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How is leadership experienced in joy-of-life-nursing-homes compared to ordinary nursing homes: a qualitative study. BMC Nurs 2022; 21:73. [PMID: 35351102 PMCID: PMC8966162 DOI: 10.1186/s12912-022-00850-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/21/2022] [Indexed: 12/01/2022] Open
Abstract
Background Nursing homes are under strong pressure to provide good care to the patients. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Homes’ (JoLNH) strategy which is based on a health-promoting approach building on the older persons’ resources. Meanwhile job satisfaction is closely related to less intention to leave, less turnover and reduced sick leave. The knowledge about adjustable influences related with job satisfaction might help nursing home leaders to minimize turnover and preserve high quality of care. This study explores leadership in Norwegian nursing homes with and without implementation of JoLNH: How does leadership influence the work environment and how is leadership experienced in JoLNH compared to ordinary Nursing Homes? Method We used a qualitative approach and interviewed 19 health care personnel working in nursing homes in two Norwegian municipalities. The analysis was conducted following Kvale’s approach to qualitative analysis. Results The main categories after the data condensing were [1] the importance of leadership, and [2] the importance of leadership for the work environment in a municipality with (a) and without (b) an implementation of the JoLNH strategy. Conclusions The health care personnel in the municipality with an implementation of JoLNH emphasize that the leader’s influence may lead to increased motivation among the staff and better control of changes and implementation processes. Our findings may indicate that the employee from a JoLNH municipality experience a more trustful relationship to the leader.
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Mjørud M, Røsvik J. You can tell it works - Experiences from using the VIPS practice model in primary healthcare. DEMENTIA 2021; 21:579-594. [PMID: 34854785 DOI: 10.1177/14713012211053979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Person-centred care is a philosophy rather than a method ready for implementation and utilization in daily clinical work. Internationally, few methods for person-centred care have been widely adopted in clinical dementia care practice. In Norway, the VIPS practice model is one that is commonly used for the implementation and use of person-centred care in primary healthcare. METHOD Nursing home physicians, managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented and used the VIPS practice model for a minimum of 12 months. Individual interviews were conducted via Facetime, Skype or telephone and analysed with qualitative content analysis. FINDINGS In all, 20 respondents were included: one manager of health and care services in the municipality, six managers and leaders working in domestic care or daytime activity centres and 10 managers/leaders and three physicians working in nursing homes. Two global categories emerged: category 1: Change in staff's professional reasoning with two sub-categories: (a) an enhanced professional level in discussions and (b) a change in focus from task to person; and category 2: Changes in the clinical work, with three sub-categories: (a) effective interventions, (b) a person-centred work environment and (c) changes in cooperation between stakeholders. CONCLUSION Regular use of the VIPS practice model appeared to change the work culture for the benefit of both service users and frontline staff. Increased cooperation between frontline staff, nurses, physicians and next of kin was described. Staff were more focused on the needs of the service users, which resulted in care interventions tailored to the needs of the individual with dementia, loyalty to care plans and fewer complaints from next of kin.
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Affiliation(s)
- Marit Mjørud
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Janne Røsvik
- 60512Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Boumans J, van Boekel L, Kools N, Scheffelaar A, Baan C, Luijkx K. How staff characteristics influence residential care facility staff's attitude toward person-centered care and informal care. BMC Nurs 2021; 20:217. [PMID: 34724935 PMCID: PMC8559399 DOI: 10.1186/s12912-021-00743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staff members, and their attitudes, are crucial for providing person-centered care in residential care facilities for people with dementia. However, the literature on the attitudes of nursing staff regarding person-centered care is limited. The objective of this study is to explore the association between staff characteristics (age, education level, years of work experience and function, i.e., care or welfare) and staff attitudes toward perceived person-centered care provision and including informal caregivers in the caregiving process in residential care facilities. METHODS A convenience sample of 68 care staff - nurses and nurse assistants - welfare staff members - activity counselors, hostesses, and living room caretakers - of two residential care facilities filled out a questionnaire. Staff attitudes regarding perceived person-centered care were measured with the Person-centered Care Assessment Tool (P-CAT). Staff attitudes regarding informal care provision were measured with the Attitudes Toward Families Checklist (AFC). Multiple linear regression analysis explored the association between variables age, work experience, education, and function (care or welfare). RESULTS A higher age of staff was associated with a more negative attitude toward perceived person-centered care and informal care provision. Welfare staff had a more negative attitude toward the inclusion of informal caregivers than care staff. The perceived person-centered care provision of the care and welfare staff was both positive. Work experience and education were not associated with perceived person-centered care provision or informal care provision. CONCLUSION This study is one of the first to provide insight into the association between staff characteristics and their attitude toward their perceived person-centered care provision and informal care provision. A higher age of both the care and welfare staff was associated with a more negative attitude toward their perceived person-centered care and informal care provision. Welfare staff had a less positive attitude toward informal care provision. Additionally, future studies, also observational studies and interview studies, are necessary to collect evidence on the reasons for negative attitudes of older staff members towards PCC and informal care giving, to be able to adequately target these reasons by implementing interventions that eliminate or reduce these negative attitudes.
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Affiliation(s)
- Jogé Boumans
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands.
| | - Leonieke van Boekel
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Nathalie Kools
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Aukelien Scheffelaar
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Caroline Baan
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Katrien Luijkx
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
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Backman A, Sjögren K, Lövheim H, Lindkvist M, Edvardsson D. The influence of nursing home managers' leadership on person-centred care and stress of conscience: A cross-sectional study. BMC Nurs 2021; 20:200. [PMID: 34654423 PMCID: PMC8518168 DOI: 10.1186/s12912-021-00718-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background Leadership and stress are common concepts in nursing, and this study explores empirically the connection between leadership and stress of conscience in the context of aged care practice. Previous literature has shown that when staff are unable to carry out their ethical liabilities towards the residents, feelings of guilt may occur among staff, which may be an expression of stress of conscience. Although leadership has been described as crucial for staff’s work perceptions of stress as well as for person-centred practices, the influence of nursing home managers’ leadership on stress of conscience among staff and person-centred practices is still not fully explored. This study attempts to address that knowledge gap by exploring the relationship between leadership, person-centred care, and stress of conscience. Methods This study was based on a cross-sectional national survey of 2985 staff and their managers in 190 nursing homes throughout Sweden. Descriptive statistics and regression modelling were used to explore associations. Results Leadership was associated with a higher degree of person-centred care and less stress of conscience. A higher degree of person-centred care was also associated with less stress of conscience. The results also showed that leadership as well as person-centred care were individually associated with lower levels of stress of conscience when adjusting for potential confounders. Conclusion Nursing home managers’ leadership was significantly associated with less staff stress of conscience and more person-centred care. This indicates that a leadership most prominently characterised by coaching and giving feedback, relying on staff and handling conflicts constructively, experimenting with new ideas, and controlling work individually can contribute to less staff stress as well as higher degree of person-centred care provision.
