Effect of a Person‐Centered Mouth Care Intervention on Care Processes and Outcomes in Three Nursing Homes

Sloane, Philip D.; Zimmerman, Sheryl; Chen, Xi; Barrick, Ann Louise; Poole, Patricia; Reed, David; Mitchell, Madeline; Cohen, Lauren W.

doi:10.1111/jgs.12317

Cited by 67 publications

(92 citation statements)

References 26 publications

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“…Germany requires that at least 50% of all care staff are Registered Nurses who have had 3-year geriatric training [76]. Considering the significant role of workforce in healthcare delivery [77] and the influence of workforce training on resident outcomes and staff working experiences [14,78], the sub-optimal staff qualification in Chinese NHs suggests this is a critical area for policy development to improve the capacity of Chinese NHs to provide competent and safe care.…”

Section: Discussionmentioning

confidence: 99%

“…The characteristics of NH staff have been extensively researched in other countries in studies of staff demographics and educational preparation and how these characteristics influence resident outcomes in NHs. For example, an interventional study in 3 NHs in the U. S. found that resident oral health was improved after training certified nurse aide about mouth care [14]. A qualitative study about end-of-life care in NHs in UK found that staff expertise about end-of-life care and their strong relationships with residents facilitated end-of-life care for residents with dementia [15].…”

Section: Introductionmentioning

confidence: 98%

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Staff characteristics and care in Chinese nursing homes: A systematic literature review

Song

Anderson

Corazzini

et al. 2014

International Journal of Nursing Sciences

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Resident careWorkforce development a b s t r a c tThe need for institutional long-term care (LTC) services, including nursing homes (NHs), is increasing in Mainland China in part due to the aging population and changing family structures. In developing NH staff training programs, a review is needed to synthesize knowledge about staff and resident characteristics, and care provided in NHs. This systematic review aims to describe, in Chinese NHs, 1) NH staff characteristics and the care they provide, 2) resident characteristics and care needs, and 3) the role of family members.The 45 articles included in this review covered both urban and rural areas of Mainland China. We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries. Most direct caregivers in urban areas were migratory workers from rural area. Chinese NHs had few qualification standards for staff preparation for their roles in NHs. Also, functional levels of residents in Chinese NHs were higher compared to NH residents in western countries. In addition, family members played important roles in caring for NH residents. These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in Mainland China. The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Staff characteristics and care in Chinese nursing homes: A systematic literature review

Song

Anderson

Corazzini

et al. 2014

International Journal of Nursing Sciences

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“…As described by Brownie [18], the concept and philosophy of person-centred care has been well described, developed and refined through conceptual work, and a number of studies have explored a variety of interventions with different endpoints [18]. Some interventions have been related to specific care situations such as bathing, mouth care or morning care [19–21], and others have focused on developing the physical environment to meet the needs of people with dementia [22, 23]. A few intervention studies have had a multi-dimensional, holistic, and individually tailored approach [24, 25], or been part of the conceptual development of person-centred care for example through life story work [26, 27].…”

Section: Introductionmentioning

confidence: 99%

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

et al. 2017

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BackgroundThe literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this.MethodsThe study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents’ thriving, relatives’ satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives’ experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention.DiscussionThe study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care.Trial registrationThe trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452.

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“…We included a total of seven references [65, 66, 91–95], four of which report different aspects of one unique research project [66, 92–94]. Therefore, these seven references represent four unique studies (i.e., research projects).…”

Section: Resultsmentioning

confidence: 99%

“…However, evidence on the effectiveness of these strategies is weak or inconclusive, and these strategies have not been tested in the context of daily oral care. A few specific strategies to reduce responsive behaviors during oral care have been suggested and trialed [65, 66] but to date, no systematic review on the effectiveness of such strategies is available.…”

Section: Introductionmentioning

confidence: 99%

Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review

et al. 2017

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BackgroundPoor oral health has been a persistent problem in nursing home residents for decades, with severe consequences for residents and the health care system. Two major barriers to providing appropriate oral care are residents’ responsive behaviors to oral care and residents’ lack of ability or motivation to perform oral care on their own.ObjectivesTo evaluate the effectiveness of strategies that nursing home care providers can apply to either prevent/overcome residents’ responsive behaviors to oral care, or enable/motivate residents to perform their own oral care.Materials and methodsWe searched the databases Medline, EMBASE, Evidence Based Reviews–Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science for intervention studies assessing the effectiveness of eligible strategies. Two reviewers independently (a) screened titles, abstracts and retrieved full-texts; (b) searched key journal contents, key author publications, and reference lists of all included studies; and (c) assessed methodological quality of included studies. Discrepancies at any stage were resolved by consensus. We conducted a narrative synthesis of study results.ResultsWe included three one-group pre-test, post-test studies, and one cross-sectional study. Methodological quality was low (n = 3) and low moderate (n = 1). Two studies assessed strategies to enable/motivate nursing home residents to perform their own oral care, and to studies assessed strategies to prevent or overcome responsive behaviors to oral care. All studies reported improvements of at least some of the outcomes measured, but interpretation is limited due to methodological problems.ConclusionsPotentially promising strategies are available that nursing home care providers can apply to prevent/overcome residents’ responsive behaviors to oral care or to enable/motivate residents to perform their own oral care. However, studies assessing these strategies have a high risk for bias. To overcome oral health problems in nursing homes, care providers will need practical strategies whose effectiveness was assessed in robust studies.

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Effect of a Person‐Centered Mouth Care Intervention on Care Processes and Outcomes in Three Nursing Homes

Cited by 67 publications

References 26 publications

Staff characteristics and care in Chinese nursing homes: A systematic literature review

Staff characteristics and care in Chinese nursing homes: A systematic literature review

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review

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