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Aim To evaluate the effects of a person‐centred and thriving‐promoting intervention in nursing homes on staff job satisfaction, stress of conscience and the person‐centredness of care and of the environment. Design A multi‐centre, non‐equivalent control group, before–after trial design. Methods Staff (N = 341) from six nursing homes in Australia, Norway and Sweden were assigned to the intervention or the control group and both groups were evaluated before the intervention, immediately after and by 6 months follow‐up. Staff completed a questionnaire about job satisfaction (primary endpoint), stress of conscience and the person‐centredness of care and of the environment (secondary endpoints). Linear regression models were used to identify the mean scores and to analyse group differences to test the effects of the intervention. Results The intervention had no statistically significant effects on staff job satisfaction, level of stress of conscience or the perceived person‐centredness of care and of the environment.

To evaluate the psychometric properties and performance of the 32-item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short-form.The 32-item TOPAS has been used in studies of place-related well-being as a positive measure in long-term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.Cross-sectional study.Staff members completed the 32-item TOPAS as proxy raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 - September 2014. Reliability analysis, exploratory factor analysis and item response theory-based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.Psychometric properties of the 32-item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short-form TOPAS exhibited a high level of internal consistency (α = 0.90) and strong correlation (r = 0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.The 32-item and short-form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.There is a lack of positive life-world measures for use in nursing homes. The short-form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health-promoting purposes in nursing homes.目的: 评价“32项老年人健康状况评估量表”中的心理测量特性和性能,并探究将其缩减为简表。 背景: “32项老年人健康状况评估量表”已用于与地方相关的福祉研究,并作为长期护理中的一项积极措施,以评估疗养院居民的健康状况。不过之前没有探究过冗余项。 设计: 横断面研究。 方法: 在2013年11月至2014年9月期间,工作人员作为随机抽取的瑞典疗养院居民(4,831人)的代理评分员,完成了“32项老年人健康状况评估量表”。期间进行了可靠性分析、探索性因素分析和基于项目反应理论的分析。采用统计和理论分析系统地确定了需削减的项目。相关试验、均值比较和模型拟合评价证实了量表的等价性。 结果: “32项老年人健康状况评估量表”中的心理测量特性令人满意,并确定了量表中需削减的项目。拟议的简表显示出与原量表高度的内部一致性(α = 0.90)和强相关性(r = 0.98),同时保持项目因素结构和项目难度的多样性。 结论: 原量表与简表显示出测量疗养院内居民健康状况的良好有效性和可靠性。 影响: 疗养院内缺乏积极的措施来感受生活世界。简表显示出测量居民健康状况的良好有效性和可靠性,提供了一种具有增强功能的可行性措施,用于疗养院促进健康的老年护理研究、评估和护理规划。.

To explore the extent to which a more person-centred climate could explain the variation in quality of care, as rated by relatives to nursing home residents in three countries.A cross-sectional, correlational, anonymous questionnaire study.Questionnaires were administered to 346 relatives to residents in six nursing homes in Australia, Norway and Sweden between April-June 2016. Relatives (N = 178) agreed to participate. Data were analysed using descriptive statistics and hierarchical multiple regression.The results showed that the relatives' experiences of a more person-centred climate were associated with higher ratings of the quality of care. A person-centred climate of safety had the strongest unique association with the quality of care, explaining 14% of the variance in quality of care. In addition, the results indicated that the relatives in general were satisfied with the quality of care and that children to the residents rated the quality of care higher than partners or other relatives.This study advances the understanding of the relationship between person-centredness in nursing homes and quality of care, showing that person-centred climate aspects of safety and hospitality have a significant role in the quality of care as perceived by relatives.Person-centredness in nursing homes is often mentioned as a quality of care indicator, but the empirical evidence for this suggestion is limited. This study expanded the evidence-base for person-centredness as a significant aspect of relatives' experiences of the quality of care in nursing homes.目的: 在于探讨患者为大氛围在多大程度上可以阐述护理质量的变化,这是由三个国家养老院居民的亲属评定的。 设计: 横断面、相关性和不记名问卷研究。 方法: 在2016年4月至6月期间,对澳大利亚、挪威和瑞典六家养老院的346名居民亲属进行了问卷调查。(有17名)亲属同意参加。使用了描述统计学和分层多元回归法来分析数据。 结果: 结果表明,亲属的患者为大氛围体验与更高护理质量评价相关。安全的患者为大氛围与护理质量有着最强的独特关联性,阐释了护理质量差异的14%。此外,调查结果表明,亲属总体上对护理质量感到满意,居民子女对护理质量的评价高于伴侣或其他亲属。 结论: 这项研究提高了对养老院中患者为大与护理质量之间关系的认识,表明安全和优待的患者为大氛围因素对亲属认为的护理质量有着重要作用。 影响: 虽然疗养院中的患者为大主义经常被称为护理质量的指标,但这一建议的实验性证据还非常有限。这项研究扩展了患者为大的证据基础,将其作为亲属体验养老院护理质量的一个重要方面。.

