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Zhou X, Wong H. Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio. BMC Geriatr 2024; 24:431. [PMID: 38750411 PMCID: PMC11097439 DOI: 10.1186/s12877-024-05029-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.
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Affiliation(s)
- Xiaofan Zhou
- School of Sociology, Central China Normal University, Wuhan, China.
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
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2
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Bru-Luna LM, Martí-Vilar M, Merino-Soto C, Livia-Segovia J, Garduño-Espinosa J, Toledano-Toledano F. Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties. BMC Psychol 2024; 12:217. [PMID: 38641852 PMCID: PMC11031960 DOI: 10.1186/s40359-024-01716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 04/07/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND The person-centered care (PCC) approach plays a fundamental role in ensuring quality healthcare. The Person-Centered Care Assessment Tool (P-CAT) is one of the shortest and simplest tools currently available for measuring PCC. The objective of this study was to conduct a systematic review of the evidence in validation studies of the P-CAT, taking the "Standards" as a frame of reference. METHODS First, a systematic literature review was conducted following the PRISMA method. Second, a systematic descriptive literature review of validity tests was conducted following the "Standards" framework. The search strategy and information sources were obtained from the Cochrane, Web of Science (WoS), Scopus and PubMed databases. With regard to the eligibility criteria and selection process, a protocol was registered in PROSPERO (CRD42022335866), and articles had to meet criteria for inclusion in the systematic review. RESULTS A total of seven articles were included. Empirical evidence indicates that these validations offer a high number of sources related to test content, internal structure for dimensionality and internal consistency. A moderate number of sources pertain to internal structure in terms of test-retest reliability and the relationship with other variables. There is little evidence of response processes, internal structure in measurement invariance terms, and test consequences. DISCUSSION The various validations of the P-CAT are not framed in a structured, valid, theory-based procedural framework like the "Standards" are. This can affect clinical practice because people's health may depend on it. The findings of this study show that validation studies continue to focus on the types of validity traditionally studied and overlook interpretation of the scores in terms of their intended use.
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Affiliation(s)
- Lluna Maria Bru-Luna
- Departamento de Educación, Facultad de Ciencias Sociales, Universidad Europea de Valencia, 46010, Valencia, Spain
| | - Manuel Martí-Vilar
- Departamento de Psicología Básica, Universitat de València, Blasco Ibáñez Avenue, 21, 46010, Valencia, Spain
| | - César Merino-Soto
- Departamento de Psicología, Instituto de Investigación de Psicología, Universidad de San Martín de Porres, Tomás Marsano Avenue 242, Lima 34, Perú
| | - José Livia-Segovia
- Instituto Central de Gestión de la Investigación, Universidad Nacional Federico Villarreal, Carlos Gonzalez Avenue 285, 15088, San Miguel, Perú
| | - Juan Garduño-Espinosa
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Dr. Márquez 162, 06720, Doctores, Cuauhtémoc, Mexico
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Dr. Márquez 162, 06720, Doctores, Cuauhtémoc, Mexico.
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, México-Xochimilco 289, Arenal de Guadalupe, 14389, Tlalpan, Mexico City, Mexico.
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, 14389, Tlalpan, Mexico City, Mexico.
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3
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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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Zhao Y, Ding Y, Liu L, Chan HYL. Feasibility of a Culturally Specific DEmentia Competence Education for Nursing Home Taskforce (DECENT) Programme: A Mixed-Method Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16679. [PMID: 36554559 PMCID: PMC9779405 DOI: 10.3390/ijerph192416679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Although educational resources have been developed to build staff's dementia care competence in Western culture, their applicability and cultural relevance to the Chinese population are questionable. To address this gap, the DEmentia Competence Education for Nursing home Taskforce (DECENT) programme was developed and tailored to Chinese staff. This study aimed to evaluate the feasibility and preliminary effects of the DECENT programme. A one-group pretest-posttest study, embedded with a qualitative component, was conducted among 12 healthcare professionals. The DECENT programme comprised eight topics covering essential competencies in dementia care. It was delivered face-to-face by a qualified educator once per week for 60-90 min over 8 weeks. Outcomes were measured at baseline and immediately post-intervention. A satisfaction survey and individual interviews were conducted post-intervention to understand participants' perceptions and experience with the intervention. Nine participants finished the post-intervention assessment. Except for staff's attitudes towards people with dementia, quantitative findings generally demonstrated positive changes following the intervention. Three categories were identified from the qualitative data: well-developed programme, perceived benefits, and barriers. The findings showed that the DECENT programme is feasible and is perceived by nursing home staff as relevant and useful to daily practice. A larger-scale study is needed to evaluate its effectiveness.
