养老院的工作环境和以患者为中心的痴呆症护理——一项横断面研究。
Work environment and person-centred dementia care in nursing homes-A cross-sectional study.
机构信息
Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
出版信息
J Nurs Manag. 2021 Oct;29(7):2314-2322. doi: 10.1111/jonm.13386. Epub 2021 Jun 27.
AIM
This study aims to explore the relationship between work environment, job characteristics and person-centred care for people with dementia in nursing homes.
BACKGROUND
Person-centred care approaches have become a dominant indicator for good quality of care in nursing homes. Little is known about the relationship between work environment, job characteristics and person-centred care in nursing homes.
METHOD(S): Cross-sectional data from the LAD study were used. Direct care staff (n = 552) of nursing homes (n = 49) filled an online questionnaire about work environment characteristics and person-centred care. To examine relationships, multilevel linear regression analyses were conducted.
RESULTS
Associations were found between a higher transformational leadership style, less social support from a leader, a higher unity in philosophy of care, higher levels of work satisfaction, more development opportunities, better experienced teamwork and staff-reported person-centred care.
CONCLUSION(S): In a complex nursing home environment, person-centred care is influenced by organisational and work characteristics, shared values and interpersonal relationships.
IMPLICATIONS FOR NURSING
Leaders may consider facilitating collaboration and creating unity between care staff, clients and family members in order to provide person-centred care. Therefore, a transformational leadership style, educational programmes and coaching for leaders are recommended.
目的
本研究旨在探讨养老院环境、工作特征与以痴呆患者为中心的护理之间的关系。
背景
以痴呆患者为中心的护理方法已成为养老院优质护理的主要指标。对于养老院环境、工作特征与以痴呆患者为中心的护理之间的关系，我们知之甚少。
方法
使用 LAD 研究的横断面数据。49 家养老院的 552 名直接护理人员（n=552）在线填写了一份关于工作环境特征和以痴呆患者为中心的护理问卷。为了检验相关性，进行了多层次线性回归分析。
结果
研究发现，较高的变革型领导风格、较少的来自领导的社会支持、更高的护理理念统一性、更高的工作满意度、更多的发展机会、更好的团队协作体验与员工报告的以痴呆患者为中心的护理之间存在关联。
结论
在复杂的养老院环境中，以痴呆患者为中心的护理受到组织和工作特征、共同价值观和人际关系的影响。
对护理的启示
为了提供以痴呆患者为中心的护理，领导者可以考虑促进护理人员、患者和家属之间的协作，并营造护理理念的统一性。因此，建议采用变革型领导风格、教育计划和对领导者的辅导。
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