Caspar Sienna, O'Rourke Norm
Department of Gerontology, Simon Fraser University-Vancouver Campus, #2800-515 West Hastings Street, Vancouver (BC) V6B 5K3 Canada.
J Gerontol B Psychol Sci Soc Sci. 2008 Jul;63(4):S255-S265. doi: 10.1093/geronb/63.4.s255.
Implementing management initiatives that enable formal caregivers to provide quality, individualized care to older adults in long-term-care (LTC) facilities is increasingly important given that the number of LTC residents is projected to triple by 2031. The objective of this study was to explore the relationship between care provider access to structural empowerment and the provision of individualized care in LTC.
We computed structural equation models separately for registered nurses and licensed practical nurses (n = 242) and care aides (n = 326) to examine the relationship between access to empowerment structures (i.e., informal power, formal power, information, support, resources, opportunity) and the provision of individualized care. We subsequently undertook invariance analyses to determine if the association between empowerment structures and reported provision of individualized care differed between caregiver groups.
Access to structural empowerment had a statistically significant, positive association with provision of individualized care for both groups. For registered nurses/licensed practical nurses and care aides, empowerment explained 50% and 45% of observed variance in individualized care, respectively. These notable percentages did not differ significantly between caregiver groups.
Of the empowerment structures, support, especially in the form of access to educational opportunities and recognition for a job well done, seems to be particularly significant to care providers. Findings from this study suggest that provision of individualized care in LTC may be enhanced when formal caregivers have appreciable access to empowerment structures.
鉴于预计到2031年长期护理（LTC）机构中的居民数量将增加两倍，实施管理举措以使正规护理人员能够为LTC机构中的老年人提供优质、个性化护理变得越来越重要。本研究的目的是探讨护理人员获得结构性赋权与LTC机构中提供个性化护理之间的关系。
我们分别为注册护士和执业护士（n = 242）以及护理助理（n = 326）计算结构方程模型，以检验获得赋权结构（即非正式权力、正式权力、信息、支持、资源、机会）与提供个性化护理之间的关系。我们随后进行了不变性分析，以确定赋权结构与报告的个性化护理提供之间的关联在护理人员群体之间是否存在差异。
获得结构性赋权与两组提供个性化护理均存在统计学上显著的正相关。对于注册护士/执业护士和护理助理，赋权分别解释了个性化护理中观察到的方差的50%和45%。这些显著的百分比在护理人员群体之间没有显著差异。
在赋权结构中，支持，特别是以获得教育机会和对出色工作的认可的形式，似乎对护理人员尤为重要。本研究的结果表明，当正规护理人员能够大量获得赋权结构时，LTC机构中个性化护理的提供可能会得到加强。
