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Deprez L, Van Durme T, Bruyère O, Adam S. The Impact of Nursing Home Culture Change: An Integrative Review. J Am Med Dir Assoc 2024; 25:105172. [PMID: 39079679 DOI: 10.1016/j.jamda.2024.105172] [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: 04/20/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVES The Nursing Home Culture Change (NHCC) movement promotes a person- and relationship-centered approach and a small-scale, homelike model for NHs. The present study aimed to integrate the most recent empirical findings regarding the impact of NHCC on resident, staff, family, and organizational outcomes. DESIGN Integrative review. SETTING AND PARTICIPANTS Not applicable. METHODS OVID MEDLINE, PsycINFO, Embase, and CINAHL databases were searched for quantitative or mixed studies published in English between 2018 and 2022 and examining the effect of NHCC on resident, staff, family, and/or organizational outcomes. A narrative and tabular synthesis of the results is provided. RESULTS A total of 1687 references were identified. Following duplicate removal, title and abstract screening, and full-text screening, 75 studies were retained for synthesis and suggest a positive impact of NHCC on resident (eg, quality of life and neuropsychiatric function), staff (eg, job satisfaction and stress), family (eg, satisfaction and depressive symptoms), and organizational (eg, NH attractiveness and occupancy rate) outcomes. CONCLUSIONS AND IMPLICATIONS NHCC shows promising results in all studied outcome categories. Future research should further investigate obstacles to NHCC implementation, conduct cost-benefit analyses supported by appropriate statistical tests, and define ways to improve NH staff education as well as NH policies and regulations to better support NHCC initiatives.
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Affiliation(s)
- Laura Deprez
- Psychology of Aging Unit, Department of Psychology, University of Liège, Liège, Belgium.
| | - Thérèse Van Durme
- Faculty of Public Health, Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Aging, University of Liège, Liege, Belgium
| | - Stéphane Adam
- Psychology of Aging Unit, Department of Psychology, University of Liège, Liège, Belgium
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Chee SY. "Savoring the Past, Nourishing the Present": Uncovering the Essence of Multicultural Mealtime Experiences in Senior Living Facilities. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:322-348. [PMID: 37786389 DOI: 10.1080/01634372.2023.2264894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023]
Abstract
Mealtimes are crucial markers of daily schedules and hold significant meaning for older adults in senior living facilities worldwide, extending beyond the food served. Utilizing Moustakas' transcendental phenomenological approach, this study explores the lived experiences and multifaceted meanings of mealtimes for older adults from multicultural backgrounds in senior living facilities in Malaysia. In six urban senior living facilities, 28 older adults from Malaysia's three major ethnic groups, namely Bumiputera Malays, Chinese, and Indians were interviewed through semi-structured one-on-one interviews. Five discernible themes beyond tangible aspects emerged: mealtimes as cultural bridges, memories and palate, emotional bonds through food, quality control and consumption, and comfort through personalized dining experience. This study raises awareness among senior-living facilitators, family caregivers, academics, and policymakers to acknowledge the evident complexities of mealtimes for older adults living away from the comfort of familiarity. Future research should consider the active involvement of all stakeholders in co-creating and implementing interventions that enhance older adults' mealtime experiences in senior-friendly establishments.
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Affiliation(s)
- Shi Yin Chee
- Faculty of Social Sciences and Leisure Management, Taylor's University, Subang Jaya, Malaysia
- Active Ageing Impact Lab, Taylor's University, Subang Jaya, Malaysia
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Barbosa MM, Teixeira L, Edvardsson D, Paul C, Yanguas J, Afonso RM. Adaptation and validation of the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population. Int J Older People Nurs 2023; 18:e12522. [PMID: 36625238 DOI: 10.1111/opn.12522] [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: 03/07/2022] [Revised: 09/22/2022] [Accepted: 12/03/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The relevance of person-centred care as an optimising approach to the quality of care provided to older adults has sparked the development of important instruments that measure this approach at residential care facilities and requires validation for the Portuguese population. OBJECTIVES This study aims to adapt and validate the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population. METHODS The P-CAT assesses the level of person-centred care provided by residential care facilities, according to staff. The process of adapting the P-CAT to the Portuguese population includes its translation, backtranslation and a pilot study. To recruit participants for the validation study, we contacted the Portuguese residential care facilities with emails provided in the official registries, and the study was also divulged on social media. RESULTS The study had the participation of 573 staff members. The mean score of P-CAT was 50.76 (SD = 7.65). The exploratory factor analysis showed three dimensions: the extent of care personalisation, the amount of organisational support and the degree of environmental accessibility. The results show good internal consistency for the total scale (α = 0.809) and good temporal stability in the test-retest assessed by intraclass correlation coefficient (0.893). CONCLUSIONS This version of the P-CAT for the Portuguese population has shown adequate psychometric properties and contributes to the study of care provided at residential care facilities in Portugal through self-reporting from staff. IMPLICATIONS FOR PRACTICE The availability of this instrument is useful for professional practice and research purposes and supports technical and scientific advancements that are necessary for the evolution of care frameworks.
