Ethics and quality care in nursing homes: Relatives’ experiences

Jakobsen, Rita; Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Sørlie, Venke

doi:10.1177/0969733017727151

Cited by 16 publications

(40 citation statements)

References 24 publications

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“…Needs of prospective resident ethics meetings have been reported (Bollig, Schmidt, Rosland, & Heller, 2015). Collaboration between nursing staff and relatives is known to be a central prerequisite for good care in these settings (Jakobsen, Sellevold, & Egede-Nissen, 2017). Decisions about ethical challenges in nursing homes, regarding end-of-life care, decision-making, donot-resuscitate orders, or decision to hospitalise or not, would then be discussed with staff members, representatives of the resident or the resident him/herself.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of cancer and management in elderly nursing home residents. A descriptive study in 45 French nursing homes

Liuu

Guyot²,

Valéro

et al. 2018

Eur J Cancer Care

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This study aimed to determine cancer prevalence occurring after the age of 75 in 45 French nursing homes (NH), as well as residents’ characteristics and parameters associated with cancer‐specific management. Descriptive retrospective study including 214 residents (mean age, 89.7 years) with cancer diagnosed after age 75. The studied parameters were sociodemographic, functional, nutritional and cognitive data; comorbidity assessment; date of tumoral diagnosis; cancer type; tumoral stage; treatment plan; multidisciplinary staff decision and oncologic follow‐up. Our results showed that cancer prevalence in NH was 8.4 ± 1.1%, diagnosed before admission in 63% of cases. The most common tumoral sites were skin (26%), digestive tract and breast (18% for both); 12% had metastasis. Cognitive impairment was the most common comorbidity (42%), and 44% of the residents were highly dependent. Multivariate analysis showed that therapeutic decisions were associated with age. Older patients had less staging exploration (odd ratios [ORs], 0.90, 95% confidence interval [CI], 0.85–0.97) and underwent less cancer‐specific treatment (ORs, 0.92; 95%CI, 0.86–0.99). Oncologic follow‐up was more frequent in younger patients (ORs, 0.90; 95%CI, 0.81–0.99) and those with recent diagnosis (ORs, 0.37; 95%CI, 0.23–0.61). This study identified factors associated with substandard neoplastic management in elderly NH residents. It highlights needs for information, education and training in cancer detection to improve cancer consideration and care in NH.

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Section: Discussionmentioning

confidence: 99%

Prevalence of cancer and management in elderly nursing home residents. A descriptive study in 45 French nursing homes

Liuu

Guyot²,

Valéro

et al. 2018

Eur J Cancer Care

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“…More recently, Jakobsen, Sellevold, Egede‐Nissen, and Sørlie () have also visualized the importance of a positive care climate for the quality of care from the perspective of relatives, with emphasis on both physical and psychosocial aspects of the environment. In another study, both nursing home residents and their relatives described the nursing home as a physical place the resident can call home and as a psychosocial space where both residents and relatives can be acknowledged as dignified human beings (Bollig et al, ).…”

Section: Introductionmentioning

confidence: 99%

Associations between person‐centred climate and perceived quality of care in nursing homes: A cross‐sectional study of relatives’ experiences

Lood

Kirkevold

Sjögren

et al. 2019

Journal of Advanced Nursing

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Aims To explore the extent to which a more person‐centred climate could explain the variation in quality of care, as rated by relatives to nursing home residents in three countries. Design A cross‐sectional, correlational, anonymous questionnaire study. Methods Questionnaires were administered to 346 relatives to residents in six nursing homes in Australia, Norway and Sweden between April–June 2016. Relatives (N = 178) agreed to participate. Data were analysed using descriptive statistics and hierarchical multiple regression. Results The results showed that the relatives’ experiences of a more person‐centred climate were associated with higher ratings of the quality of care. A person‐centred climate of safety had the strongest unique association with the quality of care, explaining 14% of the variance in quality of care. In addition, the results indicated that the relatives in general were satisfied with the quality of care and that children to the residents rated the quality of care higher than partners or other relatives. Conclusion This study advances the understanding of the relationship between person‐centredness in nursing homes and quality of care, showing that person‐centred climate aspects of safety and hospitality have a significant role in the quality of care as perceived by relatives. Impact Person‐centredness in nursing homes is often mentioned as a quality of care indicator, but the empirical evidence for this suggestion is limited. This study expanded the evidence‐base for person‐centredness as a significant aspect of relatives’ experiences of the quality of care in nursing homes.

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“…Another suggestion for future research is therefore to design interventions that specifically aim to involve relatives in the care process and improve the communication between relatives and staff. This has also been described in a qualitive study by Jakobsen and Sellevold et al [34], exploring relatives' experiences with quality of nursing home care. With focus on expectations, they describe that although relatives may be at an overall level satisfied with staff engagement and inclusion, feelings of powerlessness, guilt and distrust can be common when not being able to understand what is happening and not feeling competent enough to make medical decisions themselves [34].…”

Section: Discussionmentioning

confidence: 67%

“…This has also been described in a qualitive study by Jakobsen and Sellevold et al [34], exploring relatives' experiences with quality of nursing home care. With focus on expectations, they describe that although relatives may be at an overall level satisfied with staff engagement and inclusion, feelings of powerlessness, guilt and distrust can be common when not being able to understand what is happening and not feeling competent enough to make medical decisions themselves [34]. A focus for future studies could thus be explorations on how to invite relatives to people living in nursing homes into the decision-making process, and how to improve trust in staff competence and willingness to act upon relatives' expectations.…”

Section: Discussionmentioning

confidence: 67%

Effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care in nursing homes: a multi-centre, non-equivalent controlled before-after trial

et al. 2020

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Background: As part of a nursing home intervention study, the aim of this paper was 1) to evaluate the effects of a staff education programme about person-centred care and promotion of thriving on relatives' satisfaction with quality of care and their perceptions of the person-centredness of the environment, and 2) to outline factors of importance to explain the variance in relatives' satisfaction with quality of care. Relatives are often referred to as vital for the operationalisation of person-centredness in nursing homes, representing an important source of information for care planning and quality of care assessments. However, the evidence for effects of personcentredness in nursing homes on relatives' experiences is sparse and little is known on what could explain their satisfaction with the quality of care. Methods: A multi-centre, non-equivalent controlled group before-after design with study sites in Australia, Norway and Sweden. Staff in the intervention group participated in a 14-month education on person-centredness, personcentred care, thriving and caring environment. Staff in the control group received a one-hour lecture before the intervention period. Data were collected at baseline, after the intervention and six months after the end of the intervention, and analysed using descriptive statistics, a generalised linear model and hierarchical multiple regression.

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Ethics and quality care in nursing homes: Relatives’ experiences

Abstract: When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.

Cited by 16 publications

References 24 publications

Prevalence of cancer and management in elderly nursing home residents. A descriptive study in 45 French nursing homes

Prevalence of cancer and management in elderly nursing home residents. A descriptive study in 45 French nursing homes

Associations between person‐centred climate and perceived quality of care in nursing homes: A cross‐sectional study of relatives’ experiences

Effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care in nursing homes: a multi-centre, non-equivalent controlled before-after trial

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