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Affiliation(s)
- Yayi Zhao
- School of Nursing, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Xianlin District, Nanjing 210038, China
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing 211100, China
| | - Li Liu
- Xiangya Nursing School, Central South University, No. 172 Tongzi Slopes Road, Yuelu District, Changsha 410013, China
| | - Helen Y. L. Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin 999077, Hong Kong SAR, China
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5
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Zhao Y, Liu L, Ding Y, Chan HYL. Effect of a culturally sensitive DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in China: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 116:105434. [PMID: 35728332 DOI: 10.1016/j.nedt.2022.105434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/27/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Existing educational programmes for building capacity in dementia care are developed in the Western culture; their applicability and cultural relevancy to other cultures is questionable. There is a dearth of culturally specific dementia-care educational programme for Chinese communities. OBJECTIVES To evaluate a culturally specific DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in mainland China. DESIGN A multi-site quasi-experimental study. METHODS Nursing homes were pair-matched and allocated into intervention (n = 5) and control group (n = 5). The DECENT programme was delivered face-to-face using multiple pedagogies for 60-90 min per session by a trained educator once per week over 8 weeks. The primary outcome was the sense of competence in dementia care. The secondary outcomes were dementia knowledge, attitudes towards people with dementia, person-centred care in nursing homes and the severity of behavioral and psychological symptoms of dementia of residents with dementia and staff-perceived disturbance. They were measured at baseline (T0), immediately post-intervention (T1) and 3 months after the intervention (T2). RESULTS The intervention group has significantly greater improvement than control group in sense of competence both at T1 (B = 5.24, p < .001) and T2 (B = 4.43, p = .013). Regarding dementia knowledge and person-centred care, intervention group only showed greater improvement than control group at T1 (B = 3.18, p = .001; B = 5.75, p = .018, respectively), but not at T2 (p = .089 and .104, respectively). Group differences in attitudes and severity of behavioral and psychological symptoms of dementia and staff-perceived disturbance were not significant at both time points. CONCLUSIONS The DECENT programme is applicable and beneficial in improving staff's sense of competence in dementia care in Chinese communities, but reinforcement strategies are needed to sustain the effect for maintaining the learnt knowledge and changed person-centred care practice.
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Affiliation(s)
- Yayi Zhao
- School of Nursing, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing, 210000, Jiangsu Province, China.
| | - Li Liu
- Xiangya Nursing School, Central South University, No. 172 Tongzi Slopes Road, Yuelu District, Changsha, 410000, Hunan Province, China.
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, Jiangning District, 210000, Jiangsu Province, China.
| | - Helen Y L Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, 999077, Hong Kong Special Administrative Region.
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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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7
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Le C, Ma K, Tang P, Edvardsson D, Behm L, Zhang J, Yang J, Fu H, Ahlström G. Psychometric evaluation of the Chinese version of the Person-Centred Care Assessment Tool. BMJ Open 2020; 10:e031580. [PMID: 32665340 PMCID: PMC7359066 DOI: 10.1136/bmjopen-2019-031580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aims to test a Chinese cross-cultural adaptation of the English version of the Person-Centred Care Assessment Tool (P-CAT) and evaluate its psychometric properties. DESIGN P-CAT was translated/back-translated using established procedures before the psychometric evaluation of the Chinese version was made. SETTING Two hospitals covering urban and suburban areas of Kunming in the Yunnan province of China. PARTICIPANTS 152 female hospital staff completed the survey. MAIN OUTCOME MEASURES Construct validity and reliability, including internal consistency and test-retest reliability, were assessed among a sample of hospital staff. RESULTS The factor analysis resulted in a two-component solution that consisted of two subscales. The corrected item-total correlations for all of the items ranged from 0.14 to 0.44, with six items not meeting the cut-off level for item-total correlation (>0.3). The Chinese P-CAT demonstrated strong reliability, with a Cronbach's alpha of 0.91-0.94 for the scales and a test-retest reliability coefficient of 0.88 for the overall scale scores. The intraclass correlation was 0.92 (95% CI 0.90 to 0.95). CONCLUSION P-CAT appears to be a promising measure for evaluating staff perceptions of person-centredness in Chinese hospital environments. The results show that P-CAT can be a useful tool for improving the quality of healthcare in terms of person-centred care in the Chinese context.
