scholarly journals 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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annica Backman ◽  
Per-Olof Sandman ◽  
Anders Sköldunger
Keyword(s):  
Professional Development ◽  
Nursing Home ◽  
Assessment Tool ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Cross Sectional ◽  
Low Degree ◽  
Care Assessment ◽  
Leadership Engagement

Abstract 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.

scholarly journals Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021317 ◽  
Author(s):  
Lina Li ◽  
Chenwen Zhong ◽  
Jie Mei ◽  
Yuan Liang ◽  
Li Li ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Practice ◽  
Assessment Tool ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
First Contact

ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.

scholarly journals Assessment of access to first contact in the perspective of professionals

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Glaucia Margarida Bezerra Bispo ◽  
Eduarda Maria Duarte Rodrigues ◽  
Amanda Cordeiro de Oliveira Carvalho ◽  
Kenya Waleria de Siqueira Coêlho Lisboa ◽  
Roberto Wagner Júnior Freire Freitas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Assessment Tool ◽  
Family Health ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Unified Health System ◽  
Basic Care ◽  
Care Assessment ◽  
First Contact

ABSTRACT Objectives: to evaluate the “access to first contact” attribute, from the perspective of Primary Care Health professionals. Methods: an evaluative and cross-sectional study, carried out from February to March 2017. The sample consisted of 163 health professionals, of both genders, who worked in the basic care of the Municipality of Juazeiro do Norte, Ceará. Access to first contact was evaluated by the Primary Care Assessment Tool (PCATool). The 6.60 mark was used as the cut-off point for the evaluated attribute. Results: access to first contact reached a score of 3.3, denoting a low degree of orientation for Primary Health Care. Nurses were the ones who evaluated the attribute more negatively (p=3.2). Conclusions: access to first contact obtained a low score, pointing to the fragility of the Family Health Strategy as a gateway to the Brazilian Unified Health System (Sistema Único de Saúde).

Stakeholder perceptions on resident-to-resident aggression: implications for prevention

2018 ◽  
Vol 42 (6) ◽  
pp. 680 ◽  
Author(s):  
Briony Jain ◽  
Melissa Willoughby ◽  
Margaret Winbolt ◽  
Dina Lo Giudice ◽  
Joseph Ibrahim
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Senior Management ◽  
Care Needs ◽  
Cross Sectional ◽  
Home Setting ◽  
Key Stakeholders ◽  
Management Positions

Objective Resident-to-resident aggression (RRA) in nursing homes is a matter of serious and profound concern, yet action to eliminate or mitigate RRA is hampered by a paucity of research. The aim of this study was to explore key stakeholders’ knowledge and perceptions of RRA in Australian nursing homes. Methods A qualitative cross-sectional study design was used, and semistructured telephone interviews were conducted. Participants were purposively and conveniently sampled with replacement from a range of aged care, healthcare and legal professional bodies, as well as advocacy organisations. The interview contained 12 closed-ended questions and six open-ended questions about participants’ knowledge, experiences, perceptions and attitudes to RRA. Participant characteristics and responses to closed-ended questions were aggregated and proportions calculated, and thematic analysis was conducted by two independent researchers using a directed content approach. Results Fifteen participants (11 females; 73.3%) in senior management positions were interviewed. All were familiar with the concept of RRA and just over half (n=8; 53.3%) had witnessed an incident. Major themes included the nature and causes of RRA and attitudes and responses to RRA. Potential causes of RRA included maladaptation to nursing home life, transfer of pre-existing issues into the nursing home environment, physical environment and staffing-related issues. RRA was commonly viewed by participants as dangerous and unpredictable or, conversely, as expected behaviour in a nursing home setting. A person-centred care approach was considered most effective for managing and responding to RRA. Conclusion The research demonstrates that understanding perceptions of RRA among key stakeholders is critical to identifying the nature and scope of the problem and to developing and implementing appropriate prevention strategies. What is known about the topic? RRA is common in nursing homes, with potentially fatal consequences for residents involved, and has serious implications for nursing home staff, managers, providers, and regulators. Despite this, the prevalence, impact, and prevention of RRA remains under-recognised and under-researched in Australia. What does this paper add? This is the first Australian study to produce qualitative findings on the knowledge and perceptions of RRA in nursing homes among key stakeholders. This paper reports on the knowledge and perceptions of individuals in senior management and policy roles in aged care and related fields in relation to four themes: nature; causes; attitudes; and responses to RRA. Our findings highlight the complex and multifactorial nature of RRA. What are the implications for practitioners? A movement towards person-centred care that promotes understanding of individual care needs is favoured as an approach to reducing RRA. Increased reporting of both minor and major incidents of RRA will help to identify patterns and inform appropriate responses. However, a cultural shift is first required to recognise RRA as a manageable and preventable health care and adult safeguarding issue.