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Affiliation(s)
- Annica Backman
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.
| | - Karin Sjögren
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Marie Lindkvist
- Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - David Edvardsson
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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Bru-Luna LM, Martí-Vilar M, Merino-Soto C, Livia J. Reliability Generalization Study of the Person-Centered Care Assessment Tool. Front Psychol 2021; 12:712582. [PMID: 34646202 PMCID: PMC8502849 DOI: 10.3389/fpsyg.2021.712582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
The so-called Person-Centered Care (PCC) model identifies three fundamental principles: changing the focus of attention from the disease to the person, individualizing care, and promoting empowerment. The Person-Centered Care Assessment Tool (P-CAT) has gained wide acceptance as a measure of PCC in recent years due to its brevity and simplicity, as well as its ease of application and interpretation. The objective of this study is to carry out a reliability generalization meta-analysis to estimate the internal consistency of the P-CAT and analyze possible factors that may affect it, such as the year of publication, the care context, the application method, and certain sociodemographic properties of the study sample. The mean value of α for the 25 samples of the 23 studies in the meta-analysis was 0.81 (95% CI: 0.79-0.84), with high heterogeneity (squared-I = 85.83%). The only variable that had a statistically significant relationship with the reliability coefficient was the mean age of the sample. The results show that the P-CAT gives acceptably consistent scores when its use is oriented toward the description and investigation of groups, although it may be affected by variables such as the age of participants.
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Affiliation(s)
| | - Manuel Martí-Vilar
- Departamento de Psicología Básica, Universitat de València, Valencia, Spain
| | - César Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, Chiclayo, Peru
| | - José Livia
- Universidad Nacional Federico Villareal, Lima, Peru
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Backman A, Sandman PO, Sköldunger A. Characteristics of nursing home units with high versus low levels of person-centred care in relation to leadership, staff- resident- and facility factors: findings from SWENIS, a cross-sectional study in Sweden. BMC Geriatr 2021; 21:498. [PMID: 34530734 PMCID: PMC8447583 DOI: 10.1186/s12877-021-02434-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The context of care consists of factors that determines the extent to which staff can offer person-centred care. However, few studies have investigated factors that can explain variation in levels of person-centred care among nursing home units. The aim of this study was to explore factors characterizing nursing home units with high and low degree of person-centred care, with focus on leadership, staff, resident and facility factors. METHODS Cross-sectional data from residents, staff, and managers in 172 randomly selected nursing homes in Sweden were collected in 2014. Activities of Daily Living Index, Gottfries' cognitive scale, Person-centred Care Assessment Tool together with demographic information and estimations of leadership engagement was used. Independent samples t-test and Chi2 test were conducted. RESULTS Highly person-centred units were characterised by leaders engaging in staff knowledge, professional development, team support and care quality. In highly person-centred units' staff also received supervision of a nurse to a larger extent. Highly person-centred units were also characterised as dementia specific units, units with fewer beds and with a larger proportion of enrolled nurses. No differences in degree of person-centred care were seen between public or private providers. CONCLUSIONS This study provides guidance for practitioners when designing, developing and adapting person-centred units in aged care contexts. Managers and leaders have an important role to promote the movement towards a person-centred practice of care, by supporting their staff in daily care, and engaging in staff knowledge and professional development. Targeting and adjusting environmental factors, such as provide small and dementia adapted environments to match the residents' personal preferences and capacity are also important when striving towards person-centredness.
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Affiliation(s)
- Annica Backman
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.
| | - Per-Olof Sandman
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden
- NVS, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Anders Sköldunger
- Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden
- NVS, Division of Neurogeriatrics, Department of Nursing, Karolinska Institutet, Huddinge, Sweden
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Persson SS, Blomqvist K, Lindström PN. Meetings are an Important Prerequisite for Flourishing Workplace Relationships. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158092. [PMID: 34360385 PMCID: PMC8345501 DOI: 10.3390/ijerph18158092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/12/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022]
Abstract
Relationships among colleagues, managers, and care recipients are mutually important, and need to be highlighted in workplace health promotion. The aim was to explore prerequisites for flourishing workplace relationships in a municipal healthcare setting for old people. As part of this process, we explored the staff’s suggestions on how work relationships could be improved. The study had a salutogenic and participatory approach, examining staff perceptions of what was required for flourishing relationships to be created, and their suggestions for the relationships to be more promotive. Four multi-stage focus groups, which met three times each, were conducted with staff (n = 26) in old age healthcare settings. A deductive analysis was performed, based on components of the flourishing concept: challenge, connectivity, autonomy, and competence. Informal and formal meetings at work were shown to build positively perceived relationships. The study describes meetings and relationships connected to the four components of flourishing. Suggestions for improving work relationships are also presented. This study contributes to workplace health promotion, and has a salutogenic and participatory focus on how to explore workplace relationships as a resource. The flourishing concept shows how workplace relationships can be explored as prerequisites for workplace health promotion.
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Røsvik J, Mjørud M. 'We must have a new VIPS meeting soon!' Barriers and facilitators for implementing the VIPS practice model in primary health care. DEMENTIA 2021; 20:2649-2667. [PMID: 33870756 PMCID: PMC8670746 DOI: 10.1177/14713012211007409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction Person-centred care is a philosophy of care rather than a method ready for implementation and utilisation in daily work. Internationally, few methods for the implementation of person-centred care have been widely adopted in clinical and care practice. In Norway, the VIPS practice model is a commonly used model for person-centred care implementation. Method Qualitative manifest content analysis was used. Managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented the VIPS practice model and conducted the consensus meeting regularly for a minimum of 12 months. Seventeen respondents were included. Individual interviews were conducted either via FaceTime, Skype or telephone. Results Three global categories emerged describing the implementation process: (1) factors that impact the decision made at municipal level to implement person-centred care; (2) requirements for a good start at unit level and (3) factors that help to support the new routines in the unit. The categories were entwined; the results of one affected the results of the others. The informants from both domestic nursing care and institutions described the same factors as important for the implementation of the VIPS practice model. Conclusion To implement person-centred care by use of the VIPS practice model, the frontline staff need sufficient information about the rationale for implementing the model. The management’s vision and ethos of person-centred care must be followed by time set aside for staff training and regularly scheduled VIPS practice model consensus meetings. Head nurses are key to getting the new routines established and maintained and should be supported by the management.
