Perspectives Toward Person-Centered Long-Term Care in China

Health care aides provide direct care for older residents with advanced dementia in long-term care facilities. This study aims to understand care aides’ perceptions of what is ‘good’ care, what is person-centered care, and how to provide person-centered care for older residents with advanced dementia, as preparatory work of the WE-THRIVE consortium’s efforts to develop internationally-relevant common data elements of person-centered dementia care and launch comparative research in LMICs. Semi-structured interviews were conducted with health care aides (N=35) from 2 government-owned and 2 private long-term care facilities in urban China. Directed and conventional content analysis were used, drawing upon core constructs of person-centered dementia care and Nolan’s (2006) senses framework. We found that although care aides were not trained in person-centered care, they did incorporate person-centeredness in their work by tailoring their care to the needs of older residents and facilitating interactions with residents and their peers through communication cues.

Providing Care for Older Residents With Dementia in Nursing Homes in China: Through the Lens of Adaptive Leadership

This study aims to understand staff’s experiences of providing direct care for older residents with advanced dementia in long-term care facilities through the lens of Adaptive Leadership Framework for Chronic Illness (ALFCI). Semi-structured interviews were conducted with health care aides (N=35) from 2 government-owned and 2 private long-term care facilities in urban China. Directed and conventional content analysis were used, drawing upon core constructs of ALFCI. We found that health care aides are confronted with multiple challenges such as high intensity of work, stress from managing older residents’ behavioral and psychological symptoms of dementia (BPSD), a lack of access to on-the-job dementia-specific training, and a lack of support from nurses and managing team. Some of the health care aides demonstrated use of their strengths and doing adaptive work to improve work life and care for older residents by using communication cues, enhancing person-centeredness in their care, and facilitate peer interactions.

The supportive supervisory scale: psychometric properties in Chinese health care aides samples

Objective To sinicize the Supportive Supervisory Scale (SSS) and analyze the psychometric properties of the Chinese version of SSS (SSS-C). Methods The SSS (the original English version) was firstly sinicized and adjusted, then its psychometric properties were examined in 300 health care aides from four long-term care (LTC) facilities. SPSS 22.0 was used to process the data and calculate the reliability and validity. Results The 15-item SSS-C had satisfactory internal consistency (Cronbach’s α coefficient = 0.852), split half reliability (Spearman-Brown coefficient = 0.834) and test–retest reliability (Pearson correlation coefficient = 0.784), and three factors were extracted. If the four items with their communality < 0.4 were deleted, the remaining 11 items could explain 55.654% of the total variance. The discriminant validity of the SSS-C varied significantly between sites. Conclusions The Chinese version of SSS can be used to effectively measure the supervisory support of the nurses within the LTC settings.

The Supportive Supervisory Scale: Psychometric Properties in Chinese Health Care Aides Samples

Objective: To sinicize the Supportive Supervisory Scale (SSS) and analyze the psychometric properties of the Chinese version of SSS (SSS-C).Methods: The SSS (the original English version) was firstly sinicized and adjusted, then its psychometric properties were examined in 300 health care aides from four long-term care (LTC) facilities. SPSS 22.0 was used to process the data and calculate the reliability and validity. Results The 15-item SSS-C had satisfactory internal consistency (Cronbach’s α coefficient=0.852), split half reliability (Spearman-Brown coefficient=0.834) and test-retest reliability (Pearson correlation coefficient=0.784), and three factors were extracted. If the four items with their communality <0.4 were deleted, the remaining 11 items could explain 55.654% of the total variance. The discriminant validity of the SSS-C varied significantly between sites.Conclusions The Chinese version of SSS can be used to effectively measure the supervisory support of the nurses within the LTC settings.

