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Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Care | Research article

Effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care in nursing homes: a multi-centre, non-equivalent controlled before-after trial

Authors: Qarin Lood, Karin Sjögren, Ådel Bergland, Marie Lindkvist, Marit Kirkevold, Per-Olof Sandman, David Edvardsson

Published in: BMC Geriatrics | Issue 1/2020

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Abstract

Background

As part of a nursing home intervention study, the aim of this paper was 1) to evaluate the effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care and their perceptions of the person-centredness of the environment, and 2) to outline factors of importance to explain the variance in relatives’ satisfaction with quality of care. Relatives are often referred to as vital for the operationalisation of person-centredness in nursing homes, representing an important source of information for care planning and quality of care assessments. However, the evidence for effects of person-centredness in nursing homes on relatives’ experiences is sparse and little is known on what could explain their satisfaction with the quality of care.

Methods

A multi-centre, non-equivalent controlled group before-after design with study sites in Australia, Norway and Sweden. Staff in the intervention group participated in a 14-month education on person-centredness, person-centred care, thriving and caring environment. Staff in the control group received a one-hour lecture before the intervention period. Data were collected at baseline, after the intervention and six months after the end of the intervention, and analysed using descriptive statistics, a generalised linear model and hierarchical multiple regression.

Results

In general, relatives from both the intervention and control nursing homes were satisfied with the quality of care, and no statistically significant overall between-group-effects of the intervention were revealed on satisfaction with quality of care or perceptions of the person-centredness of environment. A person-centred environment in terms of safety and hospitality were identified as factors of prominent importance for the relatives’ satisfaction with the quality of care.

Conclusion

The findings of this paper provide a foundation for future research in terms of intervention design in nursing home contexts. Staff availability, approachability, competence and communication with relatives may be important factors to consider to improve quality of care from the perspective of relatives, but more research both with and for relatives to people living in nursing homes is necessary to identify the keys to success.