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Affiliation(s)
- Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, 60512Vestfold Hospital Trust, Tonsberg, Norway, Department of Geriatric Medicine, 155272Oslo University Hospital, Oslo, Norway
| | - Marit Mjørud
- Norwegian National Advisory Unit on Ageing and Health, 60512Vestfold Hospital Trust, Tonsberg, Norway, Department of Geriatric Medicine, 155272Oslo University Hospital, Oslo, Norway
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van Diepen C, Fors A, Ekman I, Hensing G. Association between person-centred care and healthcare providers' job satisfaction and work-related health: a scoping review. BMJ Open 2020; 10:e042658. [PMID: 33293327 PMCID: PMC7722824 DOI: 10.1136/bmjopen-2020-042658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This scoping review aimed to explore and describe the research on associations between person-centred care (PCC) and healthcare provider outcomes, for example, job satisfaction and work-related health. DESIGN Scoping review. ELIGIBILITY CRITERIA Studies were included if they were empirical studies that analysed associations between PCC measurement tools and healthcare providers outcomes. SEARCH STRATEGY Searches in PubMed, CINAHL, Psychinfo and SCOPUS databases were conducted to identify relevant studies published between 2001 and 2019. Two authors independently screened studies for inclusion. RESULTS Eighteen studies fulfilled the inclusion criteria. Twelve studies were cross-sectional, four quasi-experimental, one longitudinal and one randomised controlled trial. The studies were carried out in Sweden, The Netherlands, the USA, Australia, Norway and Germany in residential care, nursing homes, safety net clinics, a hospital and community care. The healthcare provider outcomes consisted of job satisfaction, burnout, stress of conscience, psychosocial work environment, job strain and intent to leave. The cross-sectional studies found significant associations, whereas the longitudinal studies revealed no significant effects of PCC on healthcare provider outcomes over time. CONCLUSION Most studies established a positive association between PCC and healthcare provider outcomes. However, due to the methodological variation, a robust conclusion could not be generated. Further research is required to establish the viability of implementing PCC for the improvement of job satisfaction and work-related health outcomes through rigorous and consistent research.
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Affiliation(s)
- Cornelia van Diepen
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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CHOI J, KIM DE, YOON JY. Person-Centered Care Environment Associated With Care Staff Outcomes in Long-Term Care Facilities. J Nurs Res 2020; 29:e133. [PMID: 33252502 PMCID: PMC7808347 DOI: 10.1097/jnr.0000000000000412] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although a general implementation of person-centered care in Korean long-term care delivery systems would be challenging, person-centered care has the potential to improve resident and staff outcomes through changes in current care services. However, little empirical evidence currently supports a positive relationship between person-centered care environments and staff outcomes. PURPOSE This study was designed to examine the relationship between person-centered care environments and staff outcomes, including job satisfaction and turnover intention, among care staff in Korean long-term care facilities. METHODS This descriptive, correlational study used data from 235 care staff (94 nursing staff and 141 personal care workers) in 13 long-term care facilities in Korea. Data were collected using structured survey questionnaires, including items related to the person-centered care environment, job satisfaction, and turnover intention. Multilevel linear and logistic regression analyses were performed using Mplus Version 7.0. RESULTS After controlling for individual (age, education, monthly income, position, shift work, and job tenure) and organizational (type of facility, location, ownership, bed size, and staffing levels) characteristics, a significant relationship was found between the person-centered care environment and job satisfaction and turnover intention among staff in Korean long-term care facilities. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The study findings indicate that working in a person-centered care environment is key to higher job satisfaction, which is a significant predictor of turnover intention among staff in long-term care facilities. To recruit and retain qualified staff to provide high-quality person-centered care in long-term care facilities, a supportive work environment is crucial. Fostering a person-centered care environment will ultimately improve quality of care for residents.
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Affiliation(s)
- JiSun CHOI
- PhD, RN, Associate Professor, College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Da Eun KIM
- PhD, RN, Assistant Professor, College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
| | - Ju Young YOON
- PhD, RN, Associate Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
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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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Dhami CS, Donnelly LR. Exploring residential care aide experiences with oral malodour in long-term care. Nurs Open 2020; 7:1208-1216. [PMID: 32587741 PMCID: PMC7308701 DOI: 10.1002/nop2.497] [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: 06/22/2019] [Revised: 02/11/2020] [Accepted: 03/17/2020] [Indexed: 11/07/2022] Open
Abstract
Aim To determine what experiences do residential care aides (RCAs) have with individuals living with oral malodour in a long-term care (LTC) facility? Design Study investigation was done using an interpretive qualitative approach paired with a social constructivism interpretive framework. Methods The study was conducted in May of 2015 through face-to-face interviews with RCAs, which were recorded and transcribed verbatim, observations of RCAs in their work environment, as well as RCA personal logs of their daily experiences with odour during caregiving. Thereafter, data were analysed and coded for emerging themes. Results Five major themes were identified after grouping the codes: 1) attitudes and behaviours when caring for residents with malodour; 2)RCA knowledge of oral malodour; 3) level of job satisfaction among RCAs that care for residents with malodour; 4) culture and malodour; and 5) challenges of care giving compounded by malodour. These themes depict the overall experiences of study participants.
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Affiliation(s)
- Charanpreet Singh Dhami
- Department of Oral Biological and Medical SciencesFaculty of DentistryThe University of British ColumbiaVancouverBCCanada
| | - Leeann R. Donnelly
- Department of Oral Biological and Medical SciencesFaculty of DentistryThe University of British ColumbiaVancouverBCCanada
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14
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Fallahpour M, Borell L, Sandberg L, Boström AM. Dementia Care Education Targeting Job Strain and Organizational Climate Among Dementia Care Specialists in Swedish Home Care Services. J Multidiscip Healthc 2020; 13:85-97. [PMID: 32158218 PMCID: PMC6986249 DOI: 10.2147/jmdh.s214378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 11/14/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction An increasing number of older persons live at home with various limitations, such as dementia, requiring well-educated and trained home care staff to meet their complex care needs. Dementia care specialists working in home care service have reported high levels of job strain in comparison with home care staff in general. Aim This pilot study aims to evaluate the effects of a dementia care education model targeting self-reported job strain and organizational climate, among dementia care specialists in home care service. Methods A quasi-experimental, one-group pretest–posttest design was applied, with 12 months’ follow-up. Participants were dementia care specialists who worked in home care service (n=34 baseline; n=30 follow-up). The data were collected using the Strain in Dementia Care Scale and Creative Climate Questionnaires, administered pre- and post-intervention. The intervention applied an educational model based on previous research in dementia care and a person-centered approach. Results The educational model was implemented in the context of home care services. Of 34 participants at baseline, only 21 responded to the questionnaires, due to a drop off of 13 participants and recruitment of 9 new participants (follow-up=30). A significantly reduced perceived job strain among the participants was detected, indicating perceiving less difficulty in “Balancing competing needs” when caring for the older persons. No significant difference was found in the self-reported creative organizational climate between the two occasions. Conclusion The educational model could be integrated into dementia home care and it seemed to reduce job strain among dementia care specialists. Future studies are needed to evaluate the effects of the intervention using a stronger study design and a larger sample.
