Injury Prevention and Mobility Laboratory (IPML), Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada; Centre for Hip Health and Mobility, 7/F, 2635 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
Department of Statistics and Actuarial Science, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
Int J Nurs Stud. 2018 Jun;82:139-148. doi: 10.1016/j.ijnurstu.2018.03.014. Epub 2018 Mar 17.
If worn, certain models of hip protectors are highly effective at preventing hip fractures from falls in residents of long-term care, but modest acceptance and adherence have limited the effectiveness of hip protectors. Residents of long-term care are more likely to accept the initial offer of hip protectors and to adhere to recommendations concerning the use of hip protectors when staff are committed to supporting the application of hip protectors. Yet, we know very little about the nature of and factors associated with staff commitment to hip protectors in long-term care.
To identify factors associated with staff commitment to hip protectors in long-term care.
A cross-sectional survey.
Thirteen long-term care homes (total beds = 1816) from a single regional health district in British Columbia, Canada.
A convenience sample of 535 paid staff who worked most of their time (>50% of work hours) at a participating long-term care home, for at least one month, and for at least 8 h per week. We excluded six (1.1%) respondents who were unaware of hip protectors. Of the remaining 529 respondents, 90% were female and 55% were health care assistants.
Respondents completed the Commitment to Hip Protectors Index to indicate their commitment to hip protectors. We used Bayesian Model Averaging logistic regression to model staff commitment as a function of personal variables, experiences with hip protectors, intraorganizational communication and influence, and organizational context.
Staff commitment was negatively related to organizational tenure >20 years (posterior probability = 97%; logistic regression coefficient = -0.28; 95% confidence interval = -0.48, -0.08), and awareness of a padded hip fracture (100%; -0.57; -0.69, -0.44). Staff commitment was positively related to the existence of a champion of hip protectors within the home (100%; 0.24; 0.17, 0.31), perceived quality of intraorganizational communication (100%; 0.04; 0.02, 0.05), extent of mutual respect between residents and staff and perceived contribution to quality of life of the residents they serve (100%; 0.10; 0.05, 0.15), and frequency of transformational leadership practices by respondents' primary supervisors (100%; 0.01; 0.01, 0.02).
We provide novel insight into the factors governing staff commitment to hip protectors in long-term care. Targeting of these factors could improve acceptance and adherence with hip protectors, thereby contributing to enhanced effectiveness of hip protectors to prevent hip fractures in long-term care.
对于长期护理机构的居民来说，某些型号的髋保护器在预防跌倒导致的髋部骨折方面具有高度的有效性，但适度的接受度和依从性限制了髋保护器的效果。当工作人员致力于支持髋保护器的应用时，长期护理机构的居民更有可能接受髋保护器的初步提供，并遵守有关髋保护器使用的建议。然而，我们对长期护理机构工作人员对髋保护器的承诺的性质和相关因素知之甚少。
确定与长期护理机构工作人员对髋保护器的承诺相关的因素。
横断面调查。
加拿大不列颠哥伦比亚省一个单一地区卫生区的 13 个长期护理院（总床位=1816 张）。
对参加长期护理院工作时间超过一半（>50%的工作时间）、至少一个月、每周至少工作 8 小时的 535 名付费工作人员进行了方便抽样。我们排除了六名（1.1%）不知道髋保护器的受访者。在剩余的 529 名受访者中，90%为女性，55%为医疗保健助理。
受访者完成了对髋保护器的承诺指数，以表明他们对髋保护器的承诺。我们使用贝叶斯模型平均逻辑回归来模拟工作人员的承诺，将其作为个人变量、髋保护器使用经验、组织内沟通和影响以及组织背景的函数。
工作人员的承诺与组织任期>20 年呈负相关（后验概率=97%；逻辑回归系数=-0.28；95%置信区间=-0.48，-0.08），与对软垫髋部骨折的认识（100%；-0.57；-0.69，-0.44）。工作人员的承诺与家庭内部有髋保护器拥护者呈正相关（100%；0.24；0.17，0.31），与组织内沟通质量感知呈正相关（100%；0.04；0.02，0.05），与居民之间的相互尊重程度以及工作人员对所服务居民生活质量的感知呈正相关（100%；0.10；0.05，0.15），与受访者主要主管的变革型领导实践的频率呈正相关（100%；0.01；0.01，0.02）。
我们提供了关于长期护理机构工作人员对髋保护器承诺的决定因素的新见解。针对这些因素，可以提高对髋保护器的接受度和依从性，从而提高髋保护器预防长期护理机构中髋部骨折的效果。
