Person-centered Care Assessment Tool Research Articles

Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties

BackgroundThe person-centered care (PCC) approach plays a fundamental role in ensuring quality healthcare. The Person-Centered Care Assessment Tool (P-CAT) is one of the shortest and simplest tools currently available for measuring PCC. The objective of this study was to conduct a systematic review of the evidence in validation studies of the P-CAT, taking the “Standards” as a frame of reference.MethodsFirst, a systematic literature review was conducted following the PRISMA method. Second, a systematic descriptive literature review of validity tests was conducted following the “Standards” framework. The search strategy and information sources were obtained from the Cochrane, Web of Science (WoS), Scopus and PubMed databases. With regard to the eligibility criteria and selection process, a protocol was registered in PROSPERO (CRD42022335866), and articles had to meet criteria for inclusion in the systematic review.ResultsA total of seven articles were included. Empirical evidence indicates that these validations offer a high number of sources related to test content, internal structure for dimensionality and internal consistency. A moderate number of sources pertain to internal structure in terms of test-retest reliability and the relationship with other variables. There is little evidence of response processes, internal structure in measurement invariance terms, and test consequences.DiscussionThe various validations of the P-CAT are not framed in a structured, valid, theory-based procedural framework like the “Standards” are. This can affect clinical practice because people’s health may depend on it. The findings of this study show that validation studies continue to focus on the types of validity traditionally studied and overlook interpretation of the scores in terms of their intended use.

Staff perspectives on the feasibility of the person-centered care assessment tool (PCC-at) in HIV treatment settings in Ghana: a mixed-methods study

Person-centered care (PCC) aims to improve client’s experiences in HIV care while advancing outcomes. This study team developed the PCC assessment tool (PCC-AT) to assess PCC service performance in HIV treatment settings in Ghana. Study objectives aimed to describe the range of PCC-AT scores within and across study facilities and examine the feasibility of PCC-AT implementation in diverse HIV treatment settings. The PCC-AT was piloted at five health facilities providing HIV services among 37 staff. Immediately following each pilot, focus group discussions (FGDs) were conducted to gather feasibility data. Thematic qualitative analysis was conducted on translated FGD transcripts. Across facilities, providers scored highest in the staffing domain, followed by service provision, and direct client support. Time required to implement the PCC-AT averaged 62 minutes. Providers described the tool as well-structured, user-friendly, relevant, reflective of the core PCC delivery elements, and useful in elucidating actions to improve PCC service delivery across domains. The PCC-AT holds potential to strengthen activities that support clients’ broader clinical, mental and psychosocial wellbeing by offering friendly services that attend to each client’s holistic needs while contributing progress towards epidemic control.

Psychometric evaluation of the Indonesian version of the Person-centered Care Assessment Tool.

The number of Indonesian care staff working in hospitals and long-term care facilities caring for persons with dementia in Japan is increasing; however, there is no instrument available in the Indonesian language to assess their dementia care practice. This study aimed to translate the Person-centered Care Assessment Tool (P-CAT) and evaluate its psychometric properties in a sample of Indonesian care staff working in dementia care and long-term care facilities in Japan. This is a descriptive, methodological, and cross-sectional study. The P-CAT was translated into the Indonesian language. The draft was administered to Indonesian care staff (n = 218) working at long-term care facilities in Japan. Data were analysed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), known-group validity, internal consistency, and test-retest reliability. EFA showed three-factor and CFA of the three-factor indicated that the model had an acceptable fit (chi-squared statistics/degree of freedom = 1.78, comparative fit index = 0.94, root mean square error of approximation = 0.06) with a slightly different structure compared to the original P-CAT. Regarding known-group validity, the P-CAT total score was significantly higher for those who had training in dementia, who knew about person-centred care, and who showed satisfaction in the job. Internal consistency (Cronbach's α) of the total scale was 0.68 which is considered acceptable, and the test-retest reliability intraclass correlation coefficient was 0.61 which is considered moderate. The Indonesian P-CAT indicated sound validity and reliability to measure person-centred care among Indonesian care staff working in dementia care and long-term care facilities in Japan. The development of Indonesian P-CAT allows the evaluation of dementia care, promotes and further improves person-centred care for persons with dementia provided by Indonesian care staff working in long-term care facilities in Japan.

