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养老院居民对日常护理和活动的偏好:基于全国数据的潜在类别分析。

Nursing Home Resident Preferences for Daily Care and Activities: A Latent Class Analysis of National Data.

机构信息

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.

出版信息

Gerontologist. 2024 Feb 1;64(2). doi: 10.1093/geront/gnad089.

Abstract

BACKGROUND AND OBJECTIVES

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.

RESEARCH DESIGN AND METHODS

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.

RESULTS

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.

DISCUSSION AND IMPLICATIONS

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.

摘要

背景与目的

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。

研究设计与方法

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。

结果

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。

讨论与意义

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。

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本文引用的文献

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Comparing Resident, Proxy, and Staff Respondents for Nursing Home Residents' Preferences for Everyday Living.
J Appl Gerontol. 2023 Jan;42(1):28-36. doi: 10.1177/07334648221123059. Epub 2022 Aug 26.
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Preference Importance Ratings among African American and White Nursing Home Residents.
Clin Gerontol. 2023 Jan-Feb;46(1):111-121. doi: 10.1080/07317115.2021.2007436. Epub 2021 Dec 28.
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Evaluating the Implementation of a Pragmatic Person-Centered Communication Tool for the Nursing Home Setting: PAL Cards.
Clin Gerontol. 2022 May-Jun;45(3):634-646. doi: 10.1080/07317115.2021.1929632. Epub 2021 May 31.
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Predictors of the importance of everyday preferences for older adults with cognitive impairment.
Int Psychogeriatr. 2022 Mar;34(3):287-294. doi: 10.1017/S1041610220003956. Epub 2021 Jan 18.
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Clin Gerontol. 2022 Oct-Dec;45(5):1058-1072. doi: 10.1080/07317115.2020.1844356. Epub 2020 Nov 20.
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Access to Learning Opportunities for Residents in Care Homes: Reviewing the challenges and possibilities.
Maturitas. 2020 Oct;140:14-23. doi: 10.1016/j.maturitas.2020.05.019. Epub 2020 May 26.
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Unmet and Unimportant Preferences Among Nursing Home Residents: What Are Key Resident and Facility Factors?
J Am Med Dir Assoc. 2020 Nov;21(11):1712-1717. doi: 10.1016/j.jamda.2020.06.033. Epub 2020 Jul 29.
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Exploring Patterns in Preferences for Daily Care and Activities Among Nursing Home Residents.
J Gerontol Nurs. 2019 Aug 1;45(8):7-13. doi: 10.3928/00989134-20190709-02.
10
The impact of nursing home residents' characteristics on ratings of importance of autonomy preferences in daily care over time.
Aging Ment Health. 2020 Aug;24(8):1334-1341. doi: 10.1080/13607863.2019.1584875. Epub 2019 Mar 5.

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