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挪威养老院的护理质量——缺陷及其相关因素。

Quality of care in Norwegian nursing homes--deficiencies and their correlates.

作者信息

Kirkevold Øyvind, Engedal Knut

机构信息

Norwegian Centre for Dementia Research, Vestfold Mental Health Care Trust, Tønsberg, Norway.

出版信息

Scand J Caring Sci. 2008 Dec;22(4):560-7. doi: 10.1111/j.1471-6712.2007.00575.x.

Abstract

BACKGROUND

Quality of care (QoC) in nursing homes has many aspects and various proxies have been used to evaluate it. In only a few studies several proxies for quality have been combined into a common variable.

OBJECTIVE

To explore which variables are associated with low QoC in few and several areas respectively.

METHODS

A structured interview of the patients' primary carer of 1926 patients in 251 wards was carried out. Questions about different kinds of quality deficiencies during the last 7 days were recorded. Eight main types of quality deficiencies were used to construct a linear outcome variable called number of quality deficiencies (NQD) with values from zero to eight. Patient characteristics such as sex, age, function in activities of daily living (ADL), behaviour and mental capacity were recorded. Type of ward, staffing, size of ward, type of institution and formal education of the staff, were also recorded.

RESULTS

More than half of the patients in Norwegian nursing homes experienced two or more quality deficiencies in the care during 1 week. The variables that were strongest associated with NQD, were present of aggressive behaviour, low level of functioning in ADL and moderate-to-severe dementia. Staffing level and type of ward had also a significant influence on the model.

摘要

背景

养老院的护理质量(QoC)具有多个方面,并且已经使用了各种替代指标来对其进行评估。在仅有少数研究中,将几种质量替代指标组合成了一个共同变量。

目的

分别探究在少数几个领域和多个领域中,哪些变量与低护理质量相关。

方法

对251个病房中1926名患者的主要照顾者进行了结构化访谈。记录了关于过去7天内不同类型质量缺陷的问题。使用八种主要类型的质量缺陷构建了一个线性结果变量,称为质量缺陷数量(NQD),其值从零到八。记录了患者的特征,如性别、年龄、日常生活活动(ADL)功能、行为和心理能力。还记录了病房类型、人员配备、病房规模、机构类型以及工作人员的正规教育程度。

结果

挪威养老院中超过一半的患者在1周的护理期间经历了两种或更多的质量缺陷。与NQD关联最强的变量是攻击性行为的存在、ADL功能水平低以及中度至重度痴呆。人员配备水平和病房类型对该模型也有显著影响。

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