Trial registration

ClinicalTrials.gov-NCT02714452. Registered on March 19, 2016.
Literature
1.
go back to reference Lood Q, Kirkevold M, Sjögren K, Bergland Å, Sandman P, Edvardsson D. Associations between person-centred climate and perceived quality of care in nursing homes: a cross-sectional study of relatives’ experiences. J Adv Nurs. 2019;75(11):2526–34.CrossRef Lood Q, Kirkevold M, Sjögren K, Bergland Å, Sandman P, Edvardsson D. Associations between person-centred climate and perceived quality of care in nursing homes: a cross-sectional study of relatives’ experiences. J Adv Nurs. 2019;75(11):2526–34.CrossRef
2.
go back to reference Bollig G, Gjengedal E, Rosland J. Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes. Nurs Ethics. 2016;23(2):142–53.CrossRef Bollig G, Gjengedal E, Rosland J. Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes. Nurs Ethics. 2016;23(2):142–53.CrossRef
3.
go back to reference McCormack B, McCance T. Person-centred nursing: theory and practice. Chichester: Wiley-Blackwell; 2010.CrossRef McCormack B, McCance T. Person-centred nursing: theory and practice. Chichester: Wiley-Blackwell; 2010.CrossRef
4.
go back to reference Koren M. Person-centered care for nursing home residents: the culture-change movement. Health Aff. 2010;29(2):312–7.CrossRef Koren M. Person-centered care for nursing home residents: the culture-change movement. Health Aff. 2010;29(2):312–7.CrossRef
5.
go back to reference Grabowski D, O'Malley A, Afendulis C, Caudry D, Elliot A, Zimmerman S. Culture change and nursing home quality of care. The Gerontologist. 2014;54(S1):S35–45.CrossRef Grabowski D, O'Malley A, Afendulis C, Caudry D, Elliot A, Zimmerman S. Culture change and nursing home quality of care. The Gerontologist. 2014;54(S1):S35–45.CrossRef
6.
go back to reference Waters R, Buchanan A. An exploration of person-centred concepts in human services: a thematic analysis of the literature. Health Pol. 2017;121:1031–9.CrossRef Waters R, Buchanan A. An exploration of person-centred concepts in human services: a thematic analysis of the literature. Health Pol. 2017;121:1031–9.CrossRef
7.
go back to reference McCormack B, Karlsson B, Dewing J, Lerdal A. Exploring person-centredness: a qualitative meta-synthesis of four studies. Scand J Caring Sci. 2010;24(3):620–34.CrossRef McCormack B, Karlsson B, Dewing J, Lerdal A. Exploring person-centredness: a qualitative meta-synthesis of four studies. Scand J Caring Sci. 2010;24(3):620–34.CrossRef
8.
go back to reference Edvardsson D, Winblad B, Sandman P. Person-centred care for people with severe Alzheimer’s disease – current status and ways forward. Lancet Neurology. 2008;7:362–7.CrossRef Edvardsson D, Winblad B, Sandman P. Person-centred care for people with severe Alzheimer’s disease – current status and ways forward. Lancet Neurology. 2008;7:362–7.CrossRef
9.
go back to reference Curry A, Stark S. Quality of service in nursing homes. Health Serv Manag Res. 2000;13(4):205–15.CrossRef Curry A, Stark S. Quality of service in nursing homes. Health Serv Manag Res. 2000;13(4):205–15.CrossRef
10.
go back to reference Kitwood T. Dementia reconsidered: the person comes first. Buckingham: Open University Press; 1997. Kitwood T. Dementia reconsidered: the person comes first. Buckingham: Open University Press; 1997.
11.
go back to reference McCormack B. A conceptual framework for person-centred practice with older people. Int J Nurs Pract. 2003;9(3):202–9.CrossRef McCormack B. A conceptual framework for person-centred practice with older people. Int J Nurs Pract. 2003;9(3):202–9.CrossRef
12.
go back to reference Edvardsson D, Fetherstonhaugh D, Nay R. Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff. J Clin Nurs. 2010;19(17–18):2611–8.CrossRef Edvardsson D, Fetherstonhaugh D, Nay R. Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff. J Clin Nurs. 2010;19(17–18):2611–8.CrossRef
13.
go back to reference Brown WC. Developing community in care homes through a relationship-centred approach. Health Social Care Community. 2009;17(2):177–86.CrossRef Brown WC. Developing community in care homes through a relationship-centred approach. Health Social Care Community. 2009;17(2):177–86.CrossRef
14.
go back to reference Castle N, Ferguson J. What is nursing home quality and how is it measured? The Gerontologist. 2010;50(4):426–42.CrossRef Castle N, Ferguson J. What is nursing home quality and how is it measured? The Gerontologist. 2010;50(4):426–42.CrossRef
15.
