicensed staff time necessary to provide quality activities of daily living (ADL) care to residents receiving dementia care within an assisted living facility and (b) a staff management approach to maintain quality ADL care. Research Design and Methods Supervisory staff used a standardized observational method to measure ADL care quality and the staff time to provide care during the morning and evening across 12 consecutive months. Staff were given individual feedback about the quality of their care provision following each observation. Results The average staff time to provide ADL care averaged 35 (± 11) minutes per resident per care episode with bathing and 18 (± 6) minutes/resident/care episode without bathing. Morning ADL care required significantly more staff time than evening care. There was not a significant relationship between residents' levels of cognitive impairment or ADL dependency and the staff time to provide ADL care. Quality ADL care was maintained for 12 months. Discussion and Implications This study provides novel data related to the amount of staff time necessary to provide quality ADL care for persons with dementia in an assisted living care setting. This study also describes a standardized approach to staff management that was effective in maintaining quality ADL care provision. Assisted living facilities should consider these data when determining the necessary unlicensed staffing level to provide person-centered ADL care and how to effectively manage direct care providers.
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Affiliation(s)
- Sandra F Simmons
- Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Geriatric Research, Education and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville
| | - Chris S Coelho
- Abe's Garden®, Alzheimer's and Memory Care Center of Excellence, Nashville, Tennessee
| | - Andrew Sandler
- Abe's Garden®, Alzheimer's and Memory Care Center of Excellence, Nashville, Tennessee
| | - Avantika S Shah
- Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John F Schnelle
- Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Geriatric Research, Education and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville
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Jordan KJ, Tsai PF, Heo S, Bai S, Dailey D, Beck C, Butler L. Feasibility of testing a coaching training intervention for CNAs in nursing homes. Geriatr Nurs 2018; 39:702-708. [DOI: 10.1016/j.gerinurse.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/26/2018] [Indexed: 11/27/2022]
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Simmons SF, Coelho CS, Sandler A, Schnelle JF. A System for Managing Staff and Quality of Dementia Care in Assisted Living Facilities. J Am Geriatr Soc 2018; 66:1632-1637. [DOI: 10.1111/jgs.15463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Sandra F. Simmons
- Center for Quality Aging; Vanderbilt University Medical Center; Nashville Tennessee
- Division of Geriatrics, Department of Medicine; Vanderbilt University Medical Center; Nashville Tennessee
- Geriatric Research, Education and Clinical Center; Veterans Affairs Tennessee Valley Healthcare System; Nashville Tennessee
| | - Chris S. Coelho
- Abe's Garden; Alzheimer's and Memory Care Center of Excellence; Nashville Tennessee
| | - Andrew Sandler
- Abe's Garden; Alzheimer's and Memory Care Center of Excellence; Nashville Tennessee
| | - John F. Schnelle
- Center for Quality Aging; Vanderbilt University Medical Center; Nashville Tennessee
- Division of Geriatrics, Department of Medicine; Vanderbilt University Medical Center; Nashville Tennessee
- Geriatric Research, Education and Clinical Center; Veterans Affairs Tennessee Valley Healthcare System; Nashville Tennessee
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Delivering Person-Centered Care: Important Preferences for Recipients of Long-term Services and Supports. J Am Med Dir Assoc 2018; 19:169-173. [DOI: 10.1016/j.jamda.2017.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/02/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022]
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Andrew N, Meeks S. Fulfilled preferences, perceived control, life satisfaction, and loneliness in elderly long-term care residents. Aging Ment Health 2018; 22:183-189. [PMID: 27767325 DOI: 10.1080/13607863.2016.1244804] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Person-centered care constructs such as fulfilled preferences, sense of control, and life satisfaction might contribute to loneliness among nursing home residents, but these relationships have not been thoroughly explored. The aim of this study was to examine the relationship between fulfilled preferences and loneliness in nursing home residents with perceived control and life satisfaction as potential mediators. METHODS The study utilized a cross-sectional design, examining the targeted variables with a questionnaire administered by trained research staff. A convenience sample of 65 residents (median age = 71) of eight nursing homes were interviewed. Linear regression analysis was utilized to examine the mediation hypotheses. RESULTS The relationships between fulfilled preferences and loneliness (β = -.377, p = .002), fulfilled preferences and perceived control (β = -.577, p < .001), and perceived control and loneliness (β = .606, p < .001) were significant, and the relationship between fulfilled preferences and loneliness (β = -.040, p = .744) became non-significant when perceived control was included in the model. The relationships between fulfilled preferences and life satisfaction (β = .420, p < .001) and life satisfaction and loneliness (β = -.598, p < .001) were significant, and the relationship between fulfilled preferences and loneliness (β = -.152, p = .174) became non-significant when life satisfaction was included in the model. CONCLUSION The findings suggest an important association between person-centered care, particularly fulfilling personal care and recreation preferences, and social-affective needs of long-term care residents. Fulfilling preferences may be an appropriate intervention target for loneliness.
