Murphy Kathy, Shea Eamon O, Cooney Adeline
Department of Nursing, Aras Moyola, National University of Ireland, Galway, Ireland.
J Clin Nurs. 2007 Nov;16(11):2167-77. doi: 10.1111/j.1365-2702.2006.01865.x. Epub 2007 Apr 5.
The aim of this study was to explore the quality of life of older people living in long-stay care in Ireland from the perspectives of residents and staff.
While the literature on quality of life is complex, several areas of agreement are evident. Quality of life is a multi-dimensional concept, which cannot be explained solely in medical terms and only makes sense if presented in an holistic context. Quality of life contains both subjective and objective elements; therefore, there is a need to take account of both when measuring the concept.
A mixed method research design was selected for this study. Three methods were employed; focus groups (n = 7) a quantitative survey of 526 long-stay facilities and qualitative interviews with 101 residents and 48 staff.
The findings revealed four thematic domains of quality of life: care environment and ethos of care, personal identity, connectedness to family and community and activities and therapies.
The study found that there were differences in resident experiences across care study sites and important differences in staffing provision, skill mix and physical environment between private and public facilities. Several factors were also found that either enhanced or diminished residents' potential to retain their connections and relationships with other people. Finally, residents were most likely to participate in activities which were designed to take into account their own particular interests.
This study articulates domains of quality of life from the perspective of residents and staff and gives support to the claims that management and organizational structures within long-stay care facilities matter for quality of life. Clear identification of what is important to older people is important as services need to be shaped around quality of life as much as quality of care, notwithstanding the close relationship between the two.
本研究旨在从居民和工作人员的角度探讨居住在爱尔兰长期护理机构中的老年人的生活质量。
虽然关于生活质量的文献复杂,但几个共识领域是明显的。生活质量是一个多维度的概念,不能仅从医学角度来解释,只有在整体背景下呈现才有意义。生活质量包含主观和客观因素;因此,在衡量这一概念时需要兼顾两者。
本研究选择了混合方法研究设计。采用了三种方法;焦点小组(n = 7)、对526个长期护理机构的定量调查以及对101名居民和48名工作人员的定性访谈。
研究结果揭示了生活质量的四个主题领域:护理环境和护理理念、个人身份、与家庭和社区的联系以及活动和治疗。
研究发现,不同护理研究地点的居民体验存在差异,私立和公立机构在人员配备、技能组合和物理环境方面存在重要差异。还发现了几个增强或削弱居民与他人保持联系和关系潜力的因素。最后,居民最有可能参与考虑到他们自身特殊兴趣而设计的活动。
本研究从居民和工作人员的角度阐述了生活质量的领域,并支持了长期护理机构的管理和组织结构对生活质量至关重要的观点。明确确定对老年人重要的事项很重要,因为服务需要围绕生活质量以及护理质量来构建,尽管两者关系密切。