Faculty of Nursing, Edmonton Clinic Health Academy (ECHA), 3158University of Alberta, Edmonton, Alberta, Canada.
16123School of Nursing, University of Minnesota, Minneapolis, MN, USA.
Res Aging. 2022 Feb;44(2):174-185. doi: 10.1177/01640275211012652. Epub 2021 May 11.
Transforming nursing homes (NHs) from restrictive institutions to person-centered homes, referred to as NH culture change, is complex and multifaceted. This study, based on a survey of administrators in Minnesota NHs ( = 102), tested the domain-specific relationships of culture change practices with resident quality of life (QOL) and family satisfaction, and examined the moderating effect of small-home or household models on these relationships. The findings revealed that culture change operationalized through physical environment transformation, staff empowerment, staff leadership, and end-of-life care was positively associated with at least one domain of resident QOL and family satisfaction, while staff empowerment had the most extensive effects. Implementing small-home and household models had a buffering effect on the positive relationships between staff empowerment and the outcomes. The findings provide meaningful implications for designing and implementing NH culture change practices that best benefit residents' QOL and improve family satisfaction.
将养老院（NHs）从限制机构转变为以患者为中心的住所，被称为 NH 文化变革，这是一个复杂而多方面的过程。本研究基于对明尼苏达州 NH 管理人员的调查（=102），测试了文化变革实践与患者生活质量（QOL）和家庭满意度的特定领域关系，并研究了小家庭或家庭模式对这些关系的调节作用。研究结果表明，通过物理环境改造、员工赋权、员工领导力和临终关怀来实施文化变革与至少一个患者 QOL 和家庭满意度领域呈正相关，而员工赋权的影响最为广泛。实施小家庭和家庭模式对员工赋权与结果之间的积极关系具有缓冲作用。这些发现为设计和实施 NH 文化变革实践提供了有意义的启示，这些实践最有利于提高患者的生活质量和改善家庭满意度。