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Affiliation(s)
- Nathaniel Andrew
- a Department of Psychological & Brain Sciences , University of Louisville , Louisville , KY , USA
| | - Suzanne Meeks
- a Department of Psychological & Brain Sciences , University of Louisville , Louisville , KY , USA
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Palmer JA, Parker VA, Burgess JF, Berlowitz D, Lynn Snow A, Mitchell SL, Hartmann CW. Developing the Supporting Choice Observational Tool (SCOT): A Formative Assessment Tool to Assist Nursing Home Staff in Realizing Resident Choice. Res Gerontol Nurs 2017; 10:129-138. [PMID: 28541589 PMCID: PMC5767100 DOI: 10.3928/19404921-20170411-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 02/28/2017] [Indexed: 11/20/2022]
Abstract
Quality of care in nursing homes has begun to address the importance of resident choice in daily life, yet there are no published tools to teach nursing home staff how to offer such choice. In the current study, a formative assessment tool was developed that can provide staff with detailed and concrete feedback on how to realize resident choice. The tool was created and refined through 22 hours of ethnographic observation in two Veterans Health Administration Community Living Centers (CLCs), 22 hours of developmental testing in two CLCs, review by a modified Delphi panel, and use of an algorithm to assess its logical structure. The resulting Supporting Choice Observational Tool (SCOT) documents how choice is or is not offered and is or is not enabled within a singular staff-resident interaction. SCOT findings could be used in clinical teaching, quality improvement, or research efforts intent on enhancing nursing home resident quality of life. [Res Gerontol Nurs. 2017; 10(3):129-138.].
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Schnelle JF, Schroyer LD, Saraf AA, Simmons SF. Determining Nurse Aide Staffing Requirements to Provide Care Based on Resident Workload: A Discrete Event Simulation Model. J Am Med Dir Assoc 2016; 17:970-977. [DOI: 10.1016/j.jamda.2016.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/19/2016] [Indexed: 11/17/2022]
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Garcia TJ, Harrison TC, Goodwin JS. Nursing Home Stakeholder Views of Resident Involvement in Medical Care Decisions. QUALITATIVE HEALTH RESEARCH 2016; 26:712-28. [PMID: 25721717 PMCID: PMC5371402 DOI: 10.1177/1049732315573206] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Demand by nursing home residents for involvement in their medical care, or, patient-centered care, is expected to increase as baby boomers begin seeking long-term care for their chronic illnesses. To explore the needs in meeting this proposed demand, we used a qualitative descriptive method with content analysis to obtain the joint perspective of key stakeholders on the current state of person-centered medical care in the nursing home. We interviewed 31 nursing home stakeholders: 5 residents, 7 family members, 8 advanced practice registered nurses, 5 physicians, and 6 administrators. Our findings revealed constraints placed by the long-term care system limited medical involvement opportunities and created conflicting goals for patient-centered medical care. Resident participation in medical care was perceived as low, but important. The creation of supportive educational programs for all stakeholders to facilitate a common goal for nursing home admission and to provide assistance through the long-term care system was encouraged.
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Affiliation(s)
| | | | - James S Goodwin
- The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
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Fain KM, Rosenberg PB, Pirard S, Bogunovic O, Spira AP. Markers of Impaired Decision Making in Nursing Home Residents: Assessment by Nursing Home Staff in a Population-Based Study. J Am Med Dir Assoc 2015; 16:563-7. [DOI: 10.1016/j.jamda.2015.01.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/05/2014] [Accepted: 01/07/2015] [Indexed: 11/27/2022]
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Simmons SF, Rahman AN. Next Steps for Achieving Person-Centered Care in Nursing Homes. J Am Med Dir Assoc 2014; 15:615-9. [DOI: 10.1016/j.jamda.2014.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022]
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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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