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Affiliation(s)
- Mandana Fallahpour
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Lena Borell
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Linda Sandberg
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Marie Boström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet Stockholm, Solna, Sweden.,Theme Aging, Karolinska University Hospital, Stockholm, Sweden.,Department of Nursing, Western Norway University of Applied Science, Haugesund, Norway
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15
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Backman A, Ahnlund P, Sjögren K, Lövheim H, McGilton KS, Edvardsson D. Embodying person-centred being and doing: Leading towards person-centred care in nursing homes as narrated by managers. J Clin Nurs 2019; 29:172-183. [PMID: 31612556 DOI: 10.1111/jocn.15075] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/29/2019] [Accepted: 09/29/2019] [Indexed: 01/09/2023]
Abstract
AIMS AND OBJECTIVES To explore how managers describe leading towards person-centred care in Swedish nursing homes. BACKGROUND Although a growing body of research knowledge exists highlighting the importance of leadership to promote person-centred care, studies focused on nursing home managers' own descriptions of leading their staff towards providing person-centred care is lacking. DESIGN Descriptive interview study. COREQ guidelines have been applied. METHODS The study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a nationwide survey of nursing homes in Sweden. Data collection was performed in April 2017, and the data were analysed using content analysis. RESULTS Leading towards person-centred care involved a main category; embodying person-centred being and doing, with four related categories: operationalising person-centred objectives; promoting a person-centred atmosphere; maximising person-centred team potential; and optimising person-centred support structures. CONCLUSIONS The findings revealed that leading towards person-centred care was described as having a personal understanding of the PCC concept and how to translate it into practice, and maximising the potential of and providing support to care staff, within a trustful and innovative work place. The findings also describe how managers co-ordinate several aspects of care simultaneously, such as facilitating, evaluating and refining the translation of person-centred philosophy into synchronised care actions. RELEVANCE TO CLINICAL PRACTICE The findings can be used to inspire nursing home leaders' practices and may serve as a framework for implementing person-centred care within facilities. A reasonable implication of these findings is that if organisations are committed to person-centred care provision, care may need to be organised in a way that enables managers to be present on the units, to enact these strategies and lead person-centred care.
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Affiliation(s)
| | - Petra Ahnlund
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Karin Sjögren
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Katherine S McGilton
- Toronto Rehabilitation Institute University Health Network & University of Toronto, Toronto, ON, Canada
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
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16
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Yang Y, Li H, Xiao LD, Zhang W, Xia M, Feng H. Resident and staff perspectives of person-centered climate in nursing homes: a cross-sectional study. BMC Geriatr 2019; 19:292. [PMID: 31664918 PMCID: PMC6819492 DOI: 10.1186/s12877-019-1313-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Person-centered care is widely recognized as a gold standard and is based on a supportive psychosocial climate for both residents and staff in nursing homes. Residents and staff may have different perspectives as to whether the climate in which they interact is person-centered, perhaps due to their different expectations of the nursing home environment and the provision of care services. The aim of this study was to explore and compare resident and staff perspectives of person-centered climate in aged care nursing homes. METHODS This is a descriptive cross-sectional study using a cluster random sampling method. The study collected data in 2016 from residents (n = 251) and nursing staff (n = 249) in 23 nursing homes using a Person-centered Climate Questionnaire-Patient version and Person-centered Climate-Staff version. T-tests for independent-samples were used to compare scores ranked by nursing staff and residents. RESULTS The mean scores of 'A climate of safety' subscale and 'A climate of everydayness' subscale rated by residents were significantly lower than those rated by nursing staff. The mean scores of 'A climate of hospitality' rated by residents were very low among the three subscales, an indicator of the need to improve a more home-like environment for residents. Residents in larger size nursing homes showed a higher score of person-centered climate compared with their counterparts in small size nursing homes. CONCLUSIONS This study reveals that the perspectives and perceptions of person-centered climate differ between residents and nursing staff. Therefore, both resident and staff perspectives should be taken into account in attempting to improve person-centered climate for better care outcomes.
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Affiliation(s)
- Yunxia Yang
- Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China
| | - Hui Li
- Nursing Department, Ophthalmology Department, The third Xiangya Hospital of Central South University, Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China
| | - Lily Dongxia Xiao
- Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China. .,College of Nursing & Health Sciences, Flinders University, GPO Box 2100, Adelaide, 5001, Australia.
| | - Wenhui Zhang
- School of Nursing and Department of Statistics & Data Sciences, The University of Texas at Austin, 1710 Red River Street, Austin, TX, 78701, USA
| | - Menghan Xia
- Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China
| | - Hui Feng
- Health Nursing Research Center, Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410013, Hunan, China.
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17
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Vassbø TK, Kirkevold M, Edvardsson D, Sjögren K, Lood Q, Bergland Å. The meaning of working in a person-centred way in nursing homes: a phenomenological-hermeneutical study. BMC Nurs 2019; 18:45. [PMID: 31632193 PMCID: PMC6790040 DOI: 10.1186/s12912-019-0372-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 09/30/2019] [Indexed: 11/13/2022] Open
Abstract
Background The present study aims to illuminate the meaning of working in a person-centred way as experienced by staff in nursing homes. Insights into what working in a person-centred way mean for nursing home staff may contribute to a more comprehensive understanding of what gives staff satisfaction in their work and support further development of person-centred care approach in nursing homes. Methods Interviews with 29 health care personnel who had participated in a one-year intervention focusing on person-centred care and thriving in three nursing homes in Australia, Norway and Sweden were performed, and a phenomenological-hermeneutical method was used to explore staffs’ lived experiences of working in a person-centred way in nursing homes. Results For nursing home staff, working in a person-centred way meant that they were able to meet individual resident’s needs and expressed preferences in close family-like relationships, understanding the residents’ rhythms and preferences as the basis of the daily work plans and being able to do ‘the little extra’ for residents. Also, working in a person-centred way meant meeting shared goals by working towards a collective practice in collaborative teams. As a whole, the staffs’ lived experiences of working in a person-centred way in nursing homes was interpreted to mean thriving at work as a psychological state in which individuals experience both a sense of vitality and learning. Conclusions Working in a person-centred way means staff thriving at work in nursing homes. The results further indicate that delivering care by only focusing on routines and practical tasks and not on residents’ preferences and well-being would inhibit thriving among nursing staff, leading to the potential for dissatisfaction with work.
