Effects of a person-centred and thriving-promoting intervention on nursing home staff job satisfaction: A multi-centre, non-equivalent controlled before-after study

Effectiveness of an educational intervention to increase professional nurses' person-centred care competence in long-term care of older people-Quasi-experimental study

BACKGROUND

Based on previous evidence person-centred care (PCC) as a quality indicator is important in long-term care (LTC) settings for older people. Effective ways to increase nurses' person-centred care competence are missing.

AIM

To evaluate the effectiveness of a continuing education (CE) intervention named 'Person First-Please' (PFP) for improving nurses' PPC competence and its connection to PPC climate.

METHODS

Quasi-experimental cluster design with intervention and control groups was carried out in LTC settings for older people. The intervention group (n = 77) received a 10-week CE intervention, with control group (n = 123) working as usual. The primary outcome was professional nurses' PCC competence. Secondary outcome was the PCC climate as perceived by nurses and, residents with their next of kin. Measurements were conducted pre-/post-intervention and after 6 weeks using the validated, Person-centred Care Competence scale and the Person-centred Care Climate questionnaire, staff and patient versions. Data was analysed with descriptive and inferential statistics.

RESULTS

PCC competence was significantly increased in the intervention group and remained after 6 weeks of follow-up. PCC climate increased in the intervention group in total score and also in all sub-scales, across residents with their next of kin. The control group did not show any significant change. Comparisons of PCC competence and PCC climate in time between intervention and control groups confirmed that changes seen between groups were statistically significant in intervention group.

LIMITATIONS

Measurements were self-assessments, which may have been affected by bias, especially in context of competence assessment.

CONCLUSION

The intervention was effective in increasing professional nurses' PCC competence and on person-centred care climate in long-term care settings for older people.

How the current non-significant effects of person-centred care on nurses' outcomes could be abated by the WE-CARE roadmap enablers: A discursive paper

AIM

To describe the non-significant results in nurses' outcomes after the implementation of person-centred care (PCC) and discuss if and how enablers of the WE-CARE roadmap for implementing PCC could abate the non-significant results.

DESIGN

In this paper, an innovative framework of enablers in the WE-CARE Roadmap is explained in relation to increased PCC and nurses' job satisfaction.

METHOD

Findings from a scoping review and published material provided how PCC and nurses' outcomes connect. The WE-CARE roadmap entails five enablers: Information technology, Quality measures, Infrastructure, Incentive systems and contracting strategies.

RESULTS

The WE-CARE roadmap was described and each enabler in the WE-CARE roadmap is discussed concerning PCC and the nurses' job satisfaction. Thus far, the effects of PCC on nurses' outcomes have been non-significant. The WE-CARE roadmap enablers can be implemented to ensure an increased PCC implementation and higher nurses' job satisfaction.

Person-centred care competence and person-centred care climate described by nurses in older people's long-term care-A cross-sectional survey

BACKGROUND

Person-centred care requires that nurses are competent in this approach to care. There may be an association between person-centred care competence and person-centred care climate, but it has not been demonstrated in the literature. This is the justification for the survey study to gain staff's perceptions of such a relationship.

OBJECTIVES

The aim of this study was to analyse the levels and associations between person-centred care competence and the person-centred care climate as assessed by professional nurses in long-term care settings for older people.

METHODS

A descriptive cross-sectional survey design with cluster sampling was used to recruit professional nurses of different levels from six long-term care institutions for older people. Data were collected using the Patient-centred Care Competency scale (PCC) and the Person-centred Climate Questionnaire staff version (PCQ-S) in September 2021 and analysed with descriptive and inferential statistics.

RESULTS

The mean score on the PCC was rated at a good level of 3.80 (SD 0.45), and the PCQ-S was rated at a good level of 3.87 (SD 0.53). The correlation between PCC and PCQ-S total scores (r = .37, p < .001) indicated that person-centred care competence and person-centred care climate were associated. No associations were detected between nurses' educational levels and PCC (p = .19) or PCQ-S (p = .13) or in terms of age or work experience.

CONCLUSIONS

The results provide insights into competence and climate levels of person-centred care and preliminary evidence of an association between nurses' assessed competence in person-centred care and the perceived person-centred care climate in long-term care. Nurses' individual characteristics did not appear to affect the level of person-centred care competence or climate. In the future professional nurses of different levels could benefit from effective continuing education in person-centred care. This study design serving for the future intervention study registered to the ClinicalTrials.goc NCT04833153.

Communication in home care-A feasibility study of an educational intervention in self-efficacy and job satisfaction

AIM

To explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.

DESIGN

A feasibility study with pre- and post-assessments.

METHODS

Feasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.

RESULTS

The questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.

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

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.

Reliability Generalization Study of the Person-Centered Care Assessment Tool

The so-called Person-Centered Care (PCC) model identifies three fundamental principles: changing the focus of attention from the disease to the person, individualizing care, and promoting empowerment. The Person-Centered Care Assessment Tool (P-CAT) has gained wide acceptance as a measure of PCC in recent years due to its brevity and simplicity, as well as its ease of application and interpretation. The objective of this study is to carry out a reliability generalization meta-analysis to estimate the internal consistency of the P-CAT and analyze possible factors that may affect it, such as the year of publication, the care context, the application method, and certain sociodemographic properties of the study sample. The mean value of α for the 25 samples of the 23 studies in the meta-analysis was 0.81 (95% CI: 0.79-0.84), with high heterogeneity (squared-I = 85.83%). The only variable that had a statistically significant relationship with the reliability coefficient was the mean age of the sample. The results show that the P-CAT gives acceptably consistent scores when its use is oriented toward the description and investigation of groups, although it may be affected by variables such as the age of participants.

Associations between person-centred care and job strain, stress of conscience, and intent to leave among hospital personnel

AIM

To determine the associations between person-centred care (PCC) and job strain, stress of conscience and intent to leave among healthcare professionals in Swedish hospital departments.

BACKGROUND

Hospitals have experienced difficulty in retaining qualified healthcare personnel. Previous studies have shown that working in a person-centred environment could offset this challenge, but research is scarce.

DESIGN

A cross-sectional survey design using the STROBE checklist.

METHODS

Healthcare professionals (n = 94) in six hospital departments in Sweden completed a survey measuring perceived PCC, job strain, stress of conscience and intent to leave. Data were collected from April 2019 to April 2020. Bivariate analysis was used to describe the sample and correlations between the explanatory variables and perceived PCC and its subscales. Regression analyses were performed to explore the associations between perceived PCC and job strain, stress of conscience and intent to leave.

RESULTS

The organisational and environmental support subscale of perceived PCC showed significant correlations with all explanatory variables, while the extent of personalising care subscale only correlated with job strain and intent to leave. The regression analyses showed that higher perceived PCC was associated with higher job strain, less stress of conscience and less intent to leave.

CONCLUSION

Higher perceived PCC is associated with work-related factors in hospital departments. There is scope for further research in this area.