A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection
2.2.1. Literature Search and Selection
2.2.2. Quality Appraisal
2.3. Data Analysis and Synthesis
3. Results
3.1. Theme I. Promotion of Mutual Understanding through Communication
3.1.1. Sub-Theme 1. Building Closeness with Nursing Staff
“My doctor still doesn’t want me to go right now because of my heart. After she talked to me about it, I really don’t want to go home, get sick, and have to come back. I was frustrated, but now I’m satisfied with what she’s saying.”([28], p. 197)
3.1.2. Sub-Theme 2. Sharing Enough Information about Caring
“They listen to us more. They ask our opinions. The administrator comes to the resident council meetings. Before it was only the activity director and we wondered if our suggestions got passed on because I never really saw any changes, but now the head guy comes and the director of dining comes. I think that we are being heard and that they are taking us more seriously now.”([27], p. 9)
“Since I’ve been here, my administrator told me not to be afraid to talk to anyone. So of course I go and talk to her if I have a problem. And we sit down and we discuss it, and she takes the action that needs to be taken.”([28], p. 193)
3.2. Theme II. Care That Acknowledges the Independence of Residents
3.2.1. Sub-Theme 3. Respect for the Individuality of Residents
“Well the challenge is that, depending on staffing level, I mean you can’t get everybody cared for all at the same time. You have to be very aware of knowing your resident, knowing a time that works well for them as well as knowing a time that works well for the congregate environment. And that comes with a skilled worker.”([31], p. 10)
“Well yes, you see—they do the best they can for you. They work hard all day long. They help you right away… if you need it.”([25], p. 1361)
“I rang the bell for help yesterday, and it took 45 min for someone to come help me. When you are old and on diuretics and have to go to the bathroom, you can’t wait that long. I can’t get to the toilet by myself, so I rang again and then finally just had to go. When she got there, the aid was frustrated that I was wet and so was I.”([26], p. 708)
3.2.2. Sub-Theme 4. Focusing on the Residents’ Own Life
“I decide over my own schedule, I’m independent and that is a good feeling. I feel free, and I am too. But of course I am dependent. And that is a feeling of safety…I am safe, you know. My life is so good. I make my own decisions.”([25], p. 1362)
“I forget my problems by reading or looking at something worthwhile on the TV or by being around friends…Going to activities… I like something to do… to be with a crowd… and getting involved in groups.”([26], p. 709)
3.3. Theme III. Finding the Optimized State
3.3.1. Sub-Theme 5. Care to Maintain Physical and Psychological Well-Being
“Quality of care is related to emotions and experiences in all phases of the disease.”([29], p. 6)
3.3.2. Sub-Theme 6. Creating a Therapeutic Environment for Care
“It means that this is our home. You have to respect people when you go into their home. You have to knock and ask to come in, not just barge in the door.”([27], p. 8)
“The last time you were here, there were just rules, rules, rules. Now, we have more freedom. No one wakes me up for breakfast anymore at 5:30 a.m. because I asked them not to. They had me on the list before, I don’t know why, but now I can say no. I like that.”([28], p. 198)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- World Report on Ageing and Health. Available online: https://apps.who.int/iris/handle/10665/186463 (accessed on 28 March 2022).
