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Broekharst DSE, Stoop A, Caljouw MAA, Achterberg WP. Relocating within and between nursing homes during infectious disease outbreaks: A focus group study. Health Sci Rep 2024; 7:e1907. [PMID: 38742093 PMCID: PMC11089084 DOI: 10.1002/hsr2.1907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 05/16/2024] Open
Affiliation(s)
- Damien S E Broekharst
- Department of Public Health and Primary Care Leiden University Medical Center Leiden The Netherlands
- University Network for the Care Sector South Holland Leiden University Medical Center Leiden The Netherlands
| | - Annerieke Stoop
- Academic Collaborative Center Older Adults, Tranzo Scientific Centre for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences Tilburg University Tilburg The Netherlands
| | - Monique A A Caljouw
- Department of Public Health and Primary Care Leiden University Medical Center Leiden The Netherlands
- University Network for the Care Sector South Holland Leiden University Medical Center Leiden The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care Leiden University Medical Center Leiden The Netherlands
- University Network for the Care Sector South Holland Leiden University Medical Center Leiden The Netherlands
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Waterschoot K, Roelofs TSM, van Dam A, Luijkx KG. Including personal boundaries scale: development and psychometric properties of a measurement for nurses' self-efficacy toward intimate and sexual behavior in dementia care. FRONTIERS IN DEMENTIA 2024; 3:1304438. [PMID: 39081612 PMCID: PMC11285599 DOI: 10.3389/frdem.2024.1304438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/29/2024] [Indexed: 08/02/2024]
Abstract
Background Person-centered nursing home care recognizes the intimate and sexual needs of residents with dementia but lacks guidance for nurses to address them while effectively respecting their personal boundaries. The Including Personal Boundaries (IPB) scale was developed to complement clinical and scientific efforts to support both nurse and resident wellbeing. Methods Through a co-creative process, theoretical principles, day-to-day experiences, and expert knowledge were integrated into an initial nineteen-item version of the IPB scale. The pilot sample comprised 297 Dutch (vocational) nurses in dementia nursing care. Results After Principal Component Analysis, nine items with strong factor loadings (>0.6) were retained. Internal reliability measures supported the item selection, such as high internal consistency (α = 0.866) and adequate corrected item-total correlations (0.532-0.781). Conclusion The presented IPB scale, a nine-item scale, is a short, robust measure to assess nurses' self-efficacy in their capabilities to include personal boundaries (physical and emotional) when confronted with the intimate and sexual behaviors of residents with dementia. Further validation is recommended. The IPB scale could provide valuable insights for research, clinical practice, and education.
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Affiliation(s)
- Karien Waterschoot
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Tineke S. M. Roelofs
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Psychogeriatric Psychology, Archipel Zorggroep Care Institute, Eindhoven, Netherlands
| | - Arno van Dam
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Research and Innovation, GGZ WNB Mental Health Institute, Halsteren, Netherlands
| | - Katrien G. Luijkx
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
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Broekharst DSE, Stoop A, Achterberg WP, Caljouw MAA. An exploration of relocation initiatives deployed within and between nursing homes: a qualitative study. BMC Health Serv Res 2024; 24:22. [PMID: 38178063 PMCID: PMC10768348 DOI: 10.1186/s12913-023-10505-8] [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: 05/07/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Relocations within and between nursing homes often induce stress, anxiety, and depression in residents and cause additional workload for and burnout in staff. To prevent this, many nursing homes deploy pre-transition initiatives, bridging initiatives, and post-transition initiatives to support residents and staff during the relocation process. As little is known about these initiatives, this study aims to explore the pre-relocation, bridging and post-relocation initiatives used for relocations within and between nursing homes. METHODS In seven Dutch nursing homes, eight focus groups were conducted with two to six participants (N = 37) who were actively involved in relocation processes in different roles (i.e., managers, healthcare professionals, support staff, client council members, residents and family). The focus groups were conducted based on a predefined topic list and lasted approximately 60 min. The transcripts were recorded, transcribed verbatim and analysed using thematic coding. RESULTS Nursing homes had to be inventive in developing relocation initiatives as neither shared guidelines nor knowledge exchange on this topic were available. A total of thirty-seven relocation initiatives were identified in these seven nursing homes. Nineteen pre-relocation initiatives were identified, of which eight emphasized information and engagement, three highlighted training and practice and eight stressed orientation and visualization. Seven bridging initiatives were identified, of which four emphasized coordination and continuity and three highlighted entertainment and celebration. Eleven post-relocation initiatives were identified, of which seven emphasized evaluation and troubleshooting and four highlighted change and adjustment. CONCLUSION The identified relocation initiatives were developed unassisted by nursing homes, due to a lack of shared guidelines, knowledge exchange and mutual learning on this topic. Therefore, it may be expedient and more effective to develop general guidelines for relocations within and between nursing homes in collaboration with nursing homes.