Frequency and nature of coroners’ recommendations from injury-related deaths among nursing home residents: a retrospective national cross-sectional study

2017 ◽  
Vol 24 (6) ◽  
pp. 418-423 ◽  
Author(s):  
Lyndal Bugeja ◽  
Marta H Woolford ◽  
Melissa Willoughby ◽  
David Ranson ◽  
Joseph E Ibrahim
Keyword(s):  
Public Health ◽  
Nursing Home ◽  
Best Practice ◽  
Care Setting ◽  
Clinical Care ◽  
Health And Safety ◽  
Nursing Home Residents ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Cross Sectional

BackgroundCoroners are tasked with the investigation of unnatural and unexpected deaths. In Australia, the coroner’s role also includes making recommendations for promoting interventions to improve public safety. However, the coroners’ role in public health and safety in the aged care setting is an underexplored area of research.ObjectivesTo describe the frequency and nature of coroners’ recommendations for prevention of harm from injury-related deaths among nursing home residents in Australia.SettingAccredited nursing homes in Australia.SubjectsNursing home residents whose deaths resulted from external causes occurring between 1 July 2000 and 31 December 2013 and notified to a coroner.MeasurementsCoroners’ recommendations were identified and extracted from the National Coronial Information System. Descriptive statistical techniques were used to calculate the frequency and proportion of recommendations made. The nature of recommendations was quantified using a method comprising seven elements derived from internationally accepted and applied public health conceptual models of mortality causation and prevention.ResultsCoroners made recommendations about the prevention of harm in 53 of the 3289 (1.6%) external cause deaths of nursing home residents. Recommendations were most frequently made for deaths resulting from falls; however, the rate of recommendations per 1000 deaths was highest for thermal mechanisms and complications of clinical care. Most recommendations described the ‘countermeasure’ element, but rarely specified a timeframe for implementation.ConclusionCoroners’ recommendations need to be further enhanced in the age care setting. The development of national and international guidelines on best practice in the formulation of effective recommendations should be undertaken.

scholarly journals Primary health care attributes of family health teams with and without family physician

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A C F Martins ◽  
G A Pereira ◽  
W P P Gomes ◽  
C N Monteiro ◽  
C A S Siqueri ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Management ◽  
Assessment Tool ◽  
Family Health ◽  
Cross Sectional Study ◽  
Point Of View ◽  
Cross Sectional ◽  
Primary Health ◽  
Care Assessment