The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic

ObjectivesThe aim was to describe the Person-Centred Practice Framework's four domains (prerequisites, care environment, person-centred processes, and person-centred outcomes) through the perspectives of critical care nurses working in intensive care units during the second year of the COVID-19 pandemic. Furthermore, the aim was to investigate the relationships between prerequisites, care environment, person-centred processes, and person-centred outcomes. Design/methodsA cross-sectional study involving questionnaires. Prerequisites were measured using person-related conditions, the care environment by using the Person-Centred Climate Questionnaire–Staff version, the person-centred processes by using the Person-Centred Care Assessment Tool and person-centred outcomes were measured with one question about present health and well-being and by using Self-rated Exhaustion Disorder. Descriptive and analytic statistics were used. Data was collected from July 2021 to November 2021. SettingCritical care nurses (n = 217) working in 15 Swedish adult intensive care units. ResultsParticipants’ average length of experience in intensive care units was 14 years, and most participants experienced increased nursing care responsibilities. They perceived the climate as safe but had limitations in terms of its everydayness and community. Participants perceived the organisations both supported and hindered personalized care. Most participants experienced a variety of exhaustion symptoms, and their health had positive relationship with community. ConclusionBy showing how prerequisites, care environment, person-centred process influences critical care nurses’ health and well-being, organisations might identify aspects in the work environment that require targeted interventions to reach healthy workplaces. Implications for clinical practiceTo preserve the health and well-being of critical care nurses and to flourish as humans in their professional roles, they need to interact with and form relationships with their colleagues, patients, and relatives. Organisations should have a person-centred approach for every individual in the workforce to harness each critical care nurses’ knowledge and skills for individuals to growth in their roles.

Adaptation and validation of the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population.

The relevance of person-centred care as an optimising approach to the quality of care provided to older adults has sparked the development of important instruments that measure this approach at residential care facilities and requires validation for the Portuguese population. This study aims to adapt and validate the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population. The P-CAT assesses the level of person-centred care provided by residential care facilities, according to staff. The process of adapting the P-CAT to the Portuguese population includes its translation, backtranslation and a pilot study. To recruit participants for the validation study, we contacted the Portuguese residential care facilities with emails provided in the official registries, and the study was also divulged on social media. The study had the participation of 573 staff members. The mean score of P-CAT was 50.76 (SD=7.65). The exploratory factor analysis showed three dimensions: the extent of care personalisation, the amount of organisational support and the degree of environmental accessibility. The results show good internal consistency for the total scale (α=0.809) and good temporal stability in the test-retest assessed by intraclass correlation coefficient (0.893). This version of the P-CAT for the Portuguese population has shown adequate psychometric properties and contributes to the study of care provided at residential care facilities in Portugal through self-reporting from staff. The availability of this instrument is useful for professional practice and research purposes and supports technical and scientific advancements that are necessary for the evolution of care frameworks.

Effectiveness of an aged simulation training suit to support development of compassion and person-centred care in the aged-care workforce.

The Australian aged-care sector employees are diverse, with a wide range of training backgrounds and work experience. Compassion and person-centred care (PCC) are essential for quality care. Effective training is required to facilitate compassion and PCC in the diverse workforce. Eligible staff members (n=732) participated in a 3-hour training activity using an aged simulation training suit. Training sessions were offered at eight ACH Group residential care sites. During the training, staff were required to complete functional daily tasks while wearing the suit. Pre- and post-training questionnaires were used to assess change in staff members' self-assessment of compassion and PCC. The Compassion Competence Scale and the Person-centred Care Assessment Tool were used to assess compassion and PCC. In total, 160 (22%) staff members participated in the evaluation of the training. Overall, participants reported significant improvements in self-reported compassion (p<0.01) and PCC after the training (p<0.001), compassionate communication (p<0.001) and insight (p<0.001), and ability to personalise care (p<0.001) and in recognising patients' environmental accessibility (p<0.01). The simulation activity improved aspects of compassion and person-centred care for the aged-care workforce. Further research is required to understand whether these changes are reflected in daily practice.

Reliability and validity of the Japanese version of the Person-Centered Care Assessment Tool.