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Affiliation(s)
- Tove K Vassbø
- 1Department of Nursing, Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway.,2Lovisenberg Diaconal University College, Oslo, Norway
| | - Marit Kirkevold
- 1Department of Nursing, Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway
| | - David Edvardsson
- 3Department of Nursing, Umeå University, Umeå, Sweden.,4School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Karin Sjögren
- 3Department of Nursing, Umeå University, Umeå, Sweden
| | - Qarin Lood
- 3Department of Nursing, Umeå University, Umeå, Sweden.,4School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.,5Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Ådel Bergland
- 1Department of Nursing, Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway
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18
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du Toit SHJ, Buchanan H. Embracing Cultural Diversity: Meaningful Engagement for Older Adults With Advanced Dementia in a Residential Care Setting. Am J Occup Ther 2019; 72:7206205090p1-7206205090p8. [PMID: 30760401 DOI: 10.5014/ajot.2018.027292] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Providing person-centered care (PCC) that focuses on meaningful engagement in residential care settings for older adults with moderate to advanced dementia is an internationally recognized challenge. In this study, we aimed to identify best-practice scenarios for supporting older adults with moderate to advanced dementia from culturally and linguistically diverse backgrounds who lived in care facilities. A mixed-methods study with a concurrent triangulation strategy was adopted. Data collection occurred with care partners by means of a preworkshop questionnaire, an appreciative-inquiry workshop, and an adapted Delphi technique. The findings indicate that care partners valued the care facilities' residents' needs for doing, being, and belonging. Collaborative data generation reflected the setting-specific PCC practices. Leadership team members agreed that enabling inclusion and celebrating cultural diversity were important but that cultural humility needed to be promoted.
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Affiliation(s)
- Sanetta H J du Toit
- Sanetta H. J. du Toit, BOccTher, MOccTher (UFS), MScOccTher, PhD, is Lecturer, Faculty of Health Sciences, Discipline of Occupational Therapy, University of Sydney, Sydney, New South Wales, Australia, and Affiliated Lecturer, Department of Occupational Therapy, University of the Free State, Bloemfontein, South Africa
| | - Helen Buchanan
- Helen Buchanan, BSc(OT), MSc(OT), PhD, is Associate Professor, Department of Health and Rehabilitation Sciences, Division of Occupational Therapy, University of Cape Town, Cape Town, South Africa;
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19
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Bethell J, Chu CH, Wodchis WP, Walker K, Stewart SC, McGilton KS. Supportive Supervision and Staff Intent to Turn Over in Long-Term Care Homes. THE GERONTOLOGIST 2019; 58:953-959. [PMID: 28329826 DOI: 10.1093/geront/gnx008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Indexed: 01/14/2023] Open
Abstract
Background and Objectives To examine the association between supervisory support and intent to turn over among personal support workers (PSWs) employed in long-term care (LTC) homes in Ontario, Canada, by assessing whether the association is mediated by job satisfaction and the potential confounding effect of happiness. Research Design and Methods Cross-sectional survey data of 5,645 PSWs working within 398 LTC homes in Ontario, Canada, were obtained and analysed through a series of multilevel regression models. Results Overall, analyses support the assertion that the effect of supervisory support on intent to turn over is partially mediated by job satisfaction. However, happiness may act as an effect modifier rather than as a confounder. Discussion and Implications These results reinforce the importance of supportive supervision for PSWs working in LTC homes and highlight the multifaceted role of nurses in LTC, who traditionally provide the majority of PSW supervision. Nurses must be equipped with competencies and skills that reflect the complex organisational environments in which they work. However, these results must also be interpreted in context with the limitations of cross-sectional data; future research should incorporate prospective data collection and clarify the potential role of happiness.
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Affiliation(s)
- Jennifer Bethell
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Charlene H Chu
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Walter P Wodchis
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Kevin Walker
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Steven C Stewart
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Katherine S McGilton
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada
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20
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Persson SS, Lindström PN, Pettersson P, Andersson I. Workplace relationships impact self-rated health: A survey of Swedish municipal health care employees. Work 2019; 60:85-94. [PMID: 29843296 DOI: 10.3233/wor-182721] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The impact of positive social relationships on the health of municipal employees in the elder care sector in Sweden needs further examination. OBJECTIVE To explore the association between health and relationships among elderly care employees using a salutogenic perspective. METHOD Survey of all employees (n = 997) in special housing, home care and Disabled Support and Services in a Swedish municipality. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, social climate, and health-promoting workplace relationships. RESULTS The response rate was 69% . Results of a multivariable linear regression model showed four significant predictors of health: general work experiences, colleague belongingness and positive relationships with managers and care recipients. In another model, colleague belongingness was significantly related to satisfaction with care recipients, work, length of employment as well as general work experiences and relationships with managers. CONCLUSION Strengthening of positive work relationships, not only between workmates but also with managers and care recipients, seems to be an essential area for employee health promotion. Colleague belongingness may be deepened by development of a positive work climate, including satisfactory work experiences, positive manager relationships and a stable work force.
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Affiliation(s)
- Sophie Schön Persson
- School of Health and Society, Kristianstad University, Kristianstad, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Pär Pettersson
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Ingemar Andersson
- School of Health and Society, Kristianstad University, Kristianstad, Sweden
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21
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Silén M, Skytt B, Engström M. Relationships between structural and psychological empowerment, mediated by person-centred processes and thriving for nursing home staff. Geriatr Nurs 2019; 40:67-71. [DOI: 10.1016/j.gerinurse.2018.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 12/22/2022]
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22
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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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23
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Wu X, Li J, Liu G, Liu Y, Cao J, Jia Z. The effects of emotional labor and competency on job satisfaction in nurses of China: A nationwide cross-sectional survey. Int J Nurs Sci 2018; 5:383-389. [PMID: 31406852 PMCID: PMC6626301 DOI: 10.1016/j.ijnss.2018.08.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/20/2018] [Accepted: 08/30/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to explore the status of job satisfaction, emotional labour, core competencies and job stress and the associations of emotional labour and core competencies with the job satisfaction of nurses in China. Methods Data were collected by using a self-designed general information questionnaire, a job satisfaction questionnaire (McCloskey/Mueller Satisfaction Scale), a nurse emotional labour questionnaire, the Competency Inventory for Registered Nurses questionnaire, and a nurse job stressor questionnaire. A total of 13,448 nurses from 92 hospitals across mainland of China were surveyed, and 11,337 respondents (84.3% response rate) completed the questionnaires. Results The survey results indicated that Chinese nurses had average job satisfaction (24.77 ± 5.23), moderate job stress (86.84 ± 21.12), moderate to high emotional labour experiences (55.08 ± 9.63) and high competency (195.77 ± 37.61). Multiple linear regression indicated that surface acting was negatively correlated with job satisfaction (P < 0.01), while deep acting (P < 0.01) and nurses’ core competence (P < 0.01) were positively associated with job satisfaction. Besides, The results also indicated job stress, geographical distribution, hospital category, gender, work shift, only children, parenting status, monthly salary, nursing experience, professional title, hospital area were the influencing factors of job satisfaction (P < 0.05). Conclusion The improvement of the emotional labour and competency of nurses may help enhance their job satisfaction.