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Affiliation(s)
- Damien S E Broekharst
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands.
- University Network for the Care Sector South Holland, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands.
| | - Annerieke Stoop
- Academic Collaborative Centre Older Adults, Tranzo Scientific Centre for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000, LE, Tilburg, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector South Holland, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
| | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector South Holland, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
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van Loon J, Janssen M, Janssen B, de Rooij I, Luijkx K. Developing a person-centred care environment aiming to enhance the autonomy of nursing home residents with physical impairments, a descriptive study. BMC Geriatr 2023; 23:747. [PMID: 37968597 PMCID: PMC10652543 DOI: 10.1186/s12877-023-04434-8] [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: 03/20/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Enhancing autonomy is important within the context of the care environment in nursing homes. A nursing home is a place for older adults with physical impairments, who need assistance, to live and where staff work who help them to exercise autonomy. Previous research shows that older adults and staff are influenced by the care environment to apply autonomy-enhancing activities. Therefore, organisational policies regarding the care environment seem promising for enhancing autonomy. The aim is to gain a deeper insight into the development and implementation of organisational policies aimed to enhance the autonomy of older adults with physical impairments. METHODS A qualitative descriptive design was chosen, using two methods. A document study was conducted on the policies, plans and proceedings in two care organisations. Moreover, interviews were conducted with 17 stakeholders involved in the policies, such as managers and members of the client council. The fragments of the 137 documents and 17 verbatim transcripts were coded and deductively categorised into the seven aspects (i.e., power-sharing, supportive organisational systems, appropriate skill mix, potential for innovation and risk-taking, the physical environment, effective staff relationships and shared decision-making systems) of the key domain care environment, as defined in the person-centred practice (PCP) framework developed by McCormack and McCance. RESULTS The aspect of power-sharing was used the most in the policies of the two participating organisations. The organisations expected much from the implementation of indirect interventions, such as access to the electronic care plan for residents and the development of staff towards self-managing teams. Less attention was paid to interventions in the physical environment, such as the interior of the building and privacy, and the collaboration processes between staff. CONCLUSIONS The PCP framework poses that all aspects of the key domain care environment are important to develop a person-centred practice. This is not yet the case in practice and the authors therefore recommend using all seven aspects of the care environment in a balanced combination with the other key domains of the PCP framework to achieve person-centred practice and as a result the enhancement of the autonomy of nursing home residents with physical impairments.
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Affiliation(s)
- Jolande van Loon
- Department of Tranzo, School of Social and Behavioural Sciences, Tilburg University, Tranzo, Post Box 90153, Tilburg, 5000 LE, The Netherlands.
- De Wever, Organisation for Elderly Care, Post Box 1173, Tilburg, 5004 BD, The Netherlands.
- School of People and Health, Fontys University of Applied Sciences, Post Box 347, Eindhoven, 5600 AH, The Netherlands.
