The impact of person-centered care on residents' perceptions of care quality in nursing homes: an intervention study

V. A. Grøndahl, Liv Berit Fagerli, Heidi Karlsen, Ellen Rosseland Hansen, H. Johansson, Anne Gerd Mathisen, A. Helgesen
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引用次数: 6

Abstract

Background: The quality of care offered to older people is still poor. Nursing home administrators often claim that they provide person-centered care, but research indicates that institutional goals take precedence. Aim: The aim was to explore the impact of person-centered care on residents’ perceptions of care quality.  Methods: An intervention study was conducted in one nursing home (41 residents). Person-centered care was operationalized into the interventions: greeting the resident on each shift, one-to-one contact (resident – carer) for 30 minutes twice a week, informing the residents continuously about changes in medication, and informing the residents about their legal rights at admission and three months after admission. The interventions were systematically conducted for 12 months. Face-to-face interviews using the Quality from Patient’s Perspective (QPP) questionnaire were conducted both prior to interventions and immediately after the 12-month period. Descriptive and comparative statistics were used to test for differences between care quality perceptions before and after intervention (p ≤ .05). Results: The residents rated all four quality dimensions (caregivers’ medical-technical competence and identity-oriented approach, care organization’s socio-cultural atmosphere, and physical-technical conditions) more highly after the 12-month period, and the socio-cultural atmosphere was rated significantly more highly. At item level, 44 items received higher scores, and, among them, significantly higher scores were given to 6 items. One item received a significantly lower score. Conclusions: Residents’ perceptions of care quality increase when person-centered care is operationalized and takes precedence over the ward’s routines or is part of the ward’s routines. The results indicate that it is possible to design a care system where the residents are at the centre of the health care offered.
以人为本的护理对养老院居民护理质量感知的影响:一项干预研究
背景:为老年人提供的护理质量仍然很差。养老院的管理者经常声称他们提供以人为本的护理,但研究表明,机构目标优先。目的:探讨以人为本的护理对住院医师护理质量感知的影响。方法:对1所养老院41名住客进行干预研究。以人为本的护理在干预措施中得以实施:每班问候住院医师,每周两次30分钟的一对一接触(住院医师-护理人员),不断告知住院医师药物的变化,并告知住院医师入院时和入院后三个月的法律权利。这些干预措施系统地进行了12个月。在干预之前和12个月后立即进行面对面访谈,使用从患者角度看质量(QPP)问卷。采用描述性统计和比较统计学检验干预前后护理质量感知的差异(p≤0.05)。结果:12个月后,住院医师对护理人员的医疗技术能力和身份导向方法、护理机构的社会文化氛围和身体技术条件四个质量维度的评价均有所提高,其中社会文化氛围的评价显著提高。在项目水平上,有44个项目得分较高,其中6个项目得分显著较高。其中一项得分明显较低。结论:当以人为中心的护理被操作时,住院医师对护理质量的感知会增加,并且优先于病房的日常工作或成为病房日常工作的一部分。结果表明,设计一个以居民为中心的医疗保健系统是可能的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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