go back to reference Forbes D, Neufeld A. Strategies to address the methodological challenges of client-satisfaction research in home care. Can J Nurs Res. 1997;29(2):69–77.PubMed Forbes D, Neufeld A. Strategies to address the methodological challenges of client-satisfaction research in home care. Can J Nurs Res. 1997;29(2):69–77.PubMed
16.
go back to reference Chenoweth L, Jeon Y-H, Stein-Parbury J, Forbes I, Fleming R, Cook J, et al. PerCEN trial participant perspectives on the implementation and outcomes of person-centered dementia care and environments. Int Psychogeriatr. 2015;27(12):2045–57.CrossRef Chenoweth L, Jeon Y-H, Stein-Parbury J, Forbes I, Fleming R, Cook J, et al. PerCEN trial participant perspectives on the implementation and outcomes of person-centered dementia care and environments. Int Psychogeriatr. 2015;27(12):2045–57.CrossRef
17.
go back to reference Graneheim U, Johansson A, Lindgren B-M. Family caregivers' experiences of relinquishing the care of a person with dementia to a nursing home: insights from a meta-etnographic study. Scand J Caring Sci. 2013;28:215–24.CrossRef Graneheim U, Johansson A, Lindgren B-M. Family caregivers' experiences of relinquishing the care of a person with dementia to a nursing home: insights from a meta-etnographic study. Scand J Caring Sci. 2013;28:215–24.CrossRef
18.
go back to reference Björnsdòttir K, Ceci C, Purkis M. The ‘right’ place to care for older people: home or institution? Nurs Inq. 2013;22(1):64–73.CrossRef Björnsdòttir K, Ceci C, Purkis M. The ‘right’ place to care for older people: home or institution? Nurs Inq. 2013;22(1):64–73.CrossRef
19.
go back to reference Logue R. Maintaining family connectedness in long-term care. J Gerontol Nurs. 2003;29(6):49–60.CrossRef Logue R. Maintaining family connectedness in long-term care. J Gerontol Nurs. 2003;29(6):49–60.CrossRef
20.
21.
go back to reference Kellet U. Seizing possibilities for positive family caregiving in nursing homes. J Clin Nurs. 2007;16(8):1479–87.CrossRef Kellet U. Seizing possibilities for positive family caregiving in nursing homes. J Clin Nurs. 2007;16(8):1479–87.CrossRef
22.
go back to reference Rognstad M, Sagbakken M, Nåden D. Family members’ role as resources and collaborating partners: a study focusing on dementia and long term stay in a nursing home. Nordic J Nursing Res. 2015;35(1):57–64.CrossRef Rognstad M, Sagbakken M, Nåden D. Family members’ role as resources and collaborating partners: a study focusing on dementia and long term stay in a nursing home. Nordic J Nursing Res. 2015;35(1):57–64.CrossRef
23.
go back to reference Bauer M, Fetherstonhaugh D, Tarzia I, Chenco C. Staff-family relationships in residential aged care facilities: the views of residents’ family members and care staff. J Appl Gerontol. 2014;33:564–685.CrossRef Bauer M, Fetherstonhaugh D, Tarzia I, Chenco C. Staff-family relationships in residential aged care facilities: the views of residents’ family members and care staff. J Appl Gerontol. 2014;33:564–685.CrossRef
24.
go back to reference Lopez R, Mazor K, Mitchell S, Givens J. What is family-centered care for nursing home residents with advanced dementia. Am J Alzheimers Dis Other Dement. 2013;28(8):763–8.CrossRef Lopez R, Mazor K, Mitchell S, Givens J. What is family-centered care for nursing home residents with advanced dementia. Am J Alzheimers Dis Other Dement. 2013;28(8):763–8.CrossRef
25.
go back to reference Heggestad A, Nortvedt P, Slettebø A. Dignity and care for people with dementia living in nursing homes. Dementia. 2015;14(6):825–41.CrossRef Heggestad A, Nortvedt P, Slettebø A. Dignity and care for people with dementia living in nursing homes. Dementia. 2015;14(6):825–41.CrossRef
26.
go back to reference Koskenniemi J, Leino-Kilpi H, Suhonen R. Manifestation of respect in the care of older patients in longterm care settings. Scand J Caring Sci. 2015;29(2):288–96.CrossRef Koskenniemi J, Leino-Kilpi H, Suhonen R. Manifestation of respect in the care of older patients in longterm care settings. Scand J Caring Sci. 2015;29(2):288–96.CrossRef
27.
go back to reference Edvardsson D, Sjögren K, Lood Q, Bergland Å, Kirkevold M, Sandman P-O. A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-age nursing home multi-Centre, non-equivalent controlled group before-after trial. BMC Geriatr. 2017;17(1):22.CrossRef Edvardsson D, Sjögren K, Lood Q, Bergland Å, Kirkevold M, Sandman P-O. A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-age nursing home multi-Centre, non-equivalent controlled group before-after trial. BMC Geriatr. 2017;17(1):22.CrossRef
28.