| | - Meriam Janssen
- Department of Tranzo, School of Social and Behavioural Sciences, Tilburg University, Tranzo, Post Box 90153, Tilburg, 5000 LE, The Netherlands
| | - Bienke Janssen
- School of People and Health, Fontys University of Applied Sciences, Post Box 347, Eindhoven, 5600 AH, The Netherlands
| | - Ietje de Rooij
- De Wever, Organisation for Elderly Care, Post Box 1173, Tilburg, 5004 BD, The Netherlands
| | - Katrien Luijkx
- Department of Tranzo, School of Social and Behavioural Sciences, Tilburg University, Tranzo, Post Box 90153, Tilburg, 5000 LE, The Netherlands
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Bühler F, Leinen A, Schneider-Schelte H, Meyer G, Dichter MN, Köpke S, Wilm S, Bieber A. Exploring stakeholders' perspectives on the adaptation of the Living Lab approach to dementia care: A qualitative study. Geriatr Nurs 2023; 54:184-191. [PMID: 37797546 DOI: 10.1016/j.gerinurse.2023.09.008] [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: 07/13/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023]
Abstract
Collaborative research can promote knowledge translation and help to link care practice and research. Academic-practice partnerships enable joint research projects in collaboration between care professionals, researchers, patients, and other stakeholders. This qualitative study was conducted during the adaptation phase of the Living Lab Dementia, an academic-practice partnership for collaborative research on long-term dementia care. The aim was to explore stakeholders' perspectives on linking care practice and research in a sustainable, research-focused partnership. Data were collected in fifteen qualitative interviews with representatives from three stakeholder groups: nursing care professionals, people with dementia, and nursing researchers. Thematic Framework Analysis resulted in five themes: (1) Access, (2) Expectations, (3) Shaping the collaboration, (4) Linking Pins, and (5) Participation. The findings suggest that care professionals expect support in implementing research results into practice. Researchers should take the lead in shaping the collaboration and create opportunities for stakeholders to get involved.
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Affiliation(s)
- Felix Bühler
- Institute for Health and Nursing Science, University Medicine Halle, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale) 06112, Germany.
| | - Andrea Leinen
- Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Gleueler Strasse 176-178, Cologne 50935, Germany
| | | | - Gabriele Meyer
- Institute for Health and Nursing Science, University Medicine Halle, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale) 06112, Germany
| | - Martin N Dichter
- Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Gleueler Strasse 176-178, Cologne 50935, Germany
| | - Sascha Köpke
- Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Gleueler Strasse 176-178, Cologne 50935, Germany
| | - Stefan Wilm
- Institute of General Practice, Heinrich Heine University Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany
| | - Anja Bieber
- Institute for Health and Nursing Science, University Medicine Halle, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale) 06112, Germany
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de Graaf L, Janssen M, Roelofs T, Luijkx K. Who's Involved? Case Reports on Older Adults' Alcohol and Tobacco Use in Dutch Residential Care Facilities. QUALITATIVE HEALTH RESEARCH 2023; 33:945-955. [PMID: 37429034 PMCID: PMC10494475 DOI: 10.1177/10497323231186879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Residential care facilities (RCFs) provide 24/7 care to older adults with cognitive and/or physical disabilities and aim to provide person-centered care (PCC). Maintaining residents' autonomy is important to provide PCC, for example, with shared decision-making (SDM). Residents are largely dependent on multiple stakeholders, which could jeopardize their autonomy, especially regarding unhealthy behaviors, such as smoking tobacco or drinking alcohol. This case study explores the dynamics of multiple stakeholders around four RCF residents regarding their alcohol and/or tobacco use. Four RCF residents who smoke tobacco and/or drink alcohol were selected from a previous study, and their (in)formal caregivers were additionally invited to participate. A qualitative research design was chosen, and semi-structured interviews were conducted. The Ethics Review Board from the Tilburg University School of Social and Behavioral Sciences (Reference: RP39) and the executive boards of the two participating organizations granted approval. Narrative portraiture resulted in four case descriptions. Two cases focused mostly on tobacco use, and two cases focused mostly on alcohol use. Multiple stakeholders were involved on different levels: family bought alcohol or cigarettes, and team managers supported care professionals. However, little interaction was found between stakeholders. In these cases, limited interaction between the stakeholders, including the resident, jeopardizes SDM and, in this way, PCC regarding residents' alcohol and/or tobacco use. SDM on this topic could enhance interaction between all stakeholders involved, which could increase PCC. Finally, the cases indicate a constant struggle between protecting residents from adverse outcomes of alcohol and tobacco use and enhancing their autonomy.