Abstract Background The four essential attributes of primary health care (PHC): access, longitudinality, comprehensiveness and coordination, guide the professional practices of service management and also the professionals of the family health strategy teams. Family medicine residence (FMR) is the speciality that trains medical practitioners capable of acting properly in PHC. It develops a person-centred approach, oriented towards the individual, his family and community, which dialogues with the PHC precepts of comprehensive patient care from a social point of view. Thus, the objective of this study was to verify whether there are differences in the PHC attributes perceived by patients treated by teams with FMR doctors and by the others. Methods This was an observed cross-sectional study conducted during 2019, which used the Adult Primary Care Assessment Tool (PCATool) to evaluate preliminarily 28 PHC teams working at the city of São Paulo, Brazil. The teams were compared based on 337 patient answers using domains medians and Mann-Whitney tests. The study was approved by the ethics committee. Results Eight teams (28.6%) had doctors trained in FMR. The attributes of longitudinality and access were very similar between the two groups. The teams with FMR doctors showed better evaluations in the components: information systems, median 7.78, versus 6.67 (p = 0.391); services available, median 6.52, versus 6.06 (p = 0.086); and services received, median 4.85, versus 3.85 (p = 0.180) of the coordination and comprehensiveness attributes. Conclusions We didn't find statistically significant results indicating better PHC attributes of teams with FMR doctors, based on user perception. A continuous study is recommended to follow the evolution of this speciality in the PHC context. Key messages FMR is a fundamental key to PHC and must be evaluated continuously. It is necessary to strengthen their insertion in the Brazilian health system and discuss the ways to do so.

scholarly journals Longitudinality and community orientation in the context of indigenous health

2021 ◽  
Vol 74 (1) ◽  
Author(s):  
Esron Soares Carvalho Rocha ◽  
Rizioléia Marina Pinheiro Pina ◽  
Rosana Cristina Pereira Parente ◽  
Maria Luiza Pereira Garnelo ◽  
Rúbia Aparecida Lacerda
Keyword(s):  
Health Services ◽  
Assessment Tool ◽  
Indigenous Health ◽  
Cross Sectional Study ◽  
Municipal Services ◽  
Chi Square ◽  
Cross Sectional ◽  
Community Orientation ◽  
Rio Negro ◽  
Care Assessment

ABSTRACT Objectives: to analyze, from healthcare professionals’ perspectives, the longitudinality and community orientation in Primary Health Care, offered both in the Special Indigenous Health District and in the primary network that assists non-indigenous population in municipal health services in Upper Rio Negro region. Methods a cross-sectional study with 116 professionals, 87 (75%) of indigenous health, 29 (25%) of municipal services. Primary Care Assessment Tool, professional version, used by Upper Rio Negro for Social Sciences region. For association of variables, chi-square test and Kruskal-Wallis were used. Results longitudinality obtained an unsatisfactory score (6.4 and 6.5), as well as community orientation (6.1 and 5.6) for both services. Weaknesses refer to professional turnover, little knowledge about users’ living conditions, precarious employment relationship. In indigenous health, satisfaction was higher when compared to municipal services. Conclusions: it is necessary to improve work management in health services, seeking to guarantee the quality of performance of professionals.

scholarly journals The influence of nursing home managers’ leadership on person-centred care and stress of conscience: A cross-sectional study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Annica Backman ◽  
Karin Sjögren ◽  
Hugo Lövheim ◽  
Marie Lindkvist ◽  
David Edvardsson
Keyword(s):  
Nursing Home ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Care Provision ◽  
Cross Sectional ◽  
New Ideas ◽  
Stress Of Conscience ◽  
Giving Feedback ◽  
The Relationship

Abstract Background Leadership and stress are common concepts in nursing, and this study explores empirically the connection between leadership and stress of conscience in the context of aged care practice. Previous literature has shown that when staff are unable to carry out their ethical liabilities towards the residents, feelings of guilt may occur among staff, which may be an expression of stress of conscience. Although leadership has been described as crucial for staff’s work perceptions of stress as well as for person-centred practices, the influence of nursing home managers’ leadership on stress of conscience among staff and person-centred practices is still not fully explored. This study attempts to address that knowledge gap by exploring the relationship between leadership, person-centred care, and stress of conscience. Methods This study was based on a cross-sectional national survey of 2985 staff and their managers in 190 nursing homes throughout Sweden. Descriptive statistics and regression modelling were used to explore associations. Results Leadership was associated with a higher degree of person-centred care and less stress of conscience. A higher degree of person-centred care was also associated with less stress of conscience. The results also showed that leadership as well as person-centred care were individually associated with lower levels of stress of conscience when adjusting for potential confounders. Conclusion Nursing home managers’ leadership was significantly associated with less staff stress of conscience and more person-centred care. This indicates that a leadership most prominently characterised by coaching and giving feedback, relying on staff and handling conflicts constructively, experimenting with new ideas, and controlling work individually can contribute to less staff stress as well as higher degree of person-centred care provision.