To evaluate the reliability and validity of the Japanese version of the Person-Centered Care Assessment Tool (P-CAT-J) in a Japanese long-term care setting. This was a cross-sectional survey using self-administered questionnaires distributed among the nurses or care staff of 2000 special nursing homes randomly selected nationwide using stratified random sampling according to each prefecture's ratio of numbers of facilities. The internal consistency of the tool was calculated using Cronbach's α and construct validity was assessed using confirmatory factor analysis. The criterion-related validity of the scale was based on the partial correlation between the possible outcomes of person-centered care (PCC). In total, 324 samples were analyzed after excluding samples with incomplete P-CAT-J. Cronbach's α value for the entire P-CAT-J was adequate, although internal consistency values for each factor were not strong. Confirmatory factor analysis revealed an acceptable value after adjusting for error variables. The partial correlation coefficients among workplace satisfaction, quality of care, PCC implementation and total P-CAT-J score were significantly correlated. The overall P-CAT-J was developed with good reliability and acceptable criteria based on the responses of long-term care staff in Japan. The P-CAT-J has the potential for international comparison and can provide long-term care staff with PCC examples to learn relevant actions and concepts. Geriatr Gerontol Int 2022; 22: 344-349.

Measuring What Matters Across International Long-Term Care Settings

Measuring what matters most to residents, relatives and staff in residential long-term care settings is critical, yet underdeveloped in our predominantly frailty and deficits-focused measurement frameworks. The Worldwide Elements to Harmonize Research in Long-Term Care Living Environments (WE-THRIVE) consortium has previously prioritized measurement concepts in the areas of care outcomes, workforce and staffing, person-centered care, and care context. These concepts include knowing the resident and what matters most to the resident, and outcomes such as quality of life, and personhood. We present findings of our currently recommended measures, including both general population and dementia-specific measures, such as the Person-Centered Care Assessment Tool (PCAT), the Personhood in Dementia Questionnaire (PDQ), and the ICEpop CAPability Measure for Older People (ICECAP-O). We also describe remaining gaps in existing measures that will need to be addressed to fully specify common data elements focused on measuring what matters most to residents, relatives and staff.

How staff characteristics influence residential care facility staff\u2019s attitude toward person-centered care and informal care

BackgroundStaff members, and their attitudes, are crucial for providing person-centered care in residential care facilities for people with dementia. However, the literature on the attitudes of nursing staff regarding person-centered care is limited. The objective of this study is to explore the association between staff characteristics (age, education level, years of work experience and function, i.e., care or welfare) and staff attitudes toward perceived person-centered care provision and including informal caregivers in the caregiving process in residential care facilities.MethodsA convenience sample of 68 care staff – nurses and nurse assistants - welfare staff members – activity counselors, hostesses, and living room caretakers - of two residential care facilities filled out a questionnaire. Staff attitudes regarding perceived person-centered care were measured with the Person-centered Care Assessment Tool (P-CAT). Staff attitudes regarding informal care provision were measured with the Attitudes Toward Families Checklist (AFC). Multiple linear regression analysis explored the association between variables age, work experience, education, and function (care or welfare).ResultsA higher age of staff was associated with a more negative attitude toward perceived person-centered care and informal care provision. Welfare staff had a more negative attitude toward the inclusion of informal caregivers than care staff. The perceived person-centered care provision of the care and welfare staff was both positive. Work experience and education were not associated with perceived person-centered care provision or informal care provision.ConclusionThis study is one of the first to provide insight into the association between staff characteristics and their attitude toward their perceived person-centered care provision and informal care provision. A higher age of both the care and welfare staff was associated with a more negative attitude toward their perceived person-centered care and informal care provision. Welfare staff had a less positive attitude toward informal care provision. Additionally, future studies, also observational studies and interview studies, are necessary to collect evidence on the reasons for negative attitudes of older staff members towards PCC and informal care giving, to be able to adequately target these reasons by implementing interventions that eliminate or reduce these negative attitudes.

Characteristics of nursing home units with high versus low levels of person-centred care in relation to leadership, staff- resident- and facility factors: findings from SWENIS, a cross-sectional study in Sweden

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.

Person-Centered Care Practice, Patient Safety Competence, and Patient Safety Nursing Activities of Nurses Working in Geriatric Hospitals.