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Affiliation(s)
- Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Beijing, China
| | - Jiaqian Li
- Department of Nursing, Peking Union Medical College Hospital, Beijing, China
| | - Ge Liu
- Department of Nursing, Peking Union Medical College Hospital, Beijing, China
| | - Ying Liu
- Department of Nursing, Peking Union Medical College Hospital, Beijing, China
| | - Jing Cao
- Department of Nursing, Peking Union Medical College Hospital, Beijing, China
| | - Zhaoxia Jia
- Department of Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
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24
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Schön Persson S, Nilsson Lindström P, Pettersson P, Nilsson M, Blomqvist K. Resources for work-related well-being: A qualitative study about healthcare employees' experiences of relationships at work. J Clin Nurs 2018; 27:4302-4310. [PMID: 29791765 DOI: 10.1111/jocn.14543] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore municipal healthcare employees' experiences of relationships with care recipients and colleagues. The specific research questions were when do the relationships enhance well-being, and what prerequisites are needed for such relationships to occur? BACKGROUND Employees in health and social care for older people often depict their work in negative terms, and they often take a high number of sick leaves. Despite the heavy workload, other employees express well-being at work and highlight social relationships as one reason for this. However, a greater understanding of how these relationships can act as resources for workplace well-being is needed. DESIGN The design of the study was qualitative and exploratory. METHODS Qualitative interview studies were conducted with 23 healthcare employees in municipal health care. Thematic analysis was used to analyse the data. RESULTS Two themes were identified as resources for promoting relationships between employees and care recipients or colleagues: (a) Being personal-a close interpersonal relationship to a care recipient-and (b) Colleague belongingness-a sense of togetherness within the working group. Spending quality time together, providing long-term care and providing additional care were prerequisites for a close interpersonal relationship with care recipients. Trust, mutual responsibility and cooperation were prerequisites for a sense of togetherness within the working group. CONCLUSIONS The findings provide an empirical base to raise awareness of relationships with care recipients and colleagues as health aspects. Relationships among employees in health care are vital resources that must be considered to create sustainable workplaces and consequently improve the quality of care. RELEVANCE TO CLINICAL PRACTICE The results of this study advocate health promotion efforts based on interpersonal relationships at the workplace. Dialogues in the working groups, based on the employees' experiences of positive daily situations, may be a promoting method for the work-related well-being of the employees.
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Affiliation(s)
- Sophie Schön Persson
- Faculty of Health Science, Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden.,Department of Clinical Science, Lund University, Malmö, Sweden
| | - Petra Nilsson Lindström
- Faculty of Health Science, Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden
| | - Pär Pettersson
- Faculty of Health Science, Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden
| | - Marie Nilsson
- Faculty of Health Science, Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden
| | - Kerstin Blomqvist
- Faculty of Health Science, Research Platform for Collaboration for Health, Kristianstad University, Kristianstad, Sweden
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25
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Sandberg L, Borell L, Edvardsson D, Rosenberg L, Boström AM. Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services. J Multidiscip Healthc 2018; 11:255-266. [PMID: 29861636 PMCID: PMC5969065 DOI: 10.2147/jmdh.s155467] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff’s well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. Aim To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors. Methods The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34) and other home care staff who are not specialized in dementia care (n=35). The Strain in Dementia Care Scale (SDCS) and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling) were applied. The regional ethical review board approved the study. Results Home care staff perceived job strain – particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71) than other staff members (m=4.71; p=0.04). Job strain (for total score and for all five SDCS factors) correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting) and not having Swedish as first language and SDCS factor 5 (lack of recognition) and stagnated organizational climate. Conclusion The study indicates that home care staff and particularly dementia care specialists perceived high job strain. Future studies are needed to confirm or reject findings from this study.
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Affiliation(s)
- Linda Sandberg
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Lena Borell
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Heidelberg, VIC, Australia.,Department of Nursing, Umea University, Umea, Sweden
| | - Lena Rosenberg
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Anne-Marie Boström
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Theme Aging, Karolinska University Hospital, Stockholm, Sweden.,Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway
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26
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Tangiisuran B, Tye SC, Leow MY, Awang R. Comparison of nurses and general caregivers' knowledge, attitude, and practice on medication administration process and their distress level in long-term care facilities across Penang, Kuala Lumpur, and Selangor of Malaysia. Aging Clin Exp Res 2018; 30:183-191. [PMID: 28527134 DOI: 10.1007/s40520-017-0772-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/05/2017] [Indexed: 02/06/2023]
Abstract
AIM Comparing nurses and general caregivers' knowledge, attitude, and practices (KAP) on medication administration process in long-term care (LTC) setting and an assessment of their stress, anxiety, and depression (SAD) level. METHODS A cross-sectional survey was conducted among nurses and general caregivers working in LTC using a validated questionnaire. Consisting of demographic characteristics (Section 1); 40 questions on KAP (Section 2); and assessment of Depression, Anxiety, and Stress Scale (DASS-21) (Section 3). RESULTS 155 formally paid staffs in 26 LTC facilities were recruited. Nurses scored significantly higher in the knowledge section compared to caregivers (12.4 ± 1.7 vs. 4.5 ± 3.8; P < 0.001); better attitude (41.5 ± 4.8 vs. 30.8 ± 7.3; P < 0.001); and better practice (65.2 ± 8.5 vs. 40.3 ± 10.9; P < 0.001), respectively. SAD scores reveal that caregivers had significantly higher level of stress, anxiety, and depression compared to the nurses. DISCUSSION General caregivers exhibit poorer knowledge on aspects pertaining to posology, appropriate methods of drug administration, and side effects of common drugs used by the elderly. Compared to nurses, the general caregivers also reported poorer medication administration practices; including not checking labels and expiry dates prior to administration, and not providing basic information about medication therapy to the residents. However, both nurses and general caregivers reported positive attitudes in their role as caregivers. They take pride and satisfaction in their occupation providing support to the elderly. CONCLUSION General caregivers demonstrated lesser knowledge, poorer attitude, and practices towards medication administration processes, in addition to higher SAD score in LTC facilities.