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Affiliation(s)
- Cai Le
- School of Public Health, Kunming Medical University in Kunming, Kunming, China
| | - Ke Ma
- Palliative Care, The Third People's Hospital of Kunming, Kunming, Yunnan, China
| | - Pingfen Tang
- School of Nursing, Kunming Medical University, Kunming, Yunnan, China
| | - David Edvardsson
- School of Nursing & Midwifery, College of Science, Health and Engineering, La Trobe University/Austin Health Clinical School of Nursing, Heidelberg, Victoria, Australia
| | - Lina Behm
- Faculty of Health Sciences, Kristianstad University College, Kristianstad, Sweden
| | - Jie Zhang
- Palliative Care, The Third People's Hospital of Kunming, Kunming, Yunnan, China
| | - Jiqun Yang
- Department of Palliative Care, The Third People's Hospital of Kunming, Kunming, China
| | - Haiyan Fu
- Department of Palliative Care, The Third People's Hospital of Kunming, Kunming, China
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Wang J, Wu B, Bowers BJ, Lepore MJ, Ding D, McConnell ES, Corazzini KN. Person-Centered Dementia Care in China: A Bilingual Literature Review. Gerontol Geriatr Med 2019; 5:2333721419844349. [PMID: 31192275 PMCID: PMC6540483 DOI: 10.1177/2333721419844349] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/26/2019] [Indexed: 11/30/2022] Open
Abstract
We conducted a bilingual literature review of the existing studies focusing on person-centered dementia care in China. We synthesized key findings from included articles according to three overarching themes: Chinese cultural relevance of person-centered care (PCC), perceived needs for PCC for older adults in China, implementation and measurement of PCC in China, and person-centered dementia care model. We also drew on frameworks, theories, and other contents from the examined articles to develop a person-centered dementia care model with specific relevance to China. The model is a good starting point to help us operationalize globally relevant core principles of PCC in the specific sociocultural context of China. The framework will be informed by more empirical studies and evolve with the ongoing operationalization of PCC. Although PCC is a new concept and has not been vigorously or systematically studied in China, it is attracting increasing attention from Chinese researchers. More empirical studies are needed to link PCC to measurable outcomes, enrich the framework for applying PCC, and construct assessment and evaluation systems to facilitate the provision of PCC across countries and cultures. Global consortia and collaborations with multidisciplinary expertise to develop a PCC common data infrastructure that is internationally relevant for data sharing and comparison are needed.
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Affiliation(s)
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA.,NYU Aging Incubator, New York University, New York, New York, USA
| | | | | | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Eleanor S McConnell
- Duke University, Durham, NC, USA.,Geriatric Research, Education and Clinical Center, Department of Veteran Affairs, Durham, NC, USA
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Ree E, Wiig S, Manser T, Storm M. How is patient involvement measured in patient centeredness scales for health professionals? A systematic review of their measurement properties and content. BMC Health Serv Res 2019; 19:12. [PMID: 30621682 PMCID: PMC6323701 DOI: 10.1186/s12913-018-3798-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 12/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient centeredness is an important component of patient care and healthcare quality. Several scales exist to measure patient centeredness, and previous literature provides a critical appraisal of their measurement properties. However, limited knowledge exists regarding the content of the various scales in terms of what type of patient centeredness they represent and how they can be used for quality improvement. The aim of this study was to explore the measurement properties of patient centeredness scales and their content with a special focus on patient involvement, and assess whether and how they can be used for quality improvement. METHODS A systematic review of patient centeredness scales was conducted in Medline, CINAHL, Embase, and SCOPUS in April and May 2017. Inclusion criteria were limited to articles written in English published from 2005 to 2017. Eligible studies were critically appraised in terms of internal consistency and reliability, as well as their content, structural, and cross-cultural validity. Type of studies included were scale-development articles and validation studies of relevant scales, with healthcare personnel as respondents. We used directed content analysis to categorize the scales and items according to Tritter's conceptual framework for patient and public involvement. RESULTS Eleven scales reported in 22 articles were included. Most scales represented individual, indirect, and reactive patient involvement. Most scales included items that did not reflect patient centeredness directly, but rather organizational preconditions for patient centered practices. None of the scales included items explicitly reflecting the use of patient experiences of quality improvement. CONCLUSIONS There is a lack of patient centeredness scales focusing on direct and proactive involvement of patients in quality improvement. It would be useful to develop such instruments to further study the role of patient involvement in quality improvement in healthcare. Furthermore, they could be used as important tools in quality improvement interventions.