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.

BACKGROUND The Thriving of Older People Assessment Scale has Scandinavian, Norwegian and English versions but does not yet have a Chinese version that can be used in Chinese populations and compared to global data. OBJECTIVES To evaluate the psychometric properties of the translated Chinese version of the Thriving of Older People Assessment Scale. METHODS The English version of the Thriving of Older People Assessment Scale was translated into Chinese using a forward and backward translation method. A convenience sampling strategy was used to recruit participants from five long-term care facilities in northern Taiwan (N = 285). Confirmatory factor analysis was then performed to confirm the theory of the Thriving of Older People Assessment Scale Chinese version. RESULTS The Thriving of Older People Assessment Scale Chinese version consists of 32 items loading across five domains, namely, 'resident attitudes towards being in long-term care', 'quality of care and caregivers', 'resident engagement and peer relationships', 'keeping in touch with people and places' and 'quality of the physical environment', with good internal consistency (0.971). Confirmatory factor analysis results showed that χ2 = 2255.58 (df = 459, p

To explore the level of thriving and associated factors among older adults living at home with support from home care services.An exploratory, cross-sectional survey design.A sample of 136 participants (mean 82 years) responded to a survey about thriving, health, psychosocial and care-related factors in 2016. Descriptive analysis and multiple logistic regression analysis with a stepwise backwards elimination procedure were performed.The results showed that the level of thriving was relatively high among adults living at home with support from home care services, with dimensions concerning engaging in activities and peer relations and keeping in touch with people and places being rated the lowest. Regression analysis showed that participating in social relations and experiencing self-determination in activities in and around the house were associated with thriving.Facilitating social relations and creating opportunities for self-determination seem necessary to support thriving among older adults living at home with support from home care services.The findings in this study add important knowledge about place-related well-being when living at home with home care services.目的: 探索家庭护理服务在居家老年人中的受欢迎程度和相关因素 设计: 一项探索性现状调查设计。 方法: 2016年,136名受试者(年龄平均在82岁)参与了一项关于家庭护理服务发展、健康、心理社会因素和护理相关因素。采用描述性分析和多重逻辑回归分析及逐步向后消除法。 结果: 结果表明,家庭护理服务在居家老年人中的受欢迎程度相对较高,与从事的工作、同伴关系以及与人和相关场所保持联系等有关的维度被视为最低。回归分析表明,参与社会关系、在家中和周围的活动中体验自我决定与家庭护理服务的受欢迎程度有关。 结论: 对于提高家庭护理服务在居家老年人中的受欢迎程度而言,似乎有必要促进社会关系和创造自我决定机会。 影响: 该研究结果提高了人们关于家庭护理服务和与场所相关的幸福感之间的关系的认知。.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Background: Meeting psychosocial needs is a significant component of quality dementia care. To enable persons with dementia to live at home for as long as possible, a community healthcare service offering care where physical, social, psychological, cultural and spiritual needs are met, is recommended. A comprehensive allocation process is required to allocate individually tailored healthcare services. However, the allocation process for older home-dwelling persons with dementia, specifically for services to safeguard psychosocial needs, remains largely unexplored. Accordingly, this study aims to explore purchasers’ deliberations on psychosocial needs during the process of allocating healthcare services to older home-dwelling persons with dementia. Methods: The study had a descriptive design with a qualitative approach. The primary data source was focus group interviews with purchasers who assess and allocate healthcare services. The interview data were supplemented by a review of administrative decisions made by the purchasers. Data from the focus group interviews were analysed using a descriptive and interpretive approach. Content analysis of the administrative decisions was conducted. Results: The purchasers described the allocation process as challenging. The following four themes reflect the complexity of the allocation process: (i) an unfamiliar and unclear concept; (ii) a hierarchy of needs; (iii) an adjusting allocation process; (iv) a challenging documentation of administrative decisions. Conclusions: The purchasers viewed a comprehensive allocation process as important. However, a web of different interplaying aspects prevented the purchasers from conducting a comprehensive need-led allocation process. Insufficient assessment or allocation threatens the adequate safeguarding of the psychosocial needs of persons with dementia. Having varied and sufficient services to allocate is of great importance, but is not sufficient. Psychosocial needs must be better incorporated as a significant element throughout the entire allocation process. Purchasers’ deliberations on psychosocial needs within the process of allocating healthcare services for older home-dwelling persons with dementia: a qualitative study. The study received an additional research grant from the Norwegian Nurses Organisation (number 13/0033). This funding did not influence the study design; data collection, analysis, or interpretation; or preparation of the manuscript.

