Development of a self-scan to evaluate and improve person-centered care in nursing homes:A Delphi study

Background and objective: Person centered care (PCC) has become the gold standard for providing care in nursing homes (NHs). Therefore, it is important for healthcare professionals in NHs to learn PCC-skills and to be supported to learn about- and improve the quality of PCC they provide. At this moment an instrument to support healthcare professionals in NHs to monitor and evaluate PCC is limited. The aim of the study was to develop a self-evaluation tool that provides healthcare professionals in NHs insight into the extent to which they provide PCC to residents, so that they can learn and further improve their current ways of working in a person-centered way. Methods: A three-round Delphi study with an expert panel (n = 25) in the domains of PCC, quality of NH care and education of caring staff. Findings were validated by residents and relatives during semi-structured interviews. Thematic analysis and descriptive statistics were used to analyze the data. Results: In the first round the experts did not provide measuring instruments, but we identified 18 key aspects of PCC. In the second round, three clusters were identified, and a scale was added, to enable assessment. In the third round, we deduplicated, restructured and used more clear language. This led to 14 key aspects of PCC, 24 measures, grouped into five clusters: knowing the resident, establishing relationship, a respectful approach, making decisions jointly and personal development. The result is a PCC self-scan for healthcare professionals in NHs. Residents and relatives, agreed with all aspects and stated that no aspects were missing. Conclusions: In this study we developed an accessible self-report learning tool for healthcare professionals that makes it possible to evaluate and improve their PCC-skills and improve the quality of PCC in NHs

How do practically trained (student) caregivers in nursing homes learn?:A scoping review

Background and objective: Practically trained (student) caregivers (further: caregivers) make up the majority of care staff in nursing homes (NHs). To keep up with the fast-changing healthcare environment and ensure a high quality of care, it is important to know how to stimulate continuous work-based learning (WBL) among this group. The purpose of the study was to systematically study the scientific literature published to date on (1) how caregivers learn in NHs and (2) what facilitates or impedes their learning. Methods: A scoping review was carried out, systematically searching six scientific databases. A total of 35 studies published from January 2009 to February 2021 were included. Study characteristics, learning mechanisms, facilitators, and barriers to learning were extracted and synthesized. Results: None of the studies specifically focused on how caregivers learn. Yet, we identified various learning mechanisms, and found that learning by theory or supervision was most frequently engaged in. Most learning mechanisms used among the groups in the included studies were planned and formal and developed and initiated by others out of the context. Three main themes were identified among the facilitators and barriers of WBL: individual learning, collective learning, and resources for learning. An interdependency between (sub)themes was found. Conclusions: The way caregivers in NHs learn is understudied. Moreover, both their informal learning and the support they receive to be(come) active learners has been overlooked. As WBL provides caregivers with opportunities to learn within a real-life setting, we suggest more research on informal learning mechanisms

Development of a self-scan to evaluate and improve person-centered care in nursing homes: A Delphi study

Background and objective: Person centered care (PCC) has become the gold standard for providing care in nursing homes (NHs). Therefore, it is important for healthcare professionals in NHs to learn PCC-skills and to be supported to learn about- and improve the quality of PCC they provide. At this moment an instrument to support healthcare professionals in NHs to monitor and evaluate PCC is limited. The aim of the study was to develop a self-evaluation tool that provides healthcare professionals in NHs insight into the extent to which they provide PCC to residents, so that they can learn and further improve their current ways of working in a person-centered way. Methods: A three-round Delphi study with an expert panel (n = 25) in the domains of PCC, quality of NH care and education of caring staff. Findings were validated by residents and relatives during semi-structured interviews. Thematic analysis and descriptive statistics were used to analyze the data. Results: In the first round the experts did not provide measuring instruments, but we identified 18 key aspects of PCC. In the second round, three clusters were identified, and a scale was added, to enable assessment. In the third round, we deduplicated, restructured and used more clear language. This led to 14 key aspects of PCC, 24 measures, grouped into five clusters: knowing the resident, establishing relationship, a respectful approach, making decisions jointly and personal development. The result is a PCC self-scan for healthcare professionals in NHs. Residents and relatives, agreed with all aspects and stated that no aspects were missing. Conclusions: In this study we developed an accessible self-report learning tool for healthcare professionals that makes it possible to evaluate and improve their PCC-skills and improve the quality of PCC in NHs

How do practically trained (student) caregivers in nursing homes learn? A scoping review

Background and objective: Practically trained (student) caregivers (further: caregivers) make up the majority of care staff in nursing homes (NHs). To keep up with the fast-changing healthcare environment and ensure a high quality of care, it is important to know how to stimulate continuous work-based learning (WBL) among this group. The purpose of the study was to systematically study the scientific literature published to date on (1) how caregivers learn in NHs and (2) what facilitates or impedes their learning. Methods: A scoping review was carried out, systematically searching six scientific databases. A total of 35 studies published from January 2009 to February 2021 were included. Study characteristics, learning mechanisms, facilitators, and barriers to learning were extracted and synthesized. Results: None of the studies specifically focused on how caregivers learn. Yet, we identified various learning mechanisms, and found that learning by theory or supervision was most frequently engaged in. Most learning mechanisms used among the groups in the included studies were planned and formal and developed and initiated by others out of the context. Three main themes were identified among the facilitators and barriers of WBL: individual learning, collective learning, and resources for learning. An interdependency between (sub)themes was found. Conclusions: The way caregivers in NHs learn is understudied. Moreover, both their informal learning and the support they receive to be(come) active learners has been overlooked. As WBL provides caregivers with opportunities to learn within a real-life setting, we suggest more research on informal learning mechanisms