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Affiliation(s)
- Eline Ree
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Siri Wiig
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Tanja Manser
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Marianne Storm
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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10
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Feng H, Li H, Xiao LD, Ullah S, Mao P, Yang Y, Hu H, Zhao Y. Aged care clinical mentoring model of change in nursing homes in China: study protocol for a cluster randomized controlled trial. BMC Health Serv Res 2018; 18:816. [PMID: 30359243 PMCID: PMC6203281 DOI: 10.1186/s12913-018-3596-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Residents living in nursing homes usually have complex healthcare needs and require a comprehensive care approach to identifying and meeting their care needs. Suboptimal quality of care is reported in nursing homes and is associated with the poor health and well-being of the residents, the burden on acute care hospitals and the high costs of healthcare for the government. The aim of this study is to test the hypothesis that an Aged Care Clinical Mentoring Model will create and sustain evidence-based quality improvement in priority areas and will be cost-effective in nursing homes in Hunan Province, China. Methods A cluster randomized controlled trial will be applied to the study. Fourteen nursing homes will be randomly allocated to either the intervention group (n = 7) or the control group (n = 7). Forty staff will be recruited from each nursing home and the estimated sample size will be 280 staff in each group. The intervention includes a structured, evidence-based quality improvement education program for staff to facilitate knowledge translation in evidence-based quality improvement targeting urinary incontinence, pressure injury and falls prevention. The primary outcomes are nursing homes’ capacity to create and sustain quality improvement, staff perceptions of person-centered care, self-reported quality of care by residents and selected quality indicators at 12 months follow-up adjusted for baseline value. Secondary outcomes are residents’ quality of life, residents’ unplanned admissions to acute care hospitals, quality of care reported by staff, staff job satisfaction and staff intention to leave adjusted for baseline value. A mixed linear regression model will be adopted to compare the significant differences between groups over a 12-month period. Discussion Although the Aged Care Clinical Mentoring Model has been tested as an effective model to bring positive changes in nursing homes in a high-income country, factors affecting the adaptation of the model in nursing homes in low- and middle-income countries are unknown. The carefully planned intervention protocol enables the project team to consider enablers and barriers when adapting the Model. Therefore, strategies and resources will be in place to manage challenges while demonstrating best practice in this study. Trial registration Prospectively registered via Chinese Clinical Trial Registry (ChiCTR), ChiCTR-IOC-17013109, Registered on 25 October 2017. Electronic supplementary material The online version of this article (10.1186/s12913-018-3596-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hui Feng
- Xiangya school of nursing, Central South University, Changsha, Hunan province, China.
| | - Hui Li
- Xiangya school of nursing, Central South University, Changsha, Hunan province, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Shahid Ullah
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Pan Mao
- Henan Provincial Peoples Hospital, Zhengzhou, Henan Province, China
| | - Yunxia Yang
- Xiangya school of nursing, Central South University, Changsha, Hunan province, China
| | - Hengyu Hu
- Xiangya school of nursing, Central South University, Changsha, Hunan province, China
| | - Yinan Zhao
- Xiangya school of nursing, Central South University, Changsha, Hunan province, China
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11
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Song Y, Scales K, Anderson RA, Wu B, Corazzini KN. Resident challenges with daily life in Chinese long-term care facilities: A qualitative pilot study. Geriatr Nurs 2017. [PMID: 28633954 DOI: 10.1016/j.gerinurse.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
As traditional family-based care in China declines, the demand for residential care increases. Knowledge of residents' experiences with long-term care (LTC) facilities is essential to improving quality of care. This pilot study aimed to describe residents' experiences in LTC facilities, particularly as it related to physical function. Semi-structured open-ended interviews were conducted in two facilities with residents stratified by three functional levels (n = 5). Directed content analysis was guided by the Adaptive Leadership Framework. A two-cycle coding approach was used with a first-cycle descriptive coding and second-cycle dramaturgical coding. Interviews provided examples of challenges faced by residents in meeting their daily care needs. Five themes emerged: staff care, care from family members, physical environment, other residents in the facility, and personal strategies. Findings demonstrate the significance of organizational context for care quality and reveal foci for future research.
