Abstract
BackgroundThe context of care consists of factors that determines the extent to which staff can offer person-centred care. However, few studies have investigated factors that can explain variation in levels of person-centred care among nursing home units. The aim of this study was to explore factors characterizing nursing home units with high and low degree of person-centred care, with focus on leadership, staff, resident and facility factors.MethodsCross-sectional data from residents, staff, and managers in 172 randomly selected nursing homes in Sweden were collected in 2014. Activities of Daily Living Index, Gottfries’ cognitive scale, Person-centred Care Assessment Tool together with demographic information and estimations of leadership engagement was used. Independent samples t-test and Chi2 test were conducted.ResultsHighly person-centred units were characterised by leaders engaging in staff knowledge, professional development, team support and care quality. In highly person-centred units’ staff also received supervision of a nurse to a larger extent. Highly person-centred units were also characterised as dementia specific units, units with fewer beds and with a larger proportion of enrolled nurses. No differences in degree of person-centred care were seen between public or private providers.ConclusionsThis study provides guidance for practitioners when designing, developing and adapting person-centred units in aged care contexts. Managers and leaders have an important role to promote the movement towards a person-centred practice of care, by supporting their staff in daily care, and engaging in staff knowledge and professional development. Targeting and adjusting environmental factors, such as provide small and dementia adapted environments to match the residents’ personal preferences and capacity are also important when striving towards person-centredness.
Highlights
The context of care consists of factors that determines the extent to which staff can offer personcentred care
The participating nursing homes consisted of both regular units for older people (69.1%) and special care units for dementia (SCU) (30.9%)
This study provides information about leadership, staff, resident, facility determinants with capacity to enhancing person-centred care provision, were support from leaders seems important when striving towards personcentred care in daily practice
Summary
The context of care consists of factors that determines the extent to which staff can offer personcentred care. Few studies have investigated factors that can explain variation in levels of person-centred care among nursing home units. The aim of this study was to explore factors characterizing nursing home units with high and low degree of person-centred care, with focus on leadership, staff, resident and facility factors. The care context has been described as a decisive factor for the extent to which staff can provide person-centred care, but only a few studies have empirically investigated which factors define nursing home units as being more or less person-centred. Dementia Care Mapping (DCM) increased well-being among residents and reduced depressive symptoms in a person-centred intervention by Rokstad et al [7]. A cluster-randomized trial showed that DCM and staff training in dementia care were associated with reduced agitation among nursing home residents [8].
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