Geriatric nursing activities are closely related to patient safety; therefore, nurses’ efforts to improve patient safety in geriatric hospitals are important. In the present study, we investigated the relationships between person-centered care practice, patient safety competence, and patient safety during nursing activities in geriatric hospitals. We used the following tools to investigate the factors affecting patient safety during nursing activities: (a) the Korean version of the Person-Centered Care Assessment Tool (P-CAT), (b) the Patient Safety Competence Assessment Tool for Nurses, and (c) the Patient Safety Nursing Activities Assessment Tool for geriatric nurses. The questionnaire survey was completed by 186 geriatric nurses in 12 geriatric hospitals from 1 August to 31 August 2018. We analyzed the survey data using a t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression. We identified patient safety skills (β = 0.417, p < 0.001) and age (β = 0.209, p = 0.035) as key factors that influence patient safety during nursing activities. Therefore, to improve the quality of patient safety during nursing activities conducted by geriatric nurses, it is necessary to develop strategies to improve patient safety skills and expand the pool of competent nurses with clinical experience.

Sustainable implementation of person-centred care in residential care facilities: hindering and supporting factors when improving incontinence care

Purpose: The aim of the present study was to focus on the impact of the implementation of a person-centred approach on staff perception of the likelihood of being able to provide person-centred care and strain in the workplace. Design: The study was a controlled prospective cohort study performed at three residential care facilities in western Sweden involving all nursing staff members active from 2013 through 2015 at baseline and at three follow-ups during and after the implementation period. Two of the residential care facilities were assigned to the intervention group and one was assigned to the control group. Method: The study was designed to test the sustainability of a person-centred approach based on three aspects: partnership, narrative and documentation. A cross-section of 20 coworkers were purposively sampled from a total of 100 persons working at the two Intervention nursing homes to participate in the intervention group. The process outcome was measured as: perceived ward atmosphere, using the staff version of the validated Person-Centred Climate Questionnaire; person-centred care, measured using the validated Person-centred Care Assessment Tool; and experience of strain in work, using the Strain in Nursing Care Assessment Scale. Descriptive statistics were calculated for all variables using the SPSS Statistics software package. Findings: The results show that, at the control site, there were lower staff perceptions of the care atmosphere, higher level of strain experienced in their work and a lower likelihood of providing a person-centred care approach, whereas these factors remained rather stable over time at the intervention residential care facilities. Two contrasting results were observed—namely, that the higher the staff's perception of the likelihood of being able to provide individualised care and of a more person-centred ward atmosphere, the higher their stress levels experienced at work. In addition, older ages and long durations of work experience significantly negatively affected the staff's assessment of their ability to create an atmosphere of everydayness and to adopt a person-centred approach in care. Conclusions: The findings show that sustainability of a person-centred ward atmosphere is possible in the care of older people, despite staffing problems and other organisational challenges, according to the staff's assessment, after implementation of a person-centred programme. The more experienced staff members assessed their likelihood of being able to provide a person-centred care as lower after the implementation phase, indicating that despite the ambition of supporting person-centredness and quality of care, staffing and management difficulties that are present at the outset of the programme's implementation can later lead to stress and frustration relating to roles and routines.

The Person-Centered Care Assessment Tool in Nursing Homes: Psychometric Evaluation of the Italian Version.

The Person-centered Care Assessment Tool (P-CAT) was developed as a self-reporting assessment scale for the healthcare staff ratings of the person-centeredness of their nursing practice. This study investigates the psychometric proprieties of P-CAT tool in a sample of staff working in residential units for older people, in the North of Italy. Internal consistency and reliability were examined using the Cronbach's alpha coefficient. Exploratory factor analysis was used to evaluate construct validity, homogeneity analysis performed to evaluate internal homogeneity of the items and equidistance of item options, test-retest reliability examined by the Pearson correlation coefficient and the intraclass correlation (ICC) coefficient. The P-CAT score was standardized to a 100-point scale, the score differences among groups were compared with one-way ANOVA. The exploratory factor analysis supported the construct validity of a two-factor solution. The mean standardized score of P-CAT was 67.3 (SD 12.8) and Cronbach's alpha was .79 for subscale 1 and .75 for subscale 2. The ICC coefficient was .87. Reliability and homogeneity were satisfactory for the whole P-CAT tool (Cronbach's alpha ≥ .70). Test-retest reliability showed temporal stability of the scale (r Pearson .86, ICC .86). The Italian version of the P-CAT was found to be valid, reliable, and applicable for further research. Two subscales are recommended for the Italian version.

Psychometric evaluation of the Chinese version of the Person-Centred Care Assessment Tool

ObjectiveThis study aims to test a Chinese cross-cultural adaptation of the English version of the Person-Centred Care Assessment Tool (P-CAT) and evaluate its psychometric properties.DesignP-CAT was translated/back-translated using established procedures...