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Affiliation(s)
- Maria Miguel Barbosa
- Health Sciences Research Centre of the University of Beira Interior (CICS-UBI), Covilhã, Portugal.,CINTESIS@RISE, ICBAS, University of Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Laetitia Teixeira
- CINTESIS@RISE, ICBAS, University of Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Australia, Melbourne, Australia.,Department of Nursing, Umea University, Umea, Sweden
| | - Constança Paul
- CINTESIS@RISE, ICBAS, University of Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | | | - Rosa Marina Afonso
- CINTESIS@RISE, ICBAS, University of Porto, Porto, Portugal.,Faculty of Human and Social Sciences, University of Beira Interior - Estrada do Sineiro, Covilhã, Portugal
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Davies M, Zúñiga F, Verbeek H, Staudacher S. Exploring resident experiences of person-centred care at mealtimes in long-term residential care: a rapid ethnography. BMC Geriatr 2022; 22:963. [PMID: 36513997 PMCID: PMC9747258 DOI: 10.1186/s12877-022-03657-5] [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: 07/11/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Poor nutrition is a common ongoing problem in long-term residential care, often resulting in reduced quality of life. Previous research has concluded that the content of the meal, dining environment, service style and general atmosphere all add to the mealtime experience, suggesting that person-centred mealtimes are optimal. However, knowledge about which elements of person-centred care can be achieved in a mealtime setting in a given context is currently lacking. We aimed to understand the mealtime experience in long-term residential care by exploring (missed) opportunities for person-centred care in different settings. METHODS As part of the TRANS-SENIOR research network, rapid ethnographies, were conducted across multiple sites (including interviews, observations and informal conversations), in a long-term residential care home in the UK, Switzerland and the Netherlands between October 2020 and December 2021. RESULTS: Following analysis and interpretation of observations, interviews and informal conversations, the following themes were developed where either successfully achieved or missed opportunities for person-centred moments were observed: 1) considering the setting, 2) listening to and implementing resident choice, 3) enabling residents to help/care for themselves and others, 4) providing individualised care in a communal setting, and 5) knowing the person in the past and present. Residents experienced moments of participatory choice, interaction, independence and dignity, but opportunities for these were often missed due to organisational or policy constraints. CONCLUSIONS There are opportunities for person-centred moments during the mealtime, some of which are taken and some missed. This largely depended on the setting observed, which includes the overall environment (size of dining area, seating arrangements etc.) and allocation of staff resources, and the level of resident involvement in mealtimes, from preparation to the actual activity.
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Affiliation(s)
- Megan Davies
- grid.6612.30000 0004 1937 0642Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.5012.60000 0001 0481 6099Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands ,CURAVIVA Schweiz, Zieglerstrasse 53, 3000 Bern 14, Postfach 1003 Bern, Switzerland
| | - Franziska Zúñiga
- grid.6612.30000 0004 1937 0642Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Hilde Verbeek
- grid.5012.60000 0001 0481 6099Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands
| | - Sandra Staudacher
- grid.6612.30000 0004 1937 0642Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.5012.60000 0001 0481 6099Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands
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Koh RTG, Thirumanickam A, Attrill S. How are the mealtime experiences of people in residential aged care facilities informed by policy and best practice guidelines? A scoping review. BMC Geriatr 2022; 22:737. [PMID: 36085034 PMCID: PMC9463738 DOI: 10.1186/s12877-022-03340-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mealtimes are embedded routines of residents living in residential aged care facilities (RACFs) that directly impact their health and quality of life. Little is known about how mealtime experiences are informed and affected by structures such as government and organisational policies and processes. This scoping review used Giddens' (The constitution of society: outline of the theory of structuration, 1984) Structuration Theory to investigate how governance structures related to mealtime practices inform residents' mealtime experiences. METHODS Using Arksey and O'Malley's (Int J Soc Res Methodol 8:19-32, 2005) scoping review framework, a systematic database, grey literature and policy search was completed in May 2020 and updated in July 2021. From 2725 identified articles, 137 articles were included in data charting and deductive analysis, and 76 additional Australian government policy papers were used interpretatively. RESULTS Data charting identified that the included studies were prominently situated in Western countries, with a progressive increase in publication rate over the past two decades. Qualitative findings captured structures that guide RACF mealtimes, how these relate to person-centred mealtime practices, and how these facilitate residents to enact choice and control. CONCLUSIONS Current policies lack specificity to inform the specific structures and practices of RACF mealtimes. Staff, residents, organisational and governance representatives possess different signification, legitimation and domination structures, and lack a shared understanding of policy, and how this influences processes and practices that comprise mealtimes.