Clinical leadership development workshop for licenced practical nurses in supportive living in Alberta: An exploratory qualitative study

Objective: Since 2013, the scope of practice of LPNs in Alberta, Canada has expanded to include leadership in SL that requires that the development of new CL skills be prioritized. To date, few SL work-based educational programs have been devoted to developing CL skills for LPNs. The objective of this study is the assessment of the impact of a brief patient group education intervention (Conversation MapsTM) in people with type 2 Diabetes Mellitus.Methods: An exploratory qualitative design was used, incorporating multiple data collection methods, including individual and focus group interviews, and a demographic questionnaire. Interview data were analyzed using thematic description.Results and conclusions: Findings suggest that the CLD workshop was effective and feasible in SL practice settings. Data showed that improvement in LPN autonomy and control over decision-making resulted from gaining confidence and feeling empowered, which led to positive change in participants’ CL attitudes. Including other team members, health care aides (HCAs), and management in the CLD workshops also improved team relationships for all.

“All behaviour has meaning”: A qualitative exploration of dementia training of healthcare assistant students

Statement of the Problem: Nurses face a high level of risk of violence compared with other workers, with higher frequency towards those who are younger and less experienced. Risk of violence is similar for health care aides, and nursing students, with health care aides experiencing the highest rate of injury because much of their work and clinical practice is in long-term care settings where many residents are at risk for challenging behaviours due to cognitive changes. The purpose of this project was to evaluate the effects Gentle Persuasive Approaches© (GPA) training had on health care assistant students’ knowledge and ability to care for patients who have the potential for responsive behaviours. GPA is a training program recognized in Canada as best practice in the management of responsive behaviours of patients, providing learners with the skills to interact and intervene to diffuse escalating care situations. Methodology: A mixed-methods approach with a quasi-experimental, repeated measures design was used. Health care assistant (HCA) students received GPA training by certified faculty coaches prior to their clinical practice. Repeated measure questionnaires were administered pre-GPA, post-GPA, and post-clinical practice. Focus groups allowed students to reflect on how GPA prepared them for managing responsive behaviours post-clinical practice. Findings: The results demonstrate the effectiveness of offering evidence-based dementia training program while students are still in their educational program to better prepare them to provide person-centred care and keep themselves and their patients safe.

The Supportive Supervisory Scale: Psychometric Properties in Chinese Health Care Aides Samples

Objective To sinicize the Supportive Supervisory Scale (SSS) and analyze the psychometric properties of the Chinese version of SSS (SSS-C).Methods The SSS (the original English version) was firstly sinicized and adjusted, then its psychometric properties were examined in 300 health care aides from four long-term care (LTC) facilities. SPSS 22.0 was used to process the data and calculate the reliability and validity. Results The 15-item SSS-C had satisfactory internal consistency (Cronbach’s α coefficient=0.852), split half reliability (Spearman-Brown coefficient=0.834) and test-retest reliability (Pearson correlation coefficient=0.784). Three factors were extracted, four items were deleted because their communality was less than 0.4 and the remaining 11 items could explain 55.654% of the total variance. The discriminant validity of the SSS-C varied significantly between sites.Conclusions The Chinese version of SSS can be used to effectively measure the supervisory support of the nurses within the LTC settings.

Overcoming Recruitment Challenges in Nursing Home Research with Nurses and Health Care Aides

BackgroundRecruiting busy health care providers into research can be challenging. Yet, the success of a research project can hinge on recruitment response rates. This article uses a case study to demonstrate how qualitative researchers creatively readjusted their methods when standard methods were not yielding enough recruitment response with the aim of supporting other researchers with their recruitment. MethodsCase Example – Interest was expressed but response rates were low among nurses and health care aides in a research project on person-centred health care in a personal care home research site. The research team reconceptualized the participation design, creating a research ‘event’, which accommodated the time constraints and work culture of the respondents. The research event was much better attended than standard interview recruitment.ResultsThe research event approach overcame barriers to participation. An 80% response rate resulted. Standard response rates for research interviews tend to be well under 20%.DiscussionSuccessful recruitment hinged on the researcher’s willingness to reconceptualize the recruitment approach part-way through, when recruitment difficulties were encountered. The high response could be attributed to the methods’ alignment to the available time and work culture in respondent-centred ways. The results suggest that attending to aspects of the work culture can increase recruitment, improve the chances of successful data collection, and reduce the likelihood of research ‘stall’.ConclusionNew and creative approaches to recruiting nurses and health care aides to qualitative research studies can help to meet recruitment targets. Rethinking and redesigning recruitment strategies after research begins, can be a mark of a successful research strategy and not a failure of research design.