scholarly journals Acesso às unidades de saúde da família na perspectiva de hipertensos [Access to family health unit from the hypertensive’s perspective] [Acceso a las unidades de salud de la familia desde la perspectiva de hipertensos]

2017 ◽  
Vol 25 ◽  
pp. e14442
Author(s):  
Inês Leoneza ◽  
Elisabete Pimenta Araújo Paz ◽  
Raphael Mendonça Guimarães ◽  
Adelson Antonio Castro
Keyword(s):  
Primary Care ◽  
Elementary Education ◽  
Assessment Tool ◽  
Family Health ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Cross Sectional ◽  
Care Assessment ◽  
First Contact ◽  
Primary Care Assessment Tool

Objetivo: analisar o grau de orientação oferecida por unidades primárias em relação ao atributo acesso de primeiro contato na perspectiva de usuários hipertensos. Método: estudo transversal de avaliação com uso do Primary Care Assessment Tool-Brasil. Os dados foram coletados com 373 hipertensos maiores de 20 anos, no município de Macaé, Brasil. Resultados: verificou-se a predominância das seguintes características individuais: 49% tinham entre 40 a 59 anos; 74% pertenciam ao gênero feminino; 38,1% apresentaram ensino fundamental incompleto; 59,5% tinham renda de até 2 salários mínimos. Obteve-se escore de 7,65 para acesso de primeiro contato, superior à média de 6,6 do escore padrão, e um escore de 2,40 para acessibilidade. Conclusão: os resultados apontam utilização satisfatória das unidades no que refere ao acesso de primeiro contato e insatisfatória quanto à acessibilidade aos serviços, o que mostra necessidade de investimentos na reorganização do processo de atendimento às demandas e prioridades dos usuários.ABSTRACTObjective: to analyze the degree of orientation offered by primary units in relation to the attribute first contact access from the perspective of hypertensive users. Methods: cross-sectional study using Primary Care Assessment Tool-Brazil. Data were collected with 373 hypertensive patients over 20 years of age, in the city of Macaé, Brazil. Results: the predominance of the following individual characteristics was verified: 49% were between 40 and 59 years old; 74% were female; 38.1% had incomplete elementary education; 59.5% had income of up to 2 minimum wages (about US$548.00). A score of 7.65 was obtained for first contact access, superior to the mean of 6.6 of the standard score, and a score of 2.40 for accessibility. Conclusion: the results indicate a satisfactory use of the units in relation to first contact access and unsatisfactory related to accessibility to services, which shows the need for investments in the reorganization of the process of meeting the demands and priorities of users.RESUMENObjetivo: analizar el grado de orientación ofrecida por unidades primarias en relación al atributo acceso de primer contacto en la perspectiva de usuarios hipertensos. Método: estudio transversal de evaluación con uso de Primary Care Assessment Tool-Brasil. Los datos fueron recolectados con 373 hipertensos mayores de 20 años, en el municipio de Macaé, Brasil. Resultados: se verificó la predominancia de las siguientes características individuales: el 49% tenía entre 40 a 59 años; el 74% pertenecía al género femenino; 38,1% presentaron enseñanza fundamental incompleta; el 59,5% tenía ingresos de hasta 2 salarios mínimos (alrededor de US$ 548.00). Se obtuvo una puntuación de 7,65 para acceso de primer contacto, superior a la media de 6,6 de la puntuación estándar, y una puntuación de 2,40 para accesibilidad. Conclusión: los resultados apuntan utilización satisfactoria de las unidades en lo que se refiere al acceso de primer contacto e insatisfactorio en cuanto a la accesibilidad a los servicios, lo que muestra necesidad de inversiones en la reorganización del proceso de atención a las demandas y prioridades de los usuarios. DOI: http://dx.doi.org/10.12957/reuerj.2017.14442

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