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Affiliation(s)
| | - Abirami Thirumanickam
- School of Allied Health Science and Practice, University of Adelaide, Frome Road, Adelaide, SA, 5000, Australia
| | - Stacie Attrill
- School of Allied Health Science and Practice, University of Adelaide, Frome Road, Adelaide, SA, 5000, Australia.
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Barbosa MM, Teixeira L, Yanguas J, Paul C, Afonso RM. Staff Assessment Person-Directed Care Questionnaire: Adaptation and Validation for the Portuguese Population. Gerontol Geriatr Med 2022; 8:23337214221103394. [PMID: 35677676 PMCID: PMC9168939 DOI: 10.1177/23337214221103394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Person-centered care aims to increase and guarantee the quality of care at residential
care facilities for older adults. The implementation and development of this approach
requires validated assessment tools, which are still lacking in Portugal. This study aims
to adapt and validate for the Portuguese population the internationally and widely used
essential instrument that is the Staff Assessment Person-Directed Care (SAPDC). The
adaptation of the SAPDC included its translation, back translation, and a pilot-study. For
validation, staff members were recruited by distributing the study via email and on social
media. Respondents included 546 native Portuguese-speaking staff members working at
residential care facilities for over 6 months. The mean score of SAPDC was 165.74 (SD =
36.78). The exploratory factor analysis showed eight conceptually distinct dimensions,
considered adequate by the expert team. The total scale showed a very good internal
consistency (α = .96) and excellent temporal stability assessed by Intraclass Correlation
Coefficient (> .90). Providing a Portuguese version of the SAPDC is useful to
substantiate technical and scientific advancements and define policies with implications
on evolving care approaches. This tool helps optimize the quality and dignification of
gerontological practices, which is urgent at Portuguese residential care facilities.
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Affiliation(s)
- Maria M. Barbosa
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior (CICS-UBI), Avenida Infante D. Henrique, 6201-506 Covilhã, Portugal
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - Laetitia Teixeira
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | | | - Constança Paul
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - Rosa M. Afonso
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
- Department of Psychology and Education, Faculty of Human and Social Sciences, University of Beira Interior, Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
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Caspar S, Brassolotto JM, Cooke HA. Consistent assignment in long-term care homes: Avoiding the pitfalls to capitalise on the promises. Int J Older People Nurs 2020; 16:e12345. [PMID: 32931140 DOI: 10.1111/opn.12345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/21/2020] [Accepted: 08/12/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Consistent assignment (CA) is the practice within long-term care (LTC) by which care staff work with the same residents almost every shift for an indefinite period of time. CA is considered by many to be essential to person-centred care. OBJECTIVES This paper explores how staff assignment practices impact the caregiving experience from the perspectives of resident care aides (RCAs), residents and family members and, by doing so, describe the nuanced conditions under which CA may or may not be beneficial to all, and why. METHODS Data are drawn from 40 in-depth interviews conducted as part of a larger institutional ethnography exploring the social organisation of care in three purposively selected LTC homes in Western Canada. Data analysis was based on the principles of constant comparison. RESULTS RCAs, residents and family members described the primary benefit of CA as being able to 'get to know' each other well and form meaningful relationships. However, the RCAs also indicated that CA can contribute to feelings of isolation, which has negative effects on worker comfort and satisfaction, care team dynamics and communication, and resident care. CONCLUSIONS Management initiatives are needed to ensure that the implementation of CA does not result in the unintended consequences of decreasing RCAs' experience of teamwork, decreasing RCAs' exchange of individualised resident care information, or negatively impacting RCAs' ability and desire to care for each other as well as the residents. IMPLICATIONS FOR PRACTICE The staffing practice of consistent assignment in long-term care homes provides increased opportunities for the development of stronger staff-resident and staff-family member relationships. Findings from this study enable us to offer several, evidenced-based recommendations for ensuring the successful implementation of consistent assignment, such that it may be beneficial to all.
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