Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Gerontologist. 2024 Feb 1;64(2). doi: 10.1093/geront/gnad089.
Uncovering subgroups of nursing home residents sharing similar preference patterns is useful for developing systematic approaches to person-centered care. This study aimed to (i) identify preference patterns among long-stay residents, and (ii) examine the associations of preference patterns with resident and facility characteristics.
This study was a national cross-sectional analysis of Minimum Data Set assessments in 2016. Using resident-rated importance for 16 preference items in the Preference Assessment Tool as indicators, we conducted latent class analysis to identify preference patterns and examined their associations with resident and facility characteristics.
We identified 4 preference patterns. The high salience group (43.5% of the sample) was the most likely to rate all preferences as important, whereas the low salience group (8.7%) was the least likely. The socially engaged (27.2%) and the socially independent groups (20.6%) featured high importance ratings on social/recreational activities and maintaining privacy/autonomy, respectively. The high salience group reported more favorable physical and sensory function than the other 3 groups and lived in facilities with higher staffing of activity staff. The low salience and socially independent groups reported a higher prevalence of depressive symptoms, whereas the low salience or socially engaged groups reported a higher prevalence of cognitive impairment. Preference patterns also varied by race/ethnicity and gender.
Our study advanced the understanding of within-individual variations in preferences, and the role of individual and environmental factors in shaping preferences. The findings provided implications for providing person-centered care in NHs.
揭示具有相似偏好模式的养老院居民亚组对于制定以患者为中心的护理系统方法是有用的。本研究旨在:(i) 确定长期居住居民的偏好模式;(ii) 检验偏好模式与居民和机构特征之间的关联。
这是一项 2016 年全国性的最小数据集评估的横断面分析。使用居民对偏好评估工具中 16 项偏好项目的重要性评分作为指标,我们进行潜在类别分析以确定偏好模式,并检验它们与居民和机构特征之间的关联。
我们确定了 4 种偏好模式。高显著组(样本的 43.5%)最有可能将所有偏好评为重要,而低显著组(8.7%)则最不可能。社交活跃组(27.2%)和社交独立组(20.6%)在社交/娱乐活动和维护隐私/自主性方面的重要性评分较高。高显著组报告的身体和感官功能比其他 3 组更有利,并且居住在活动员工配备更高的机构中。低显著组和社交独立组报告抑郁症状的患病率较高,而低显著组或社交活跃组报告认知障碍的患病率较高。偏好模式也因种族/民族和性别而异。
我们的研究深入了解了个体内在偏好的变化,以及个体和环境因素在塑造偏好方面的作用。研究结果为 NH 提供以患者为中心的护理提供了启示。