Engagement in Everyday Activities among People Living in Indian Nursing Homes: The Association with Person-Centredness

Introduction: It has been reported that residents living in nursing homes are often inactive and lonely and are offered a limited number of activities. However, high engagement in activities has been reported to improve residents’ quality of life and engagement in personalized activities can even reduce agitation and enhance positive mood. Information regarding occupational patterns and purpose in life is well established in Western countries. However, we know next to nothing about how people living in Indian nursing homes spend their days. Objective: To explore the participation in everyday activities among older people in Indian nursing homes and the extent to which engagement in activities is associated with person-centred care. Methods: The study was conducted in 6 nursing homes in India, comprising 147 residents. In all, 23 nursing staff took part and completed a 26-item questionnaire about resident activities based on the Multi-Dimensional Dementia Assessment Scale and the Person-Directed Care Questionnaire. Person-centredness was measured with the Person-Centred Care Assessment Tool. Results: We found low participationin everyday activities among the residents. Participation in religious activities was the most frequent, whereas the least used activities were excursions, participating in cultural activities, taking part in educational programmes, visiting a restaurant and going to the cinema. A significant positive association was foundbetween person-centred care and participation in religious activities, engagement in an activity programme and physical activity. Conclusions: The most frequently attended activity was religious activities. Person-centred care was associated with participation in religious activities, engagement in an activity programme, physical activity, spending time in the garden and playing and listening to music.

PERSON-CENTERED CARE, BURNOUT, AND BARRIERS AMONG DIRECT CARE PROFESSIONALS: TARGETED TRAINING INTERVENTION 360

Long-term care staff outcomes, such as job satisfaction and providing personalized care, are positively influenced by person-centered interventions. Implemented in eight facilities across Iowa, the Targeted Training Intervention 360 (TTI) program aimed to increase person-centered care among direct care professionals (DCP). Throughout the course of TTI, three waves of data were collected from DCPs regarding person-centered care (Person-Centered Care Assessment Tool; P-CAT) and feelings of burnout (Maslach Burnout Inventory; MBI). Analysis of variance tests were employed to identify significant differences in subscale scores across the three waves. Between waves one and two, results revealed significant increases in the P-CAT Extent of Personalizing Care (p=0.03) and Amount of Organizational Support subscales (p=0.001). Additionally, significant decreases from waves one and two were found in the MBI Emotional Exhaustion subscale (p=0.04). Between waves two and three, there were no significant changes in the P-CAT subscales; however, there was a significant increase in the MBI Emotional Exhaustion subscale (p=0.04). To supplement these findings, in wave three DCPs indicated barriers to implementing person-centered care, which included lack of time (49.0%), lack of experience (29.4%), and lack of administrative support (21.6%). Though there were no significant changes in P-CAT scores between the last two waves as well as barriers that must be addressed, DCPs described positive organizational and personal changes regarding person-centered care in the facility, including consistent staffing, using person-centered techniques in care, and individualized activities. Discussion focuses on ways to address barriers to person-centered care and sustain efforts in implementing change.

Evaluation of person-centeredness in nursing homes after a palliative care intervention: pre- and post-test experimental design

BackgroundThe needs of care based on palliative principles are stressed for all people with progressive and/or life-limiting conditions, regardless of age and the place in which care is provided. Person-centred palliative care strives to make the whole person visible and prioritizes the satisfaction of spiritual, existential, social, and psychological needs to the same extent as physical needs. However, person-centred palliative care for older persons in nursing homes seems to be sparse, possibly because staff in nursing homes do not have sufficient knowledge, skills, and training in managing symptoms and other aspects of palliative care.MethodsThis study aimed to evaluate whether an educational intervention had any effect on the staff’s perception of providing person-centred palliative care for older persons in nursing homes. Methods: A knowledge-based palliative care intervention consisting of five 2-h seminars during a 6-month period was implemented at 20 nursing homes in Sweden. In total, 365 staff members were participated, 167 in the intervention group and 198 in the control group. Data were collected using two questionnaires, the Person-centred Care Assessment Tool (P-CAT) and the Person-Centred Climate Questionnaire (PCQ-S), answered before (baseline) and 3 months after (follow-up) the educational intervention was completed. Descriptive, comparative, and univariate logistical regression analyses were performed.ResultsBoth the intervention group and the control group revealed high median scores in all subscales at baseline, except for the subscale amount of organizational and environmental support in the P-CAT. The staff’s high rating level of person-centred care before the intervention provides limited space for further improvements at follow-up.ConclusionThis study shows that staff perceived that managers’ and the organization’s amount of support to them in their everyday work was the only area for improvement in order to maintain person-centred care. The experiences among staff are crucial knowledge in understanding how palliative care can be made person-centred in spite of often limited resources in nursing homes. The dose and intensity of education activities of the intervention model need to be tested in future research to develop the most effective implementation model.Trial registrationNCT02708498. Date of registration 26 February 2016.

