The thriving of older people assessment scale: Psychometric evaluation and short-form development

Adults Aged 75+ Happy in Conventional Dwelling or Independent Living Facility but Associated With Thriving and Ageism

This study aimed to compare levels of happiness of older women and men living in conventional dwellings (CD) and independent living facilities (ILF), and examine happiness' associations with thriving, social participation, community integration and ageism (self-directed and discrimination). A cross-sectional survey was conducted with a random sample of 509 older adults in CD and 470 in ILF in Quebec, Canada. Participants' mean age was 82.22 ± 5.35, and two-thirds were women. Levels of happiness were similar in both sexes and settings. Greater happiness was associated with greater thriving for all (β = 0.28-1.48), social participation for women in CD (β = 0.67), community integration in CD (β = 0.42 for women and 1.18 for men), and reduced ageism, i.e., discrimination for women in CD (β = -1.02) and men in ILF (β = -0.28), and self-directed for men in CD (β = -0.21). The findings demonstrate that happiness was associated with factors related to the living environment and could be enhanced through targeted interventions.

Promoting resident thriving in nursing homes: A qualitative study

Aim

To explore how staff promote resident thriving in an Australian nursing home.

Design

Qualitative research design using content analysis.

Methods

Interviews were held with 14 nursing staff working in an Australian nursing home in March/April 2018. Data were analysed using qualitative content analysis.

Results

Four themes were revealed: promoting personalized care; promoting opportunities for autonomy; promoting connection and meaning; and promoting a curated environment.

Conclusions

Staff promoted resident thriving in relation to everyday care, activities, capabilities, relationships and the lived environment. Interventions that were perceived to promote thriving were described relative to the nurse, the resident, the care team and the wider nursing home context.

Implications for the Profession and/or Patient Care

The findings provide novel insight into the understanding and application of the concept of thriving in long‐term care from nursing staffs' perspective.

Impact

What Problem did the Study Address?

Nursing home staff are uniquely positioned to support resident thriving through person‐centred care, yet little is known about how staff support promotion of thriving for nursing home residents in their everyday practice.

What were the Main Findings?

Nursing home staff perceived that they promoted thriving by personalizing care and supporting autonomy, connection, meaning and pleasure for residents.

Where and on Whom will the Research have an Impact?

These findings are of interest for the clinicians, educators and researchers who develop, implement and evaluate interventions to improve place‐related well‐being in nursing homes.

Reporting Method

CORE‐Q checklist.

Patient or Public Contribution

No patient or public contribution occurred for this study as this research focused on exploring staffs' perspectives from the specific viewpoint of their personal experience.

Thriving of Older People Assessment Scale (TOPAS): Transcultural adaptation, psychometric evaluation, and refinement in a Spanish sample

The objective of this study was to culturally adapt the Thriving of Older People Assessment Scale (TOPAS) instrument and evaluate its psychometric properties. The study was carried out in two phases: cross-cultural adaptation and psychometric validation and refinement through a cross-sectional study conducted between 2018 and 2020 with 314 participants. The refinement resulted in an abbreviated version of TOPAS, maintaining the original 5 factors with 16 items. Cronbach alpha was 0.91. Composite reliability (0.72-0.89) and average variance extracted (0.57-0.81), supporting discriminant validity. Maximum shared variance for the factors (0.22-0.50) and average shared variance (0.16-0.31), demonstrating discriminant validity. The abbreviated version of TOPAS showed evidence of being a valid and reliable instrument for measuring the adaptability of elderly residents in institutions. Implementing this instrument in Spanish nursing homes allows for a continuous evaluation of residents' well-being in relation to their environment, a construct not previously assessed with available scales.

Exploring changes to resident thriving and associated factors in Swedish nursing homes: A repeated cross-sectional study

OBJECTIVE

This study aimed to explore changes to resident thriving in Swedish nursing homes over a 5-year period and describe changes in associated factors.

METHODS

Cross-sectional data were collected from a randomised sample of Swedish nursing homes in 2013/2014 (baseline) and 2018/2019 (follow-up). Descriptive statistics, independent samples t-tests, and chi squared tests were used to statistically evaluate differences between the samples. Simple and multiple linear regression analyses were used to explore associations between thriving and the study variables.

RESULTS

Resident characteristics were relatively consistent between the full baseline (N = 4831) and follow-up (N = 3894) samples. Within a sub-sample of nursing homes that participated in both data collections mean thriving scores were found to have increased from 152.9 to 155.2 (p ≤ 0.003; d =0.09) and overall neuropsychiatric index scores had decreased from 16.0 to 14.3 (p ≤ 0.004; d =0.09), as had the prevalence of several neuropsychiatric symptoms. Thriving was found to have a positive association with the neuropsychiatric symptom of elation/euphoria, and negative associations with the symptoms of aggression/agitation, depression/dysphoria, apathy, and irritability.

CONCLUSIONS

The results show an increase in overall thriving scores and a decrease in overall neuropsychiatric scores between baseline and follow-up. This study confirmed associations between thriving and certain neuropsychiatric symptoms and established comparative knowledge regarding changes in resident thriving, characteristics, and symptom prevalence. These findings could inform future care and organisational policies to support thriving in nursing homes, particularly among residents at risk of lower thriving due to cognitive impairment or neuropsychiatric symptoms.

Supporting lives lived whilst protecting lives saved during COVID-19: The relational invariant in person-centred care

There has been an impressive development of nursing knowledge around the ethics, principles, frameworks, models and practices of person-centred care over the last 15 years, with colleagues from the Nordic countries making significant contributions to global knowledge across the discipline of nursing and beyond. A disciplinary challenge remains to map the variability in person-centred care with an aim to empirically clarify the invariant in person-centred care. Based on current research and practice, as well as the COVID-19 pandemic, this article argues that the relational aspect of person-centred care is such an invariant, building on the socially constructive notion of ‘personhood’ being a standing or status that is bestowed on one human being by another in the context of relationship and social being. During the current COVID-19 pandemic, several of the key determinants of person-centred care are under threat due to health service responses and/or infection control measures, such as keeping older adults safe, imposing relationship restrictions, social distancing and isolation (or the lack thereof). Clinical examples from an Australian health service are used to show how recognizing the relational invariant of person-centred aged care facilitated supporting lives lived whilst also protecting lives saved. The relational invariant to person-centred care is who we are, constructed or deconstructed by and with others; something that may have become more visible through the relational restrictions imposed due to COVID-19. Protecting relationality in life and care and advocating for both safe and person-centred care for those who need it most is now more important than ever.