- Heliker, D.; Scholler-Jaquish, A. Transition of new residents to long-term care: Basing practice on residents’ perspective. J. Gerontol. Nurs. 2006, 32, 34–42. [Google Scholar] [CrossRef]
- Brandburg, G.L. Making the transition to nursing home life: A framework to help older adults adapt to the long-term care environment. J. Gerontol. Nurs. 2007, 33, 50–56. [Google Scholar] [CrossRef] [PubMed]
- Shin, S.H.; Park, J.S. Factors influencing quality of life of elderly residents in long-term care facilities. J. Gerontol. Nurs. 2017, 19, 113–124. [Google Scholar] [CrossRef] [Green Version]
- Huang, Z.; Liu, Q.; Meng, H.; Liu, D.; Dobbs, D.; Hyer, K.; Conner, K.O. Factors associated with willingness to enter long-term care facilities among older adults in Chengdu, China. PLoS ONE. 2018, 13, e0202225. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tak, Y.R.; Woo, H.Y.; Yi, L.H.; Kim, A.R. Useful lessons for the provision of services in long-term care facilities in South Korea operators’ experiences illuminate the phenomenon of working with the elderly in the field. Int. J. Qual. Stud. Health Well-Being 2019, 14, 1565238. [Google Scholar] [CrossRef] [Green Version]
- Botngård, A.; Eide, A.H.; Mosqueda, L.; Malmedal, W. Elder abuse in Norwegian nursing homes: A cross-sectional exploratory study. BMC Health Serv. Res. 2020, 20, 9. [Google Scholar] [CrossRef]
- Jeong, H.; Park, M.H. A predictive model on patient-centered care of hospital nurses in Korea. J. Korean Acad. Nurs. 2019, 49, 191–202. [Google Scholar] [CrossRef]
- Lee, Y.Y.; Lin, J.L. Do patient autonomy preferences matter? Linking patient-centered care to patient-physician relationships and health outcomes. Soc. Sci. Med. 2010, 71, 1811–1818. [Google Scholar] [CrossRef]
- Robinson, J.H.; Callister, L.C.; Berry, J.A.; Dearing, K.A. Patient-centered care and adherence: Definitions and applications to improve outcomes. J. Am. Acad. Nurse Pract. 2008, 20, 600–607. [Google Scholar] [CrossRef]
- Lauver, D.R.; Ward, S.E.; Heidrich, S.M.; Keller, M.L.; Bowers, B.J.; Brennan, P.F.; Wells, T.J. Patient-centered interventions. Res. Nurs. Health 2002, 25, 246–255. [Google Scholar] [CrossRef]
- Rogers, C.R. On Becoming a Person; Houghton Mifflin: New York, NY, USA, 1961. [Google Scholar]
- Balint, E. The possibilities of patient-centered medicine. J. R. Coll. Gen. Pract. 1969, 17, 269–276. [Google Scholar] [PubMed]
- Stewart, M.; Brown, J.B.; Weston, W.; McWhinney, I.; McWilliam, C.; Freeman, T. Patient-Centered Medicine: Transforming the Clinical Method; Sage: London, UK, 1995. [Google Scholar]
- The American Geriatrics Society Expert Panel on Person-Centered Care. Person-centered care: A definition and essential elements. J. Am. Geriatr. Soc. 2016, 64, 15–18. [Google Scholar] [CrossRef] [Green Version]
- Medicare and Medicaid Programs: Reform of Requirements for Long-Term Care Facilities. Available online: http://www.regulations.gov/document?D=CMS-2015-0083-0001 (accessed on 1 July 2022).
- Ventura, F.; Costeira, C.R.B.; Silva, R.; Cardoso, D.; Oliveira, C. Person-centered practice in the Portuguese healthcare services: A scoping review protocol. Nurs. Rep. 2022, 12, 235–244. [Google Scholar] [CrossRef] [PubMed]
- Yumoto, Y.; Hiroyama, N.; Sasaki, M.; Fujinami, K.; Otsuka, S.; Togari, T.; Edvardsson, D.; Ogata, Y. Reliability and validity of the Japanese version of the Person-Centered Care Assessment Tool. Geriatr. Gerontol. Int. 2022, 22, 344–349. [Google Scholar] [CrossRef] [PubMed]
- Lachal, J.; Revah-Levy, A.; Orri, M.; Moro, M.R. Metasynthesis: An original method to synthesize qualitative literature in psychiatry. Front. Psychiatry 2017, 8, 269. [Google Scholar] [CrossRef] [Green Version]
- Campbell, R.; Pound, P.; Morgan, M.; Daker-White, G.; Britten, N.; Pill, R.; Yardley, L.; Pope, C.; Donovan, J. Evaluating meta-ethnography: Systematic analysis and synthesis of qualitative research. Health Technol. Assess. 2011, 15, 1–164. [Google Scholar] [CrossRef] [Green Version]
- Noblit, G.W.; Hare, R.D. Meta-Ethnography: Synthesizing Qualitative Studies; Sage: Newcastle Upon Tyne, UK, 1988. [Google Scholar]
- Tong, A.; Flemming, K.; McInnes, E.; Oliver, S.; Craig, J. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med. Res. Methodol. 2012, 12, 181. [Google Scholar] [CrossRef] [Green Version]
- Higgins, J.P.T.; Thomas, J.; Chandler, J.; Cumpston, M.; Li, T.; Page, M.J.; Welch, V.A. (Eds.) Cochrane Handbook for Systematic Reviews of Interventions, 2nd ed.; John Wiley & Sons: Chichester, UK, 2019. [Google Scholar]
- Critical Appraisal Skills Programme. CASP Qualitative Studies Checklist. Available online: https://casp-uk.net/casp-tools-checklists/ (accessed on 12 March 2022).