BackgroundThe present study aims to illuminate the meaning of working in a person-centred way as experienced by staff in nursing homes. Insights into what working in a person-centred way mean for nursing home staff may contribute to a more comprehensive understanding of what gives staff satisfaction in their work and support further development of person-centred care approach in nursing homes.MethodsInterviews with 29 health care personnel who had participated in a one-year intervention focusing on person-centred care and thriving in three nursing homes in Australia, Norway and Sweden were performed, and a phenomenological-hermeneutical method was used to explore staffs’ lived experiences of working in a person-centred way in nursing homes.ResultsFor nursing home staff, working in a person-centred way meant that they were able to meet individual resident’s needs and expressed preferences in close family-like relationships, understanding the residents’ rhythms and preferences as the basis of the daily work plans and being able to do ‘the little extra’ for residents. Also, working in a person-centred way meant meeting shared goals by working towards a collective practice in collaborative teams. As a whole, the staffs’ lived experiences of working in a person-centred way in nursing homes was interpreted to mean thriving at work as a psychological state in which individuals experience both a sense of vitality and learning.ConclusionsWorking in a person-centred way means staff thriving at work in nursing homes. The results further indicate that delivering care by only focusing on routines and practical tasks and not on residents’ preferences and well-being would inhibit thriving among nursing staff, leading to the potential for dissatisfaction with work.

The aim of this article is to describe the Umeå ageing and health research programme that explores person-centred care and health-promoting living conditions for an ageing population in Sweden, and to place this research programme in a national and international context of available research evidence and trends in aged care policy and practice. Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umeå ageing and health research programme consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.

Objectives Simulation-based learning has been extensively explored, especially in baccalaureate nursing programmes. Recently, simulation-based learning has been introduced in perioperative nursing. The aim of this scoping review is to investigate work published on the use of simulation-based learning in the field of perioperative nursing. Design and data sources A scoping review was conducted using the methodological framework of Arksey and O'Malley to identify a broad range of relevant literature, regardless of study design. A comprehensive and systematic search was performed using Medline, CINAHL, Eric, Svemed+, PsychINFO and Embase in May 2016 and then was updated in February 2018. Each database was searched for literature published between 1st January 2005 and 8th February 2018. Review method Two authors independently assessed literature eligibility and extracted data to answer our research question ‘What is known about the use of simulation-based learning in the field of perioperative nursing?’ Results Nine articles and one doctoral thesis were included in the review. There appears to be a paucity of research or results-oriented evidence regarding the use of simulation-based learning in the field of perioperative nursing. Different goals of simulation-based learning were reported. It was difficult to confirm whether these goals had been reached as none of the articles included control groups, and no evaluations had been undertaken against Kirkpatrick's level 3 to see changes in participants' behaviours, and level 4, to determine whether the training had a positive impact on, for example, patient outcomes. Conclusion Owing to the lack of research and the inadequate descriptions of design and method in simulation-based learning in most of the articles included, there is little evidence in the existing literature to guide practitioners of this learning in the field of perioperative nursing. This indicates a need for further research in this area.