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Affiliation(s)
- Lisette de Graaf
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Mijzo, Waalwijk, The Netherlands
| | - Meriam Janssen
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Tineke Roelofs
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Archipel Zorggroep, The Netherlands
| | - Katrien Luijkx
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Scheffelaar A, Janssen M, Luijkx K. Learning as a way of achieving quality improvement in long-term care: A qualitative evaluation of The Story as a Quality Instrument. Nurse Educ Pract 2023; 70:103659. [PMID: 37201265 DOI: 10.1016/j.nepr.2023.103659] [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: 03/06/2023] [Revised: 04/24/2023] [Accepted: 05/07/2023] [Indexed: 05/20/2023]
Abstract
AIM/OBJECTIVE This study aimed to evaluate the use of the narrative quality instrument 'The Story as a Quality Instrument' (or SQI) for learning as a way of achieving quality improvement. BACKGROUND Learning is a widespread aim in long-term care. If professionals share detailed information about their views on the quality of care, they can see it from each other's perspective and create a new joint perspective that may generate a broader meaning in total. One useful source for learning and improvement is the narratives of older adults. These narratives enable reflection and learning, which encourages action. In care organizations, there is a drive to find methods that can be used to facilitate learning and encourage quality improvement. DESIGN A qualitative evaluation design. METHODS Data collection was performed in 2021-2022 at six field sites of four large care organizations providing long-term care to older adults in the Netherlands. At each field site, SQI was applied: an action plan was formulated in a quality meeting and, 8-12 weeks later, the progress was evaluated in a follow-up meeting. The data collected was participants' responses during focus groups: the verbatim transcripts of both meetings and the observation reports of the researchers. 46 participants took part in the quality meetings and 34 participants were present at the follow-up meetings. The data was analyzed using thematic analysis. RESULTS The results are mechanisms that help learning, participant responses, and practical challenges and conditions. Four mechanisms became visible that encourage learning among participants for achieving quality improvements: in-depth discussions, exchange of perspectives, abstraction, and concretization. The participants listed several outcomes regarding individual learning such as change of attitude, viewing older adults more holistically and the realization that possibilities for working on quality improvement could be just a small and part of everyday work. Participants learned from each other as they came to understand each other's perspectives. The added value lay in getting insights into the individual perceptions of clients, the concrete areas for improvement as an outcome, and getting a picture of the perspectives of diverse people and functions represented. Time was found to be the main challenge when applying SQI. CONCLUSIONS SQI is deemed promising for practice, as it allows care professionals to learn in their workplace in a structured way from narratives of older adults in order to improve the quality of care.
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Affiliation(s)
- Aukelien Scheffelaar
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, the Netherlands.
| | - Meriam Janssen
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, the Netherlands
| | - Katrien Luijkx
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, the Netherlands
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de Graaf L, Roelofs T, Janssen M, Luijkx K. Live and let live: Residents' perspectives on alcohol and tobacco (mis)use in residential care facilities. Int J Older People Nurs 2023; 18:e12508. [PMID: 36229901 PMCID: PMC10078196 DOI: 10.1111/opn.12508] [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: 03/02/2022] [Revised: 06/10/2022] [Accepted: 09/13/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alcohol and tobacco use could cause health problems in older adults. Older adults who become in need of 24/7 care due to physical and/or neurological disabilities may need to move to a Residential Care Facility (RCF). RCFs aim to provide person-centred care (PCC) to enhance quality of life (QoL) of residents. OBJECTIVES This study aims to explore perspectives of residents on alcohol and tobacco use, which is essential to provide PCC. METHODS A qualitative research design was chosen, and semi-structured interviews were conducted. Residents who use alcohol and/or tobacco and those who do not use these substances were purposively selected in two organisations on two types of units: psychogeriatric units and units providing care for residents with mainly physical disabilities. The results were analysed using thematic analysis. RESULTS Thematic analysis resulted in five themes: Current use and self-reflection, knowledge and attitudes, addiction or habit, policies and availability, dependency versus autonomy. CONCLUSION Residents in this study value their autonomy regarding alcohol and tobacco use. They experience dependency on their (in)formal caregivers to use these substances and acknowledge that their use could cause a nuisance to others, challenging the ability of caregivers to implement PCC. Future research could assess how to integrate providing PCC to residents by offering choices and autonomy, while considering the addictive component of these substances, health and safety risks for all. IMPLICATIONS FOR PRACTICE This study could help care professionals to become aware of the habits and wishes of residents regarding alcohol and tobacco use and to discuss the possibilities and limitations within RCFs.