- Nakrem, S.; Vinsnes, A.G.; Seim, A. Residents’ experiences of interpersonal factors in nursing home care: A qualitative study. Int. J. Nurs. Stud. 2011, 48, 1357–1366. [Google Scholar] [CrossRef]
- Bangerter, L.R.; Van Haitsma, K.; Heid, A.R.; Abbott, K. “Make me feel at ease and at home”: Differential care preferences of nursing home residents. Gerontologist 2016, 56, 702–713. [Google Scholar] [CrossRef] [Green Version]
- Harrison, J.; Frampton, S. Resident-centered care in 10 U.S. Nursing home: Residents’ perspectives. J. Nurs. Scholarsh. 2017, 49, 6–14. [Google Scholar] [CrossRef]
- Scales, K.; Lepore, M.; Anderson, R.A.; McConnell, E.S.; Song, Y.; Kang, B.; Porter, K.; Thach, T.; Corazzini, K.N. Person-directed care planning in nursing homes: Resident, family, and staff perspectives. J. Appl. Gerontol. 2019, 38, 183–206. [Google Scholar] [CrossRef] [PubMed]
- Vennedey, V.; Hower, K.I.; Hillen, H.; Ansmann, L.; Kuntz, L.; Stock, S. Patients’ perspectives of facilitators and barriers to patient-centered care: Insights from qualitative patient interviews. BMJ Open 2020, 10. [Google Scholar] [CrossRef]
- Sims-Gould, J.; McKay, H.A.; Feldman, F.; Scott, V.; Robinovitch, S.N. Autonomy, choice, patient-centered care, and hip protectors: The experience of residents and staff in long-term care. J. Appl. Gerontol. 2014, 33, 690–790. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kusmaul, N.; Tucker, G.G. Person-centered care in nursing homes: Many stakeholders, many perspectives. J. Gerontol. Nurs. 2020, 46, 9–13. [Google Scholar] [CrossRef] [PubMed]
- The Health Foundation. Person-Centered Care Made Simple. What Everyone Should Know about Person-Centered Care. Available online: https://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple.pdf (accessed on 5 April 2022).
- Aschieri, F.; Barello, S.; Durosini, I. “Invisible voices”: A critical incident study of family caregivers’ experience of nursing homes after their elder relative’s death. J. Nurs. Scholarsh. 2021, 53, 65–74. [Google Scholar] [CrossRef] [PubMed]
- Wagner, L.M.; Driscoll, L.; Darlington, J.L.; Flores, V.; Kim, J.; Melino, K.; Patel, H.D.; Spetz, J. Nurses’ communication of safety events to nursing home residents and families. J. Gerontol. Nurs. 2018, 44, 25–32. [Google Scholar] [CrossRef] [PubMed]
- Lee, S.; Lee, K.H. Experience of long-term care workers’ communication with older adults with dementia focused on emotional expression. J. Korean Acad. Psychiatr. Ment. Health Nurs. 2018, 27, 264–273. [Google Scholar] [CrossRef] [Green Version]
- Ha, E.H. Subjective perception of long-term care facilities in home-dwelling older adults: A Q methodological study. Korean J. Adult Nurs. 2021, 33, 269–282. [Google Scholar] [CrossRef]
- Lee, E.-H. Environmental factors for making residents feel ‘at home’ in long-term care facilities in South Korea. Soc. Sci. Res. 2019, 35, 131–159. [Google Scholar] [CrossRef]
Items | Nakrem et al. (2011) [25] | Bangerter et al. (2016) [26] | Harrison et al. (2017) [27] | Scales et al. (2019) [28] | Vennedey et al. (2020) [29] | Sims-Gould et al. (2014) [30] | Kusmaul et al. (2020) [31] |
---|---|---|---|---|---|---|---|
1. Was there a clear statement of the aims of the research? | Y | N | Y | Y | Y | Y | Y |
2. Is a qualitative methodology appropriate? | Y | Y | Y | Y | Y | Y | Y |
3. Was the research design appropriate to address the aims of the research? | Y | Y | Y | Y | Y | Y | N |
4. Was the recruitment strategy appropriate to the aims of the research? | Y | N | N | N | N | N | Y |
5. Was the data collected in a way that addressed the research issue? | N | Y | Y | Y | Y | Y | N |
6. Has the relationship between researcher and participants been adequately considered? | Y | Y | N | Y | Y | Y | Y |
7. Have ethical issues been taken into consideration? | Y | Y | Y | Y | Y | Y | Y |
8. Was the data analysis sufficiently rigorous? | Y | N | N | Y | N | N | N |
9. Is there a clear statement of findings? | Y | Y | Y | N | Y | Y | Y |
10. Was this research valuable? | Y | Y | Y | Y | Y | Y | Y |
Percentage | 90% | 70% | 70% | 80% | 80% | 80% | 70% |
Author, (Year) [Article No.] /Country | Research Type | Aims | Sample Size (F:M) | Age of Participants (Years) | Data Collection | Data Analysis | Key Findings |
---|---|---|---|---|---|---|---|