To explore the associations between job satisfaction and perceived person-centredness and ethically difficult situations among staff in nursing homes (NHs).Previous studies have indicated that person-centredness and few ethically difficult situations can contribute positively to NH staff's job satisfaction. However, empirical evidence of these associations is lacking.Cross-sectional survey design.Nursing home staff (N = 341) in six NHs in Australia, Norway, and Sweden completed the questionnaire measuring job satisfaction, person-centredness, and ethically difficult situations. Data were collected between April - June 2016. Univariate analysis was used to describe the sample, one-way analysis of variance examined differences between variables. Bivariate correlation tested the relationships between variables and hierarchical multiple regression explored the extent to which person-centredness and ethically difficult situations could explain job satisfaction among staff.After controlling for socio-demographic variables in a regression model, three variables of person-centredness and "ethically difficult situations" were significantly associated with job satisfaction. A "climate of community" contributed the most, followed by the "amount of organizational and environmental support," "a climate of everydayness," and few "ethically difficult situations."The results support the theoretical foundation and previous findings suggesting that establishing NHs organizations based on person-centredness will increase staff job satisfaction. However, this is a cross-sectional study and the causality may go in both directions and should be further explored.目的: 探讨养老院护理人员工作满意度与个人中心意识、伦理困境之间的关系。 背景: 先前的研究表明,个人中心意识和少数道德困境能对养老院员工的工作满意度产生积极的影响。然而,缺乏这些联系的经验证据。 设计: 横断面调查设计。 方法: 在澳大利亚、挪威和瑞典的6个养老院机构中,养老院的工作人员(N = 341)完成了调查问卷,计算了工作满意度、个人中心意识和道德困境。数据收集时间为2016年4月至6月。样本采用单因素分析,单因素方差分析检验变量间的差异。二元相关检验变量与层次多元回归之间的关系探讨了个人中心意识和道德困境在多大程度上可以解释员工的工作满意度。 结果: 在回归模型中控制了社会人口统计变量后,个人中心意识和“道德困境”这三个变量与工作满意度显著相关。“社区气候”贡献最大,其次是“组织和环境支持的数量”、“日常气候”和少数“伦理困境”。 结论: 这些结果支持了理论基础和先前的研究结果,即建立以人为本的养老院组织将提高员工的工作满意度。然而,这是一项横断面研究,因果关系可能是双向的,需要进一步研究。.

Interview guide. Manuscript: Purchasers’ deliberations on psychosocial needs within the process of allocating healthcare services for older home-dwelling persons with dementia: A qualitative study. (DOCX 14 kb)

To explore the extent to which environmental factors are associated with resident thriving.Thriving is a concept that denotes experiences of well-being in relation to the living environment. Although there is a substantial body of research into quality of life in nursing homes, less is known about what contributes to thriving among residents. Recent research on resident thriving has focused mainly on resident characteristics and activities associated with thriving. Less attention has been given to explore associations with the physical and psychosocial environment of the nursing home. This study explores facility- and unit-level factors associated with resident thriving.A cross-sectional national survey.Data on 4,205 residents, 3,509 staff, and environment of 147 nursing home facilities collected in 2013-2014 were analysed using descriptive statistics, multilevel simple, and multiple linear regression to explore resident thriving in relation to environmental factors.Multilevel analysis revealed that residents' thriving varied significantly across nursing home units. Several environmental factors were associated with thriving in univariate analyses. However, a positive psychosocial climate of units, having access to newspapers, living in a special care unit, and living in an unlocked facility showed significant positive associations with resident thriving when controlling for resident characteristics. The psychosocial climate showed the strongest association of the environment variables with resident thriving.Nursing home environments may have an impact on residents' thriving. A positive psychosocial climate of units seems to have an important role in facilitating thriving in nursing home residents.

To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving.Research into residents' engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives.A cross-sectional survey.A national survey of 172 Swedish nursing homes (2013-2014). Resident (n = 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed.The most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving.Engagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.