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Affiliation(s)
- Lisette de Graaf
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Mijzo, Waalwijk, The Netherlands
| | - Tineke Roelofs
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Mijzo, Waalwijk, The Netherlands
| | - Meriam Janssen
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Katrien Luijkx
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Hallam-Bowles FV, Logan PA, Timmons S, Robinson KR. Approaches to co-production of research in care homes: a scoping review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:74. [PMID: 36550509 PMCID: PMC9780102 DOI: 10.1186/s40900-022-00408-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/09/2022] [Indexed: 06/04/2023]
Abstract
BACKGROUND Using the technique of co-production to develop research is considered good practice. Co-production involves the public, practitioners and academics working together as equals throughout a research project. Co-production may help develop alternative ways of delivering care for older adults that are acceptable to those who live and work in care homes. However, guidance about applying co-production approaches in this context is lacking. This scoping review aims to map co-production approaches used in care homes for older adults in previous research to support the inclusion of residents and care staff as equal collaborators in future studies. METHODS A scoping review was conducted using the Joanna Briggs Institute scoping review methodology. Seven electronic databases were searched for peer-reviewed primary studies using co-production approaches in care home settings for older adults. Studies were independently screened against eligibility criteria by two reviewers. Citation searching was completed. Data relating to study characteristics, co-production approaches used, including any barriers and facilitators, was charted by one reviewer and checked by another. Data was summarised using tables and diagrams with an accompanying narrative description. A collaborator group of care home and health service representatives were involved in the interpretation of the findings from their perspectives. RESULTS 19 studies were selected for inclusion. A diverse range of approaches to co-production and engaging key stakeholders in care home settings were identified. 11 studies reported barriers and 13 reported facilitators affecting the co-production process. Barriers and facilitators to building relationships and achieving inclusive, equitable and reciprocal co-production were identified in alignment with the five NIHR principles. Practical considerations were also identified as potential barriers and facilitators. CONCLUSION The components of co-production approaches, barriers and facilitators identified should inform the design of future research using co-production approaches in care homes. Future studies should be explicit in reporting what is meant by co-production, the methods used to support co-production, and steps taken to enact the principles of co-production. Sharing of key learning is required to support this field to develop. Evaluation of co-production approaches, including participants' experiences of taking part in co-production processes, are areas for future research in care home settings.
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Affiliation(s)
- F V Hallam-Bowles
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK.
- Centre for Rehabilitation and Ageing Research, Injury, Inflammation and Recovery Sciences, Medical School, University of Nottingham, Nottingham, UK.
| | - P A Logan
- Centre for Rehabilitation and Ageing Research, Injury, Inflammation and Recovery Sciences, Medical School, University of Nottingham, Nottingham, UK
- Nottingham CityCare Partnership, Nottingham, UK
| | - S Timmons
- Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, University of Nottingham, Nottingham, UK
| | - K R Robinson
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Rehabilitation and Ageing Research, Injury, Inflammation and Recovery Sciences, Medical School, University of Nottingham, Nottingham, UK
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Vos den Ouden W, Janssen M, van Boekel L, Leenders R, Luijkx K. The impact of social network change due to spousal loss: A qualitative study on experiences of older adults who are aging in place. DEATH STUDIES 2022; 47:559-573. [PMID: 35979614 DOI: 10.1080/07481187.2022.2108942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Spousal loss due to nursing home admission or death is challenging for the well-being of the remaining partner and for aging in place. We explored: "How does social network change due to spousal loss impact older adults who are aging in place?." In-depth interviews were held with six older women who were aging in place and who lost their spouses in the past two years. Narrative analysis was conducted. Results indicate that the impact varies in three dimensions and that variations within dimensions follow three themes. The results emphasize the complexity of impact and the urgent need for a person-centred approach toward older adults after spousal loss.
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Affiliation(s)
- Willeke Vos den Ouden
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Meriam Janssen
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Leonieke van Boekel
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Roger Leenders
- Department of Organization Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Jheronimous Academy of Data Science, Hertogenbosch, The Netherlands
| | - Katrien Luijkx
- Department Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Waterschoot K, Roelofs TSM, van Boekel LC, Luijkx KG. Care Staff's Sense-making of Intimate and Sexual Expressions of People with Dementia in Dutch Nursing Homes. Clin Gerontol 2022; 45:833-843. [PMID: 34080959 DOI: 10.1080/07317115.2021.1928357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The Person-centered Care (PCC) philosophy emphasizes close care relationships to enable care professionals to recognize the needs of nursing home residents with dementia. This study explored how care professionals make sense of resident behavior with regard to intimacy and sexuality. METHODS 26 nursing home care professionals (15 Nurses, 9 Health Care Professionals and 2 Managers) completed in-depth interviews that were subjected to an Interpretative Phenomenological Analysis (IPA). RESULTS Three thematic layers were identified. 1. Care Professionals pursue a "true" understanding of intimate and sexual behavior that underpins a resident's expression. 2. When care professionals feel the need to protect themselves, they can reframe a specific care relation in order to continue care. 3. The social context around the resident, from family to professionals (i.e. peers), influences interpretation of behavior and, consequently, the provision of care. CONCLUSIONS Intimate and sexual expressions of residents can put care relations under pressure. Care relations that lack professional distance may compromise care professionals' judgments, impede their natural boundaries and decrease their well-being. CLINICAL IMPLICATIONS Along with implementing PCC principles, organizations should empower staff to develop, discuss and include self-reflection skills and personal boundaries within their work.
