Department of Sociology and Gerontology, Scripps Gerontology Center, Miami University, Oxford, OH.
Independent Research Consultant, Ardmore, PA.
J Am Med Dir Assoc. 2018 Dec;19(12):1092-1098. doi: 10.1016/j.jamda.2018.08.004. Epub 2018 Oct 1.
Nursing home (NH) residents' preferences for everyday living are the foundation for delivering individualized person-centered care. Yet, work has not examined what the most and least important preferences of nursing home residents are and if those preferences change over time.
This study examined the change in nursing home residents' (n = 255) preferences for everyday living over a 3-month period. Participants were recruited from 28 NHs in the suburbs of a major metropolitan East Coast area of the United States.
Residents were interviewed face-to-face using the Preferences for Everyday Living Inventory-Nursing Home version at baseline (T1) and 3 months later (T2). Change was analyzed in 2 ways: (1) percentage exact agreement (eg, respondent stated "very important" at both time points) and (2) percentage of preferences that remained either important or not important between T1 and T2.
Sixteen preferences were rated as very or somewhat important by 90% or more of NH residents. With regard to the stability of preference ratings, findings demonstrate an average exact agreement of 59%, and an average important versus not important agreement of 82%. In addition, 68 of the 72 preferences had 70% or higher stability over time. In other words, the preference either remained "important" or "not important" to the NH resident 3 months later. Preferences in the domain of enlisting others in care had the least amount of change.
CONCLUSION/IMPLICATIONS: This study highlights the most important everyday living preferences of NH residents and provides assurance to care providers that the majority of preferences assessed via the PELI are both important to NH residents and stable over time. Preference-based care plans can be designed and used over a 3-month period with confidence by providers.
养老院（NH）居民对日常生活的偏好是提供个性化以患者为中心的护理的基础。然而，目前的研究尚未探讨 NH 居民最重要和最不重要的偏好是什么，以及这些偏好是否随时间而变化。
本研究在 3 个月的时间内考察了 NH 居民（n=255）对日常生活偏好的变化。参与者是从美国东海岸大都市郊区的 28 家 NH 招募的。
居民在基线（T1）和 3 个月后（T2）使用日常生活偏好清单-养老院版（PELI-NH）进行面对面访谈。通过两种方式分析变化：（1）百分比完全一致（例如，受访者在两个时间点都表示“非常重要”）和（2）在 T1 和 T2 之间保持重要或不重要的偏好百分比。
16 种偏好被 90%或以上的 NH 居民评为非常重要或有些重要。关于偏好评分的稳定性，研究结果表明平均完全一致率为 59%，重要与不重要的平均一致率为 82%。此外，72 种偏好中有 68 种在 3 个月内保持了 70%或更高的稳定性。换句话说，该偏好对 NH 居民来说仍然是“重要”或“不重要”。在招募他人参与护理的领域，偏好的变化最小。
结论/意义：本研究强调了 NH 居民最重要的日常生活偏好，并向护理提供者保证，通过 PELI 评估的大多数偏好对 NH 居民既重要，且随时间稳定。提供者可以有信心在 3 个月的时间内设计和使用基于偏好的护理计划。