How do practically trained (student) caregivers in nursing homes learn?: A scoping review

Background and objective: Practically trained (student) caregivers (further: caregivers) make up the majority of care staff in nursing homes (NHs). To keep up with the fast-changing healthcare environment and ensure a high quality of care, it is important to know how to stimulate continuous work-based learning (WBL) among this group. The purpose of the study was to systematically study the scientific literature published to date on (1) how caregivers learn in NHs and (2) what facilitates or impedes their learning. Methods: A scoping review was carried out, systematically searching six scientific databases. A total of 35 studies published from January 2009 to February 2021 were included. Study characteristics, learning mechanisms, facilitators, and barriers to learning were extracted and synthesized. Results: None of the studies specifically focused on how caregivers learn. Yet, we identified various learning mechanisms, and found that learning by theory or supervision was most frequently engaged in. Most learning mechanisms used among the groups in the included studies were planned and formal and developed and initiated by others out of the context. Three main themes were identified among the facilitators and barriers of WBL: individual learning, collective learning, and resources for learning. An interdependency between (sub)themes was found. Conclusions: The way caregivers in NHs learn is understudied. Moreover, both their informal learning and the support they receive to be(come) active learners has been overlooked. As WBL provides caregivers with opportunities to learn within a real-life setting, we suggest more research on informal learning mechanisms

Dementia Enlightened?!: A Systematic Literature Review of the Influence of Indoor Environmental Light on the Health of Older Persons with Dementia in Long-Term Care Facilities

Light therapy for older persons with dementia is often administered with light boxes, even though indoor ambient light may more comfortably support the diverse lighting needs of this population. Our objective is to investigate the influence of indoor daylight and lighting on the health of older adults with dementia living in long-term care facilities. A systematic literature search was performed within PubMed, CINAHL, PsycINFO, Web of Science and Scopus databases. The included articles (n=37) were published from 1991 to 2020. These articles researched the influence of existing and changed indoor light conditions on health and resulted in seven categories of health outcomes. Although no conclusive evidence was found to support the ability of indoor light to decrease challenging behaviors or improve circadian rhythms, findings of two studies indicate that exposure to (very) cool light of moderate intensity diminished agitation. Promising effects of indoor light were to reduce depressive symptoms and facilitate spatial orientation. Furthermore, there were indications that indoor light improved one’s quality of life. Despite interventions with dynamic lighting having yielded little evidence of its efficacy, its potential has been insufficiently researched among this study population. This review provides a clear and comprehensive description of the impact of diverse indoor light conditions on the health of older adults with dementia living in long-term care facilities. Variation was seen in terms of research methods, (the description of) light conditions, and participants’ characteristics (types and severity of dementia), thus confounding the reliability of the findings. The authors recommend further research to corroborate the beneficial effects of indoor light on depression and to clarify its role in supporting everyday activities of this population. An implication for practice in long-term care facilities is raising the awareness of the increased lighting needs of aged residents. Original article at: https://doi.org/10.2147/CIA.S29786

Using PROMs during routine medical consultations: The perspectives of people with Parkinson’s disease and their health professionals

Background: The use of patient-reported outcomes measures (PROMs), such as quality of life or symptoms like pain or fatigue, is increasingly embraced within patient-centred care and shared decision making. Objectives: To investigate: (a) how patients and health professionals think about using PROMs during routine medical consultations; (b) for which purpose(s), patients and health professionals want to use PROMs during those consultations; and (c) how patients interpret PROMs information presented in various formats. People with Parkinson's disease and their health professionals served as case example. Methods: We performed semi-structured interviews with patients (N = 13) and professionals (N = 7 neurologists; N = 7 physiotherapists). We also used a survey in which patients (N = 115) were shown six figures displaying different information types. Presentation formats of this information varied (line/bar graphs). Interpretation by patients, perceived usefulness of information, attitude towards using information during routine medical consultations and (hypothetical) decisions were assessed. Findings: Patients and professionals were generally positive about using PROMs during medical consultations. Professionals stressed the opportunity to monitor changes in individual PROMs over time. Patients were primarily positive about aggregated PROMs to make treatment decisions. This information was also most often interpreted correctly, especially when presented through a line graph (90.1% correct). Professionals thought patients should take the initiative in discussing PROMs, whereas patients thought professionals should do so. Conclusion/Discussion: When used in routine medical consultations, PROMs seem to have potential to support shared decision making and facilitate patient-professional communication. However, training seems needed for both patients and professionals to facilitate actual discussion and proper interpretation

Replication Data for: Evaluation study narrative educational program, 2021

The goal of this study was to evaluate the impact of a co-designed educational program aimed at promoting narrative approaches in nursing homes. A mixed-methods evaluation study was conducted, adopting a pragmatic approach to answer the following research questions: Following participation in the ‘Tell Me! Learning from Narratives’ program, what is the impact on nursing and care students’ knowledge and person-centred practice? What factors influence this learning