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Affiliation(s)
- Karien Waterschoot
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Tineke S M Roelofs
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Department of Psychology, Schakelring Nursing Care Organization, Waalwijk, The Netherlands
| | - Leonieke C van Boekel
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Katrien G Luijkx
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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de Boer B, Caljouw M, Landeweer E, Perry M, Stoop A, Groen W, Schols J, Verbeek H. The Need to Consider Relocations WITHIN Long-Term Care. J Am Med Dir Assoc 2021; 23:318-320. [PMID: 34932987 DOI: 10.1016/j.jamda.2021.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Bram de Boer
- The Living Lab in Aging and Long-Term Care, Maastricht University, Maastricht, the Netherlands
| | - Monique Caljouw
- The University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Elleke Landeweer
- The University Network of Elderly Care-UMCG, University of Groningen, Groningen, the Netherlands
| | - Marieke Perry
- The University Knowledge Network for Older People-Nijmegen, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Annerieke Stoop
- The Academic Collaborative Centre Older Adults-Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Wim Groen
- The University Network for Organizations of Elderly Care-Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jos Schols
- The Living Lab in Aging and Long-Term Care, Maastricht University, Maastricht, the Netherlands
| | - Hilde Verbeek
- The Living Lab in Aging and Long-Term Care, Maastricht University, Maastricht, the Netherlands
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Ouden WVD, van Boekel L, Janssen M, Leenders R, Luijkx K. The impact of social network change and health decline: a qualitative study on experiences of older adults who are ageing in place. BMC Geriatr 2021; 21:480. [PMID: 34481476 PMCID: PMC8418744 DOI: 10.1186/s12877-021-02385-6] [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] [Received: 02/10/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
Background Older adults prefer to age in place. Social network change and health decline challenge ageing in place, as stressors that make age-related advantages disappear. The aim of this study was to explore social network change and health decline and its impact on older adults who are ageing in place. Method In-depth interviews (n = 16) were conducted with older adults who were ageing in place and who were experiencing health decline and social network change. Procedures for grounded theory building were followed to analyse the interviews with respondents who were discharged from the hospital less than 4 months ago (n = 7). Narrative analysis was conducted to reach a deeper understanding of the expected complexity of experiences of this targeted sample. Results Results encompass a typology with four types of impact: A. Sneak preview of old age, B. Disruptive transition into old age, C. Drastically ageing, and D. Steadily ageing. Additionally, indications were found that older adults should be able to move along the four types of impact and ideally could end up in quartile D, experiencing little or no impact at all (anymore). Conclusion The results present an optimistic view on the possibilities of older adults to continue ageing in place despite experiencing unavoidable and uncontrollable stressors in life. Also, the results provide leads for practice, to develop an action perspective for home care nurses and gerontological social workers to determine and reduce the impact of social network change and health decline on older adults who are ageing in place. Suggestions for further research would be to unravel how to detect temporal setbacks in successful ageing in place. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02385-6.