Expresión sexual y regulación de la sexualidad en residencias de personas mayores

ObjectivesThe study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies. MethodsA total of 160 Directors of Nursing and 623 technical staff from Spanish long term care residential facilities completed a self-administered questionnaire including ítems to assess the experience and estimated frequency of different sexual expressions, an inventory of policies regarding sexual expression, and the Spanish version of the Person-Centred Care Assessment Tool. ResultsCertain sexual behaviours, such as kisses and hugs, or masturbation, are very frequent in nursing homes. Many participants have reported to staff members on having witnessed inappropriate sexual behaviours, such as exhibitionism (39%) or unwanted touching (27%). Policies in relation to guaranteeing residents’ sexual rights were the most frequently mentioned. In contrast, there were fewer participants who mentioned policies regarding training or availability of helpful materials and resources. Factors such as occupational level (Directors of Nursing vs.technical staff), personal education, the centre commitment to person-centred care, and estimated frequency of sexual behaviour were associated with a higher presence of sexual expression policies. ConclusionAlthough sexual behaviours among residents are quite frequent, there is still room for improvement in policies that support residents’ expression of sexuality. Person-centred care models might help to guarantee sexual rights of older people living in long-term care facilities.

CONNECTING ENVIRONMENTAL, ADMINISTRATION, AND DIRECT CARE FACTORS AFFECTING PATIENT-CENTERED CARE

The Targeted Training Intervention 360 (TTI 360) program, led by the Alzheimer’s Association, aims to improve quality of care for persons with dementia (PWD) living in Iowa long-term care communities. TTI provides training to administrators (n=10) and direct care professionals (n=45) at 10 participating facilities in Iowa. TTI employs the Experiential Model of Dementia, which focuses on the unmet needs of PWD to increase person-centered care. Data were collected from a pre-test given at the training sessions. An organization’s patient-centered care level was measured using the Person Centered Care Assessment tool (P-CAT). Administrators and their employees were asked to decide the degree to which they believed the statements corresponded to their own experiences within the organization. Participants were split in to three groups for purposes of data analysis: -direct care professionals, directors of nursing, and administrators. An analysis of variance model revealed that administrators endorsed significantly greater person-centered care support (Mean = 48) compared to direct care professionals (M = 42; p=.002). Perceptions of person-centered care were positively related to CMS rating. The results demonstrate that the participating administrators may be disconnected from the reality of care on the ground level of their organizations. Methods that are used to bolster person-centered care and improve the quality of care will be discussed.

Influence of Moral Sensitivity and Nursing Practice Environment in Person-centered Care in Long-term Care Hospital Nurses

Purpose The aim of this study was to examine effects of moral sensitivity and nursing practice environment on person-centered care by nurses in long-term care hospitals. Methods Participants in this study were 118 nurses, with a least 4 months experience working in a long-term care hospital in Daegu City or North Gyeongsang Province. Data were collected from March 17 to 28, 2017 using questionnaires about general characteristics, the Korean Version Person-centered Care Assessment Tool, the Korean Moral Sensitivity Questionnaire, and the Korean Version of the Practice Environment Scale of Nursing Work Index. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation and hierarchial multiple regression analysis with the IBM SPSS statistics 19.0 Program. Results Person-centered care showed significantly positive correlations with moral sensitivity (r=.21, p=.024) and nursing practice environment (r=.62, p<.001). In the hierarchial regression analysis, moral sensitivity explained 4%(F=5.24, p=.024) of the variance in person-centered care and nursing practice environment accounted for 38% (F=35.15, p<.001) of the variance in person-centered care. Conclusion Findings indicate that improvements in person-centered care should be developed to provide a good nursing practice environment in long-term care hospitals. 주요어: 간호, 근무환경, ë„ë•ì  민감성, 인간중심돌봄 Key Words: Environment, Morals, Nursing, Patient-centered care