Custers Annette F J, Westerhof Gerben J, Kuin Yolande, Gerritsen Debby L, Riksen-Walraven J Marianne
Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
Institute for Behavioural Research, University of Twente, P.O. Box 217, 7500 HE Enschede, The Netherlands.
Eur J Ageing. 2013 Mar 14;10(3):201-209. doi: 10.1007/s10433-013-0263-y. eCollection 2013 Sep.
Self-reports in nursing homes generally show highly satisfied residents, whereas observational studies provide more nuanced results. In this study, which is based on self-determination theory, the perspective of nursing home residents (self-reports) is compared to the perspective of trained "neutral" observers (video-observations). The experiences of physically frail older residents are measured with regard to the fulfillment of their needs for relatedness, autonomy, and competence. Self-reports of need fulfillment , and of 36 residents (64 % female, mean age 80 years) were compared with observer ratings of resident need fulfillment during the latter caregiving episode. Furthermore, it was investigated which measure relates best to residents' self-reported well-being. The results show that residents rate their need fulfillment higher than observers. There is weak to moderate agreement between resident and observer ratings. Furthermore, only residents' self-reported need fulfillment is related with self-reported well-being. Different explanations are provided, including the "barrier of happiness," the use of cognitive strategies, a change in identity and existing power relations. There seems to be a paradox in caregiving: Residents and their needs should be central, but because residents might adapt their needs and wishes it is hard to assess these. Suggestions for practical applications are given.
养老院中的自我报告通常显示居民满意度很高，而观察性研究则提供了更细致入微的结果。在这项基于自我决定理论的研究中，将养老院居民的视角（自我报告）与训练有素的“中立”观察者的视角（视频观察）进行了比较。针对身体虚弱的老年居民在相关性、自主性和能力需求的满足方面的体验进行了测量。将36名居民（64%为女性，平均年龄80岁）需求满足情况的自我报告与观察者对其在最近一次护理期间需求满足情况的评分进行了比较。此外，还研究了哪种测量方法与居民自我报告的幸福感最相关。结果显示，居民对自身需求满足情况的评分高于观察者。居民评分与观察者评分之间的一致性较弱到中等。此外，只有居民自我报告的需求满足情况与自我报告的幸福感相关。文中提供了不同的解释，包括“幸福障碍”、认知策略的运用、身份的转变以及现有的权力关系。护理过程中似乎存在一个悖论：居民及其需求应该是核心，但由于居民可能会调整自己的需求和愿望，因此很难对这些进行评估。文中给出了实际应用的建议。