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Affiliation(s)
- Willeke Vos-den Ouden
- Department Tranzo, Tilburg University, Tilburg School of Social and Behavioral Sciences, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands.
| | - Leonieke van Boekel
- Department Tranzo, Tilburg University, Tilburg School of Social and Behavioral Sciences, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands
| | - Meriam Janssen
- Department Tranzo, Tilburg University, Tilburg School of Social and Behavioral Sciences, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands
| | - Roger Leenders
- Department Organization Studies, Tilburg University, Tilburg School of Social and Behavioral Sciences, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands.,Jheronimus Academy of Data Science, St. Janssingel 92, 5211, DA, 's-Hertogenbosch, The Netherlands
| | - Katrien Luijkx
- Department Tranzo, Tilburg University, Tilburg School of Social and Behavioral Sciences, P.O. Box 90153, 5000, LE, Tilburg, The Netherlands
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Scheffelaar A, Janssen M, Luijkx K. The Story as a Quality Instrument: Developing an Instrument for Quality Improvement Based on Narratives of Older Adults Receiving Long-Term Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052773. [PMID: 33803372 PMCID: PMC7967278 DOI: 10.3390/ijerph18052773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 11/25/2022]
Abstract
The individual experiences of older adults in long-term care are broadly recognized as an important source of information for measuring wellbeing and quality of care. Narrative research is a special type of qualitative research to elicit people’s individual, diverse experiences in the context of their lifeworld. Narratives are potentially useful for long-term care improvement as they can provide a rich description of an older adult’s life from their own point of view, including the provided care. Little is known about how narratives can best be collected and used to stimulate learning and quality improvement in long-term care for older adults. The current study takes a theoretical approach to developing a narrative quality instrument for care practice in order to discover the experiences of older adults receiving long-term care. The new narrative quality instrument is based on the available literature describing narrative research methodology. The instrument is deemed promising for practice, as it allows care professionals to collect narratives among older adults in a thorough manner for team reflection in order to improve the quality of care. In the future, the feasibility and usability of the instrument will have to be empirically tested.
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van Hoof J, Marston HR. Age-Friendly Cities and Communities: State of the Art and Future Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041644. [PMID: 33572181 PMCID: PMC7914698 DOI: 10.3390/ijerph18041644] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Joost van Hoof
- Faculty of Social Work & Education, The Hague University of Applied Sciences, 2521 EN Den Haag, The Netherlands
- Faculty of Environmental Engineering and Geodesy, Institute of Spatial Management, Wrocław University of Environmental and Life Sciences, 50-357 Wrocław, Poland
- Correspondence: ; Tel.: +31-6-23381404
| | - Hannah R. Marston
- Health & Wellbeing Strategic Research Area, School of Health, Wellbeing & Social Care, The Open University, Buckinghamshire MK7 6HH, UK;
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de Boer B, Bozdemir B, Jansen J, Hermans M, Hamers JPH, Verbeek H. The Homestead: Developing a Conceptual Framework through Co-Creation for Innovating Long-Term Dementia Care Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E57. [PMID: 33374761 PMCID: PMC7795205 DOI: 10.3390/ijerph18010057] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/19/2020] [Indexed: 12/22/2022]
Abstract
Alternative care environments for regular nursing homes are highly warranted to promote health and well-being of residents with dementia that are part of an age-friendly and dementia-friendly city and society. Insight is lacking on how to translate evidence-based knowledge from theory into a congruent conceptual model for innovation in current practice. This study reports on the co-creation of an alternative nursing home model in the Netherlands. A participatory research approach was used to co-create a conceptual framework with researchers, practitioners and older people following an iterative process. Results indicate that achieving positive outcomes for people with dementia, (in)formal caregivers, and the community is dependent on how well the physical, social and organizational environment are congruently designed. The theoretical underpinnings of the conceptual model have been translated into "the homestead," which is conceptualized around three main pillars: activation, freedom and relationships. The Homestead Care Model is an illustrative example of how residential care facilities can support the development of age-friendly communities that take into consideration the needs and requirements of older citizens. However, challenges remain to implement radical changes within residential care. More research is needed into the actual implementation of the Homestead Care Model.
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Affiliation(s)
- Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands;
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
| | - Belkis Bozdemir
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
- MeanderGroep Zuid Limburg, 6372 PP Landgraaf, The Netherlands
| | - Jack Jansen
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
- MeanderGroep Zuid Limburg, 6372 PP Landgraaf, The Netherlands
| | - Monique Hermans
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
- MeanderGroep Zuid Limburg, 6372 PP Landgraaf, The Netherlands
| | - Jan P. H. Hamers
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands;
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6229 GT Maastricht, The Netherlands;
- Living Lab in Ageing and Long-Term Care, 6229 GT Maastricht, The Netherlands; (B.B.); (J.J.); (M.H.)
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