Nakrem et al. (2011) [25]/Norway | Quality inquiry study | To describe the nursing home residents’ experience with direct nursing care, related to the interpersonal aspects of quality of care | 15 (9:6) | 70s: 4 80s: 9 90s: 2 | In-depth interview | Content analysis |
|
Bangerter et al. (2016) [26]/USA | Qualitative study | To assess older adults’ preferences for person-centered care in long-term care facilities. | 337 (240:97) | Mean: 81 | In-person interview | Content analysis |
|
Harrison et al. (2017) [27]/USA | Qualitative study | To describe resident perspectives of resident-centered care (RCC) in 10 U.S. nursing homes in order to highlight the meaning of the term RCC | 227 (Not reported) | 52–101 | Focus group interview | Phenomenological approach |
|
Scales et al. (2019) [28]/USA | Qualitative study | To elicit input from a range of nursing home stakeholders about how to enhance resident and family engagement in care planning and delivery with a view to developing an operational framework for PDCP (Person Directed Care Planning). | 97 (87:10) Residents:16:3 Family members: 4:2 NA,LPN:13:0 Managers/administrators: 55:4 | Residents: 53–92 Family members: 50–79 NA,LPN: 27–61 Managers/administrators: 25–65 | Semi-structured interview | Qualitative data analysis |
|
Vennedey et al. (2020) [29]/Germany | Qualitative study | To analyse patients’ perspectives of facilitators and barriers towards implementing PCC. | 25 (17:8) | Mean: 60 | Semi-structured individual interview | Content analysis |
|
Sims-Gould et al. (2014) [30]/Canada | Larger mixed methods | To examine long-term care (LTC) resident and staff perceptions on the decision to use hip protectors and identify the factors that influence attitudes toward hip protector use | 27 (19:8) | 72–91 (mean: 87.8) | Focus group interview | Thematic analysis |
|
Kusmaul et al. (2020) [31]/USA | Descriptive qualitative study | To examine how people in different roles experienced choice and autonomy in four areas addressed by culture change. | 32 (24:8) | Not reported | Semi-structured interview | Qualitative data analysis |
|
Key Concepts from First, Second-Order Constructs | Sub-Themes | Themes |
---|---|---|
Sharing daily life Consultation for residents’ concerns Conversation in positive language Expression in the words of the resident Extending the relationship to the family | 1. Building closeness with nursing staff | I. Promotion of mutual understanding through communication |
Getting information about the care provided and care plan Providing detailed historical information about residents Desiring medical providers with comprehensive medical knowledge Expecting a health care provider with a lot of knowledge about the residents | 2. Sharing enough information about caring | |
Nursing staff who are well aware of residents’ health conditions Providing care tailored to the needs of residents Wanting the assignment of a dedicated nursing staff Quick response of nursing staff to residents’ requests | 3. Respect for the individuality of residents | II. Care that acknowledges the independence of residents |
Able to live independently Self-determination ability Desire to maintain a hobby | 4. Focusing on the residents’ own life | |
Preventing residents’ body dysfunction Desire to maintain a healthy daily life Life without pain Monitoring of residents’ physical needs Positive attitude of nursing staff | 5. Care to maintain physical and psychological well-being | III. Finding the optimized state |
A place where their safety is guaranteed A comfortable space like home Environment where privacy is respected | 6. Creating a therapeutic environment for care |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kim, E.-Y.; Chang, S.-O. A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents. Int. J. Environ. Res. Public Health 2022, 19, 8576. https://doi.org/10.3390/ijerph19148576
Kim E-Y, Chang S-O. A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents. International Journal of Environmental Research and Public Health. 2022; 19(14):8576. https://doi.org/10.3390/ijerph19148576
Chicago/Turabian StyleKim, Eun-Young, and Sung-Ok Chang. 2022. "A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents" International Journal of Environmental Research and Public Health 19, no. 14: 8576. https://doi.org/10.3390/ijerph19148576