go back to reference Vossius C, Selbæk G, Šaltytė Benth J, Bergh S. Mortality in nursing home residents: A longitudinal study over three years. PLoS One. 2018;13:9.CrossRef Vossius C, Selbæk G, Šaltytė Benth J, Bergh S. Mortality in nursing home residents: A longitudinal study over three years. PLoS One. 2018;13:9.CrossRef
29.
go back to reference Verho H, Arnetz J. Validation and application of an instrument for measuring patient relatives’ perception of quality of geriatric care. Int J Qual Health Care. 2003;15(3):197–206.CrossRef Verho H, Arnetz J. Validation and application of an instrument for measuring patient relatives’ perception of quality of geriatric care. Int J Qual Health Care. 2003;15(3):197–206.CrossRef
30.
go back to reference Lindahl J, Elmqvist C, Thulesius H, Edvardsson D. Psychometric evaluation of the Swedish language person-centred climate questionnaire–family version. Scand J Caring Sci. 2015;29(4):859–64.CrossRef Lindahl J, Elmqvist C, Thulesius H, Edvardsson D. Psychometric evaluation of the Swedish language person-centred climate questionnaire–family version. Scand J Caring Sci. 2015;29(4):859–64.CrossRef
31.
go back to reference Pallant J. SPSS survival manual: a step by step guide to data anlysis using SPSS. 4th ed. Maidenhead: Open University Press/McGraw Hill; 2010. Pallant J. SPSS survival manual: a step by step guide to data anlysis using SPSS. 4th ed. Maidenhead: Open University Press/McGraw Hill; 2010.
32.
go back to reference Shrive F, Stuart H, Quan H, Ghali W. Dealing with missing data in a multi-question depression scale: a comparison of imputation methods. BMC Med Res Methodol. 2006;6(1):57–67.CrossRef Shrive F, Stuart H, Quan H, Ghali W. Dealing with missing data in a multi-question depression scale: a comparison of imputation methods. BMC Med Res Methodol. 2006;6(1):57–67.CrossRef
33.
go back to reference Edvardsson D, Sandman P, Rasmussen B. Swedish language person-centred climate questionnaire - patient version: construction and psychometric evaluation. J Adv Nurs. 2008;63(3):302–9.CrossRef Edvardsson D, Sandman P, Rasmussen B. Swedish language person-centred climate questionnaire - patient version: construction and psychometric evaluation. J Adv Nurs. 2008;63(3):302–9.CrossRef
34.
go back to reference Jakobsen R, Sellevold G, Egede-Nissen V, Sørlie V. Ethics and quality care in nursing homes: relatives’ experiences. Nurs Ethics. 2019;26(3):767–77.CrossRef Jakobsen R, Sellevold G, Egede-Nissen V, Sørlie V. Ethics and quality care in nursing homes: relatives’ experiences. Nurs Ethics. 2019;26(3):767–77.CrossRef
35.
go back to reference Wiig S, Storm M, Aase K, Gjestsen M, Solheim M, Harthug S, et al. Investigating the use of patient involvement and patient experience in quality improvement in Norway: rhetoric or reality? BMC Health Serv Res. 2013;6(13):206.CrossRef Wiig S, Storm M, Aase K, Gjestsen M, Solheim M, Harthug S, et al. Investigating the use of patient involvement and patient experience in quality improvement in Norway: rhetoric or reality? BMC Health Serv Res. 2013;6(13):206.CrossRef
36.
go back to reference Chenoweth L, Forbes I, Fleming R, King MT, Stein-Parbury J, Luscombe G, et al. PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia. Int Psychogeriatr. 2014;26(07):1147–60.CrossRef Chenoweth L, Forbes I, Fleming R, King MT, Stein-Parbury J, Luscombe G, et al. PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia. Int Psychogeriatr. 2014;26(07):1147–60.CrossRef
37.
go back to reference Rosher RB, Robinson S. Impact of the Eden alternative on family satisfaction. J Am Med Dir Assoc. 2005;6(3):189–93.CrossRef Rosher RB, Robinson S. Impact of the Eden alternative on family satisfaction. J Am Med Dir Assoc. 2005;6(3):189–93.CrossRef
38.
go back to reference Kaplan H, Brady P, Dritz M, Hooper D, Linam W, Froehle C, et al. The influence of context on quality improvement success in health care: a systematic review of the literature. The Milbank Quarterly. 2010;88(4):500–59.CrossRef Kaplan H, Brady P, Dritz M, Hooper D, Linam W, Froehle C, et al. The influence of context on quality improvement success in health care: a systematic review of the literature. The Milbank Quarterly. 2010;88(4):500–59.CrossRef
Metadata
Title
Effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care in nursing homes: a multi-centre, non-equivalent controlled before-after trial
Authors
Qarin Lood
Karin Sjögren
Ådel Bergland
Marie Lindkvist
Marit Kirkevold
Per-Olof Sandman
David Edvardsson
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01677-7

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