具有高低水平以人为主导的护理院单元的特征与领导力、员工-居民-和设施因素有关：来自瑞典 SWENIS 的横断面研究结果。
Characteristics of nursing home units with high versus low levels of person-centred care in relation to leadership, staff- resident- and facility factors: findings from SWENIS, a cross-sectional study in Sweden.
机构信息
Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.
NVS, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
出版信息
BMC Geriatr. 2021 Sep 16;21(1):498. doi: 10.1186/s12877-021-02434-0.
BACKGROUND
The context of care consists of factors that determines the extent to which staff can offer person-centred care. However, few studies have investigated factors that can explain variation in levels of person-centred care among nursing home units. The aim of this study was to explore factors characterizing nursing home units with high and low degree of person-centred care, with focus on leadership, staff, resident and facility factors.
METHODS
Cross-sectional data from residents, staff, and managers in 172 randomly selected nursing homes in Sweden were collected in 2014. Activities of Daily Living Index, Gottfries' cognitive scale, Person-centred Care Assessment Tool together with demographic information and estimations of leadership engagement was used. Independent samples t-test and Chi2 test were conducted.
RESULTS
Highly person-centred units were characterised by leaders engaging in staff knowledge, professional development, team support and care quality. In highly person-centred units' staff also received supervision of a nurse to a larger extent. Highly person-centred units were also characterised as dementia specific units, units with fewer beds and with a larger proportion of enrolled nurses. No differences in degree of person-centred care were seen between public or private providers.
CONCLUSIONS
This study provides guidance for practitioners when designing, developing and adapting person-centred units in aged care contexts. Managers and leaders have an important role to promote the movement towards a person-centred practice of care, by supporting their staff in daily care, and engaging in staff knowledge and professional development. Targeting and adjusting environmental factors, such as provide small and dementia adapted environments to match the residents' personal preferences and capacity are also important when striving towards person-centredness.
背景
关怀背景由决定员工能够提供以患者为中心的关怀程度的因素组成。然而，很少有研究调查可以解释养老院单元之间以患者为中心的护理水平差异的因素。本研究的目的是探讨以患者为中心的护理程度高和低的养老院单元的特征因素，重点是领导力、员工、居民和设施因素。
方法
2014 年，从瑞典随机选择的 172 家养老院的居民、员工和管理人员收集了横断面数据。使用日常生活活动指数、戈特弗里德认知量表、以患者为中心的护理评估工具以及人口统计学信息和领导力参与度的估计值。进行了独立样本 t 检验和 Chi2 检验。
结果
高度以患者为中心的单元的特点是领导者参与员工知识、专业发展、团队支持和护理质量。在高度以患者为中心的单元中，员工也更多地接受护士的监督。高度以患者为中心的单元还具有以下特点：特定于痴呆症的单元、床位较少、注册护士比例较大。在公共或私人提供者之间，以患者为中心的护理程度没有差异。
结论
本研究为从业者在老年护理环境中设计、开发和调整以患者为中心的单元提供了指导。管理者和领导者在支持员工日常护理、参与员工知识和专业发展方面，在推动以患者为中心的护理实践方面发挥着重要作用。当努力实现以患者为中心时，还需要针对和调整环境因素，例如提供小而适应痴呆症的环境，以匹配居民的个人喜好和能力。
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