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Affiliation(s)
| | - Kezia Scales
- Duke University School of Nursing, USA; Duke University Center for the Study of Aging and Human Development, USA
| | - Ruth A Anderson
- University of North Carolina at Chapel Hill, School of Nursing, USA
| | - Bei Wu
- New York University Rory Meyers College of Nursing, USA
| | - Kirsten N Corazzini
- Duke University School of Nursing, USA; Duke University Center for the Study of Aging and Human Development, USA
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Selan D, Jakobsson U, Condelius A. The Swedish P-CAT: modification and exploration of psychometric properties of two different versions. Scand J Caring Sci 2016; 31:527-535. [PMID: 27501454 DOI: 10.1111/scs.12366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/30/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to further investigate the psychometric properties (with focus on construct validity and scale function) of the Swedish version of the Person-centred Care Assessment Tool (P-CAT) in a sample consisting of staff working in elderly care units (N = 142). The aim was also to further develop and psychometrically test a modified, noncontext-specific version of the instrument (mP-CAT) in a sample consisting of staff working in primary health care or within home care for older people (N = 182). Principal component analysis with varimax rotation initially suggested a three-factor solution for the P-CAT, explaining 55.96% of variance. Item 13 solely represented one factor wherefore this solution was rejected. A final 2-factor solution, without item 13, had a cumulative explained variance of 50.03%. All communalities were satisfactory (>0.3), and alpha values for both first factor (items 1-6, 11) and second factor (items 7-10, 12) were found to be acceptable. Principal component analysis with varimax rotation suggested a final 2-factor solution for the mP-CAT explaining 46.15% of the total variance with communalities ranging from 0.263 to 0.712. Cronbach's α for both factors was found to be acceptable (>0.7). This study suggests a 2-factor structure for the P-CAT and an exclusion of item 13. The results indicated that the modified noncontext-specific version, mP-CAT, seems to be a valid measure. Further psychometric testing of the mP-CAT is however needed in order to establish the instrument's validity and reliability in various contexts.
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Affiliation(s)
- Denis Selan
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ulf Jakobsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Anna Condelius
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Martínez T, Suárez-Álvarez J, Yanguas J, Muñiz J. Spanish validation of the Person-centered Care Assessment Tool (P-CAT). Aging Ment Health 2016; 20:550-8. [PMID: 25811968 DOI: 10.1080/13607863.2015.1023768] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Person-centered Care (PCC) is an innovative approach which seeks to improve the quality of care services given to the care-dependent elderly. At present there are no Spanish language instruments for the evaluation of PCC delivered by elderly care services. The aim of this work is the adaptation and validation of the Person-centered Care Assessment Tool (P-CAT) for a Spanish population. METHOD The P-CAT was translated and adapted into Spanish, then given to a sample of 1339 front-line care professionals from 56 residential elderly care homes. The reliability and validity of the P-CAT were analyzed, within the frameworks of Classical Test Theory and Item Response Theory models. RESULTS The Spanish P-CAT demonstrated good reliability, with an alpha coefficient of .88 and a test-retest reliability coefficient of .79. The P-CAT information function indicates that the test measures with good precision for the majority of levels of the measured variables (θ values between -2 and +1). The factorial structure of the test is essentially one-dimensional and the item discrimination indices are high, with values between .26 and .61. In terms of predictive validity, the correlations which stand out are between the P-CAT and organizational climate (r = .689), and the burnout factors; personal accomplishment (r = .382), and emotional exhaustion (r = - .510). CONCLUSION The Spanish version of the P-CAT demonstrates good psychometric properties for its use in the evaluation of elderly care homes both professionally and in research.