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Affiliation(s)
- Balamurugan Tangiisuran
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.
| | - Sok Cin Tye
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - May Yen Leow
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia
| | - Rahmat Awang
- WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia, 11800, Penang, Malaysia
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Lerner NB, Trinkoff A, Storr CL, Han K, Yang BK. Leadership tenure is related to aide turnover in US assisted living facilities: Cross-sectional secondary data analysis. Appl Nurs Res 2017; 36:33-36. [DOI: 10.1016/j.apnr.2017.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/26/2017] [Indexed: 10/19/2022]
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Pung LX, Shorey S, Goh YS. Job satisfaction, demands of immigration among international nursing staff working in the long-term care setting: A cross-sectional study. Appl Nurs Res 2017; 36:42-49. [DOI: 10.1016/j.apnr.2017.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/11/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
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Chamberlain SA, Hoben M, Squires JE, Estabrooks CA. Individual and organizational predictors of health care aide job satisfaction in long term care. BMC Health Serv Res 2016; 16:577. [PMID: 27737672 PMCID: PMC5064796 DOI: 10.1186/s12913-016-1815-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/04/2016] [Indexed: 11/27/2022] Open
Abstract
Background Unregulated health care aides provide the majority of direct health care to residents in long term care homes. Lower job satisfaction as reported by care aides is associated with increased turnover of staff. Turnover leads to inferior job performance and negatively impacts quality of care for residents. This study aimed to determine the individual and organizational variables associated with job satisfaction in care aides. Methods We surveyed a sample of 1224 care aides from 30 long term care homes in three Western Canadian provinces. The care aides reported their job satisfaction and their perception of the work environment. We used a hierarchical, mixed-effects ordered logistic regression to model the relative odds of care aide job satisfaction for individual, care unit, and facility factors. Results Care aide exhaustion, professional efficacy, and cynicism were associated with job satisfaction. Factors in the organizational context that are associated with increased care aide job satisfaction include: leadership, culture, social capital, organizational slack—staff, organizational slack—space, and organizational slack—time. Conclusions Our findings suggest that organizational factors account for a greater increase in care aide job satisfaction than do individual factors. These features of the work environment are modifiable and predict care aide job satisfaction. Efforts to improve care aide work environment and quality of care should focus on organizational context.
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Affiliation(s)
| | - Matthias Hoben
- Faculty of Nursing, University of Alberta, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Janet E Squires
- University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.,Ottawa Hospital Research Institute, Centre for Practice-Changing Research (CPCR), 501 Smyth Road, Room 1282, Box 711, Ottawa, ON, K1H 8L6, Canada
| | - Carole A Estabrooks
- Faculty of Nursing, University of Alberta, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
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McGilton KS, Chu CH, Shaw AC, Wong R, Ploeg J. Outcomes related to effective nurse supervision in long-term care homes: an integrative review. J Nurs Manag 2016; 24:1007-1026. [DOI: 10.1111/jonm.12419] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Katherine S. McGilton
- Department of Research; Toronto Rehabilitation Institute-UHN; Toronto Ontario Canada
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto Ontario Canada
| | - Charlene H. Chu
- Department of Research; Toronto Rehabilitation Institute-UHN; Toronto Ontario Canada
| | | | - Rosalind Wong
- Toronto Western Research Institute; Toronto Ontario Canada
| | - Jenny Ploeg
- McMaster University; Hamilton Ontario Canada
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31
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Shannon K, McKenzie-Green B. Current role challenges in New Zealand aged residential care: the potential consequences for healthcare assistant role expansion. Contemp Nurse 2016; 52:140-51. [DOI: 10.1080/10376178.2016.1221322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schwendimann R, Dhaini S, Ausserhofer D, Engberg S, Zúñiga F. Factors associated with high job satisfaction among care workers in Swiss nursing homes - a cross sectional survey study. BMC Nurs 2016; 15:37. [PMID: 27274334 PMCID: PMC4895903 DOI: 10.1186/s12912-016-0160-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background While the relationship between nurses’ job satisfaction and their work in hospital environments is well known, it remains unclear, which factors are most influential in the nursing home setting. The purpose of this study was to describe job satisfaction among care workers in Swiss nursing homes and to examine its associations with work environment factors, work stressors, and health issues. Methods This cross-sectional study used data from a representative national sample of 162 Swiss nursing homes including 4,145 care workers from all educational levels (registered nurses, licensed practical nurses, nursing assistants and aides). Care worker-reported job satisfaction was measured with a single item. Explanatory variables were assessed with established scales, as e.g. the Practice Environment Scale – Nursing Work Index. Generalized Estimating Equation (GEE) models were used to examine factors related to job satisfaction. Results Overall, 36.2 % of respondents reported high satisfaction with their workplace, while another 50.4 % were rather satisfied. Factors significantly associated with high job satisfaction were supportive leadership (OR = 3.76), better teamwork and resident safety climate (OR = 2.60), a resonant nursing home administrator (OR = 2.30), adequate staffing resources (OR = 1.40), fewer workplace conflicts (OR = .61), less sense of depletion after work (OR = .88), and fewer physical health problems (OR = .91). Conclusions The quality of nursing home leadership–at both the unit supervisor and the executive administrator level–was strongly associated with care workers’ job satisfaction. Therefore, recruitment strategies addressing specific profiles for nursing home leaders are needed, followed by ongoing leadership training. Future studies should examine the effects of interventions designed to improve nursing home leadership and work environments on outcomes both for care staff and for residents.
