Health and Quality of Life in Nursing Homes: A Repeated Cross-Sectional Study on the Impact of Leadership and Person-Centred Care.

Aim: The aim of this work was to investigate whether leadership, person-centred care and social interactions are associated with residents' health, including cognitive impairment, neuropsychiatric symptoms, activities of daily living and health-related quality of life, and to assess whether these relationships change over a period of 5 years.

Design: A repeated cross-sectional survey study was carried out in 2014 and 2019. Valid and reliable scales were used to assess leadership, person-centred care, neuropsychiatric symptoms, cognition, activities of daily living and health-related quality of life. The study involved care units participating in both surveys (n = 182). At T1, there were 1587 residents and 1239 staff. At T2, there were 1382 residents and 1169 staff. Regression analyses were used. Interaction analyses explored changes over time, emphasising leadership and PCC as the main explanatory variables.

Results: Stability was observed over time for person-centred care in relation to health-related quality of life, neuropsychiatric symptoms, activities of daily living function and cognitive function. Person-centred care was associated with a higher level of health-related quality of life and cognitive function, and a lower level of neuropsychiatric symptoms. Leadership showed no significant association with the outcomes.

Patient or public contribution: Residents did not actively participate in the study, as data was obtained by proxy rating. No public was involved in the design, data collection, or dissemination plans of this study.