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Affiliation(s)
- Teresa Martínez
- a Servicio de Calidad e Inspección , Consejería de Bienestar Social y Vivienda del Principado de Asturias , Oviedo , Spain
| | | | | | - José Muñiz
- b Departamento de Psicología , Universidad de Oviedo , Oviedo , Spain.,d Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Oviedo , Spain
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Tak YR, Woo HY, You SY, Kim JH. [Validity and Reliability of the Person-centered Care Assessment Tool in Long-term Care Facilities in Korea]. J Korean Acad Nurs 2016; 45:412-9. [PMID: 26159142 DOI: 10.4040/jkan.2015.45.3.412] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of this study was to evaluate the validity and reliability of the Korean version of the Person-centered Care Assessment Tool (P-CAT). METHODS The English P-CAT was translated into Korean with forward and backward translation. Survey data were collected from 458 staff in 17 long-term care facilities in Korea. Construct validity and criterion related validity were evaluated. Cronbach's alpha was used to assess reliability. RESULTS The Korean version of P-CAT was shown to be valid homogeneously by factor, item and content analysis. Internal consistency reliability was satisfactory in which the values of factor 1, factor 2 and the total scale were .84, .77 and .86 respectively. Exploratory factor analysis supported the construct validity with a two-factor solution. Factor loadings of the 13 items ranged in .34~.80. Criterion validity to the Person-centered Climate Questionnaire-staff (PCQ-S) was .74 (p<.001). CONCLUSION The Korean version of the P-CAT was found to be an applicable instrument with satisfactory reliability and validity for further use in measuring successful person-centered care in long-term care facilities for older persons.
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Affiliation(s)
- Young Ran Tak
- Department of Nursing, College of Nursing, Hanyang University, Seoul, Korea
| | - Hae Young Woo
- Department of Nursing, College of Nursing, Hanyang University, Seoul, Korea.
| | - Sun Young You
- Department of Nursing, College of Nursing, Hanyang University, Seoul, Korea
| | - Ji Hye Kim
- Department of Nursing, College of Nursing, Hanyang University, Seoul, Korea
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Wilberforce M, Challis D, Davies L, Kelly MP, Roberts C, Loynes N. Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties. BMC Geriatr 2016; 16:63. [PMID: 26951641 PMCID: PMC4782329 DOI: 10.1186/s12877-016-0229-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/21/2016] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Person-centredness is promoted as a central feature of the long-term care of older adults. Measures are needed to assist researchers, service planners and regulators in assessing this feature of quality. However, no systematic review exists to identify potential instruments and to provide a critical appraisal of their measurement properties. METHOD A systematic review of measures of person-centredness was undertaken. Inclusion criteria restricted references to multi-item instruments designed for older adult services, or otherwise with measurement properties tested in an older adult population. A two-stage critical appraisal was conducted. First, the methodological quality of included references was assessed using the COSMIN toolkit. Second, seven measurement properties were rated using widely-recognised thresholds of acceptability. These results were then synthesised to provide an overall appraisal of the strength of evidence for each measurement property for each instrument. RESULTS Eleven measures tested in 22 references were included. Six instruments were designed principally for use in long-stay residential facilities, and four were for ambulatory hospital or clinic-based services. Only one measure was designed mainly for completion by users of home care services. No measure could be assessed across all seven measurement properties. Despite some instruments having promising measurement properties, this was consistently undermined by the poor methodological quality underpinning them. Testing of hypotheses to support construct validity was of particularly low quality, whilst measurement error was rarely assessed. Two measures were identified as having been the subject of the most rigorous testing. CONCLUSION The review is unable to unequivocally recommend any measures of person-centredness for use in older adult care. Researchers are advised to improve methodological rigour when testing instruments. Efforts may be best focused on testing a narrower range of measurement properties but to a higher standard, and ensuring that translations to new languages are resisted until strong measurement properties are demonstrated in the original tongue. Limitations of the review include inevitable semantic and conceptual challenges involved in defining 'person-centredness'. The review protocol was registered with PROSPERO (ref: CRD42014005935).
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Affiliation(s)
- Mark Wilberforce
- Personal Social Services Research Unit, Precinct Centre, Crawford House, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - David Challis
- Personal Social Services Research Unit, Precinct Centre, Crawford House, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Linda Davies
- Institute of Population Health, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Michael P Kelly
- Institute of Public Health, Forvie Site, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0SR, UK.
| | - Chris Roberts
- Institute of Population Health, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Nik Loynes
- Personal Social Services Research Unit, Precinct Centre, Crawford House, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
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