Background The majority of persons with dementia are home-dwelling. To enable these persons to stay in their own homes as long as possible, a holistic, individual and flexible care is recommended. Despite a requirement for meeting psychological, social and physical needs, home care services seem to focus on patients’ physical needs. Accordingly, the aim of this study was to explore how the psychosocial needs of home-dwelling, older persons with dementia were perceived, emphasized and met by home care services. Methods A descriptive, qualitative approach was used. Data were collected through semi-structured focus group interviews with 24 health care providers in home care services from four municipalities. Data were analysed using systematic text condensation. Results This study showed major differences in how health care providers perceived the psychosocial needs of older home-dwelling persons with dementia and how they perceived their responsibilities for meeting those psychosocial needs. The differences in the health care providers’ perceptions seemed to significantly influence the provided care. Three co-existing logics of care were identified: the physical need-oriented logic, the renouncement logic and the integrated logic. Conclusions The differences in how health care providers perceived the psychosocial needs of persons with dementia and their responsibilities for meeting those needs, influenced how the psychosocial needs were met. These differences indicates a need for a clarification of how psychosocial needs should be conceptualized and who should be responsible for meeting these needs. Further, increased competence and increased consciousness of psychosocial needs and how those needs can be met, are essential for delivering high-quality holistic care that enables persons with dementia to live in their own home for as long as possible. Electronic supplementary material The online version of this article (10.1186/s12877-017-0612-3) contains supplementary material, which is available to authorized users.

Background Although a large number of people are diagnosed with dementia each year, the syndrome is still perceived as a sensitive and tabooed topic. Communication about dementia to those living with the syndrome and their relatives is often experienced as challenging by health professionals. Failure to communicate clearly may threaten assessment and allocation of appropriate, effective healthcare services. Accordingly, the aim of this study was to explore how purchasers, assessing and allocating healthcare services to home-dwelling older people with dementia, described challenges in communicating about dementia with those with the syndrome and their relatives. Furthermore, the study aimed to explore the purchasers’ justifications for their choice of words. Methods A qualitative study was conducted to investigate two data sources: focus group interviews with purchasers assessing need for healthcare services, and a review of administrative decisions written by those allocating services. Focus group data were explored using an interpretive approach and qualitative content analysis was carried out with the administrative decisions. Results The purchasers found it challenging to talk and write about dementia to those with the syndrome and their relatives when assessing and allocating services. The purchasers were flexible in their communication and aimed to be open when talking and writing about dementia. However, euphemisms and omission were used extensively. Four justifications for the chosen verbal and written language were identified: avoiding disclosure; protecting the person with dementia; protecting the relatives/avoiding conflict; and last, taboo and stigma. Conclusions Despite purchasers experiencing difficulties in communicating about dementia to those with the syndrome and their relatives, they did manage to communicate in a conscious and flexible way. The purchasers had several justifications for their language choice. However, extensive use of euphemisms and omission might threaten appropriate identification of needs and provision of high quality healthcare services. The challenges experienced by the purchasers demonstrate the need to focus on appropriate and flexible strategies for individually-tailored communication about dementia with people living with the syndrome. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1659-0) contains supplementary material, which is available to authorized users.

Aim Describe professional caregivers' perceptions of factors and processes contributing to mealtime agitation and strategies for attaining and maintaining calm mealtimes. Design Qualitative and descriptive. Methods A convenience sample of professional caregivers working in two wards for residents with dementia was used. Data were collected during two focus-group interviews and supplemented with field notes from six reflection groups. Thematic content analysis was conducted. Data collection occurred from 2010–2011. Results Professional caregivers perceived agitation during mealtime as resulting from negative feelings in residents triggered by a lack of or negative social interaction, too much or ambiguous stimuli or demands exceeding residents' capacity. Strategies for attaining calm mealtimes involved thorough planning beforehand. During mealtime, professional caregivers focused on establishing a positive community around the table, helping residents focus on eating and continuously observing residents for subtle signals indicating that agitation was about to develop. The prerequisites to succeed with the strategies were knowledge of the residents' preferences and abilities, knowledge sharing within the team and awareness of one's own communication style. Thus, the professional caregivers operationalized person-centred care in a mealtime context.