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Affiliation(s)
- René Schwendimann
- Institute of Nursing Science, University of Basel, Bernoullistr. 28, Basel, 4056 Switzerland
| | - Suzanne Dhaini
- Institute of Nursing Science, University of Basel, Bernoullistr. 28, Basel, 4056 Switzerland
| | - Dietmar Ausserhofer
- Institute of Nursing Science, University of Basel, Bernoullistr. 28, Basel, 4056 Switzerland ; College of Health-Care Professions Claudiana, Lorenz-Böhlerstr. 13, Bozen, 39100 Italy
| | - Sandra Engberg
- Institute of Nursing Science, University of Basel, Bernoullistr. 28, Basel, 4056 Switzerland ; Pittsburgh University, School of Nursing, 350 Victoria Building, 3500 Victoria St, Pittsburgh, PA 15261 USA
| | - Franziska Zúñiga
- Institute of Nursing Science, University of Basel, Bernoullistr. 28, Basel, 4056 Switzerland
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Johannessen B, Garvik G. Experiences with the use of complementary and alternative medicine in nursing homes: A focus group study. Complement Ther Clin Pract 2016; 23:136-40. [DOI: 10.1016/j.ctcp.2015.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
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Condelius A, Jakobsson U, Karlsson S. Exploring the Implementation of Individual Care Plans in Relation to Characteristics of Staff. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojn.2016.68062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND Though many staff gain satisfaction from working with people with dementia in residential facilities, they also experience significant stress. This is a serious issue because this in turn can affect the quality of care. There is, however, a lack of instruments to measure staff strain in the dementia-specific residential care environment, and the aim of this study, accordingly, was to develop the "Strain in Dementia Care Scale." METHODS The instrument was developed in three steps. In the first step, items were derived from six focus group discussions with 35 nurses in the United Kingdom, Australia, and Sweden concerning their experience of strain. In the second step, a preliminary 64-item scale was distributed to 927 dementia care staff in Australia and Sweden, which, based on exploratory factor analysis, resulted in a 29-item scale. In the final step, the 29-item scale was distributed to a new sample of 346 staff in Sweden, and the results were subjected to confirmatory factor analysis. RESULTS The final scale comprised the following 27 items producing a five-factor solution: Frustrated empathy; difficulties understanding and interpreting; balancing competing needs; balancing emotional involvement; and lack of recognition. CONCLUSIONS The scale can be used (a) as an outcome measurement in residential care intervention studies; (b) to help residential facilities identify interventions needed to improve staff well-being, and, by extension, those they care for; and
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36
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Cluster Randomized Controlled Trial of An Aged Care Specific Leadership and Management Program to Improve Work Environment, Staff Turnover, and Care Quality. J Am Med Dir Assoc 2015; 16:629.e19-28. [DOI: 10.1016/j.jamda.2015.04.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/12/2015] [Accepted: 04/08/2015] [Indexed: 11/16/2022]
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Nilsson A, Rasmussen BH, Edvardsson D. A threat to our integrity - Meanings of providing nursing care for older patients with cognitive impairment in acute care settings. Scand J Caring Sci 2015; 30:48-56. [DOI: 10.1111/scs.12220] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/17/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - David Edvardsson
- Department of Nursing; Umeå University; Umeå Sweden
- School of Nursing and Midwifery; La Trobe University; Melbourne Vic. Australia
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Sjögren K, Lindkvist M, Sandman PO, Zingmark K, Edvardsson D. To what extent is the work environment of staff related to person-centred care? A cross-sectional study of residential aged care. J Clin Nurs 2014; 24:1310-9. [PMID: 25420415 DOI: 10.1111/jocn.12734] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2014] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationship between staff characteristics, perceived work environment and person-centred care in residential aged care units. BACKGROUND Person-centred care is often described as the model of choice in residential aged care and in the care of persons with dementia. Few empirical studies have reported on the relationship between how staff experience different aspects of their work and person-centred care. DESIGN The study had a cross-sectional quantitative design. METHODS Staff in 151 residential aged care units in Sweden (n = 1169) completed surveys which included questions about staff characteristics, valid and reliable measures of person-centred care, satisfaction with work and care, job strain, stress of conscience and psychosocial unit climate. Statistical analyses of correlations, group differences and multiple linear regression analysis estimated with generalised estimating equation were conducted. RESULTS Higher levels of staff satisfaction, lower levels of job strain, lower levels of stress of conscience, higher levels of a supportive psychosocial unit climate and a higher proportion of staff with continuing education in dementia care were associated with higher levels of person-centred care. Job strain and a supportive psychosocial climate, explained most of the variation in person-centred care. CONCLUSIONS This study shows that the work environment as perceived by staff is associated with the extent to which staff perceive the care as being person-centred in residential aged care. These empirical findings support the theoretical postulation that the work environment is an important aspect of person-centred care. RELEVANCE TO CLINICAL PRACTICE Promoting a positive and supportive psychosocial climate and a work environment where staff experience balance between demands and control in their work, to enable person-centred care practice, seems to be important implications for managers and leaders in residential aged care.
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Affiliation(s)
- Karin Sjögren
- Department of Nursing, Umeå University, Umeå, Sweden
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39
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Applying a palliative care approach in residential care: Effects on nurse assistants' work situation. Palliat Support Care 2013; 13:543-53. [DOI: 10.1017/s1478951513000783] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectives:The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.Method:A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).Results:Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.Significance of results:The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
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40
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Edvardsson D, Sjögren K, Lindkvist M, Taylor M, Edvardsson K, Sandman P. Person-centred climate questionnaire (PCQ-S): establishing reliability and cut-off scores in residential aged care. J Nurs Manag 2013; 23:315-23. [DOI: 10.1111/jonm.12132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2013] [Indexed: 11/30/2022]
Affiliation(s)
- David Edvardsson
- School of Nursing and Midwifery; La Trobe University; Melbourne Australia
- Department of Nursing; Umeå University; Umeå Sweden
| | | | - Marie Lindkvist
- Departments of Statistics, Public Health and Clinical Medicine; Umeå University; Umeå Sweden
| | - Michael Taylor
- Australian Institute for Primary Care and Ageing; La Trobe University; Melbourne Australia
| | - Kristina Edvardsson
- Department of Public Health and Clinical Medicine; Epidemiology and Global Health; Umeå University; Umeå Sweden
| | - P.O. Sandman
- Department of Neurobiology; Care Sciences and Society; Division of Nursing; Karolinska Institutet; Stockholm Sweden
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Orrung Wallin A, Edberg AK, Beck I, Jakobsson U. Psychometric properties concerning four instruments measuring job satisfaction, strain, and stress of conscience in a residential care context. Arch Gerontol Geriatr 2013; 57:162-71. [PMID: 23643346 DOI: 10.1016/j.archger.2013.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 04/01/2013] [Accepted: 04/04/2013] [Indexed: 11/25/2022]
Abstract
There are many instruments assessing the wellbeing of staff, but far from all have been psychometrically investigated. When evaluating supportive interventions directed toward nurse assistants in residential care, valid and reliable instruments are needed in order to detect possible changes. The aim of the study was to investigate validity in terms of data quality, construct validity, convergent and divergent validity and reliability in terms of the internal consistency and stability of the Job Satisfaction Questionnaire, the Psychosocial Aspects of Job Satisfaction, the Strain in Dementia Care Scale (SDCS), and the Stress of Conscience Questionnaire (SCQ) in a residential care context. The psychometric properties of the instruments were investigated in terms of data quality, construct validity, convergent and divergent validity and reliability, including test-retest reliability, in a residential care context with a sample consisting of nurse assistants (n=114). The four instruments responded with different psychometric-related problems such as internal missing data, floor and ceiling effects, problems with construct validity and low test-retest reliability, especially when assessed on the item level. These problems were however reduced or disappeared completely when assessed for total and factor scores. From a psychometric perspective, the SDCS seemed to stand out as the best instrument. However, it should be modified in order to reduce floor effects on item level and thereby gain sensitivity. The Job Satisfaction Questionnaire seemed to have problems both with the construct validity and test-retest reliability. The final choice of instrument must, however, be made dependent on what one intends to measure.
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Affiliation(s)
- Anneli Orrung Wallin
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00 Lund, Sweden.
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