Exploring facilitators and barriers to using a person centered care intervention in a nursing home setting

Person-centered care (PCC) interventions have the potential to improve resident well-being in nursing homes, but can be difficult to implement. This study investigates perceived facilitators and barriers reported by nursing staff to using a PCC intervention consisting of three components: assessment of resident well-being, planning of well-being support, and behavioral changes in care to support resident well-being. Our explorative mixed method study combined interviews (n = 11) with a longitudinal survey (n = 132) to examine which determinants were most prevalent and predictive for intention to use the intervention and actual implementation 3 months later (n = 63). Results showed that perceived barriers and facilitators were dependent on the components of the intervention. Assessment of resident well-being required a stable nursing home context and a detailed implementation plan, while planning of well-being support was impeded by knowledge. Behavioral changes in nursing care required easy integration in daily caring tasks and social support

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

Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. Implication for Practice: 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.</p

Longitudinal Associations of Autonomy, Relatedness, and Competence with the Well-being of Nursing Home Residents

Background and Objectives As proposed by the self-determination theory, satisfying nursing home residents’ needs for autonomy, relatedness, and competence may improve their well-being. This is the first study to test the longitudinal relations of the satisfaction of these three basic psychological needs to the subjective well-being of nursing home residents and to determine whether a balance among the satisfaction of the three needs is important for well-being. Research Design and Methods Participants in this longitudinal survey study included 128 physically frail residents (mean age 85 years) at four Dutch nursing homes. Satisfaction of the three basic psychological needs was measured at baseline, and depressive feelings and life satisfaction 5–8 months later. Absolute differences between the three basic need satisfaction scores were summed to create a score of need satisfaction balance. Results All three needs were related to both well-being measures over time, although autonomy had the strongest relationships. Only autonomy and competence were uniquely associated with depressive feelings, and only autonomy was uniquely associated with life satisfaction. The need satisfaction balance score was related to well-being independent of the autonomy and relatedness scores. Discussion and Implications These results confirm that all three basic psychological needs are important for nursing home residents’ well-being, with autonomy having the strongest and most consistent relationship to their well-being. Additionally, high satisfaction of one need does not compensate for low satisfaction of another. Supporting residents’ needs for autonomy, relatedness, and competence should, therefore, have a central role in nursing home culture-change interventions

WELL-BEING OF NURSING HOME PROFESSIONAL CAREGIVERS: TESTING A POSITIVE PSYCHOLOGICAL INTERVENTION

With major job demands such as workload, professional caregivers in nursing homes are at increased risk for stress related problems like burnout. As such job demands will most likely not decrease in the near future, attention should be shifted towards resilience of all professional caregivers by focusing on increasing personal resources. The purpose of this study was to test a generic online positive psychology intervention in increasing both general wellbeing and work related wellbeing for professional caregivers of somatic units of four nursing homes. This study had a group-randomized controlled design (intervention group n = 74, control group n = 47). The intervention consisted of reading information and doing exercises of 8 themes of positive psychology (e.g. strengths, positive relations) in 12 weeks. Questionnaires on work related wellbeing (Utrecht Work Engagement Scale), general wellbeing (Mental Health Continuum) and burnout (Utrecht BurnOut Scale) were filled out online at baseline and 3 months later (T1). Mixed ANOVAs showed no significant increase in work related wellbeing (p = .61) or general wellbeing (p = .37) of the intervention group compared to the control group. Burnout and engagement at baseline were not significant moderators (p’s > .40). Providing professional caregivers of nursing homes with an online generic positive psychological intervention did not increase work related wellbeing or general wellbeing, even for caregivers most at risk for stress related problems. Possible alternative explanations such as ceiling effects, lack of intrinsic motivation and high workload as well as practical implications are discussed