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  • 1.
    Dale, Björg
    et al.
    University of Agder.
    Sævereid, Hans Inge
    Kirkevold, Marit
    Söderhamn, Olle
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Formal and informal care in relation to activities of daily living and self-perceived health among older care-dependent individuals in Norway.2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 17, no 3, p. 194-203Article in journal (Refereed)
    Abstract [en]

    Background. Research about formal care of older home-dwelling people in the Nordic countries is comprehensive, while research on informal care has been less inclusive.

    Aim. To describe self-reported activities of daily living and perceived health, and to relate them to amount and types of formal and informal care received by a group of care-dependent, home-dwelling older individuals in Norway.

    Design and methods. A sample consisting of 242 persons aged 75+ years receiving home nursing services. Data were collected by means of structured interviews with questions about activities of daily living (ADL), amount and types of formal and informal care and demographic variables. Descriptive statistics, chi-square test, Mann-Whitney U-test and multiple stepwise regression were used in the analyses.

    Results. ADL dependency was the only predictor for explaining quantity of home nursing received. Those who received a generous amount of formal care also received a lot of care and support from informal networks. The type of care from the two sources differed. The home nurses performed PADL tasks. While the informal caregivers offered help with IADL tasks.

    Conclusion. This study of receiving help in this group of older people in Norway shows that formal and informal care resources complement one another.

  • 2.
    Elfstrand Corlin, Tinna
    et al.
    School of Health and Education, University of Skövde, Skövde, Sweden.
    Kajonius, Petri
    University West, Department of Social and Behavioural Studies, Psychology and organization studies. School of Health and Education, University of Skövde, Skövde, Sweden.
    Kazemi, Ali
    School of Health and Education, University of Skövde, Skövde, Sweden.
    The impact of personality on person-centred care: a study of care staff in Swedish nursing homes2017In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 12, no 2, article id e12132Article in journal (Refereed)
    Abstract [en]

    Aim and objective

    In this study, we explore how personal and situational factors relate to the provision of person-centred care (PCC) in nursing homes. Specifically, we focus on the relationship between the care staff's personality traits and provision of PCC and to what extent perceptions of the working environment influences this relationship.

    Background

    The ultimate goal of elderly care is to meet the older person's needs and individual preferences (PCC). Interpersonal aspects of care and the quality of relationship between the care staff and the older person are therefore central in PCC.

    Design and methods

    A cross-sectional Swedish sample of elderly care staff (= 322) completed an electronic survey including measures of personality (Mini-IPIP) and person-centred care (Individualized Care Inventory, ICI). A principal component analysis was conducted on the ICI-data to separate the user orientation (process quality) of PCC from the preconditions (structure quality) of PCC.

    Results

    Among the five factors of personality, neuroticism was the strongest predictor of ICI user orientation. ICI preconditions significantly mediated this relationship, indicating the importance of a supportive working environment. In addition, stress was introduced as a potential explanation and was shown to mediate the impact of neuroticism on ICI preconditions.

    Conclusions

    Personality traits have a significant impact on user orientation, and the perception of a supportive and stress free working environment is an important prerequisite for achieving high-quality person-centred elderly care.

    Implications for practice

    Understanding how personality is linked to the way care staff interacts with the older person adds a new perspective on provision of person-centred elderly care.

  • 3.
    Elfstrand Corlin, Tinna
    et al.
    Independent Researcher, Skövde (SWE).
    Kazemi, Ali
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Staff-based measurement instruments of person-centredness in settings of care for older people: A systematic review2024In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 19, no 2Article in journal (Refereed)
    Abstract [en]

    Background: Person-centred care is widely endorsed as a promising approach for delivering high-quality care to older people. However, the multitude of existing definitions and measurement tools, coupled with the continuous emergence of new tools, can create confusion and hinder precision in assessing this concept. This review was undertaken with a recognition of the crucial role that assessment quality plays in evaluations and improvements, particularly within the context of person-centred care for older people.

    Objectives: This study aimed to systematically review staff-based measures of person-centredness in settings of care for older people. More specifically, the objectives were to provide description, methodological evaluation and synthesis of diverse conceptual understandings of person-centredness encapsulated in these measurement tools. Methods: We systematically searched the Cinahl, PsycInfo, PubMed, Scopus and Web of Science databases for English peer-reviewed journal articles between 2000 and 2021. These articles discussed the creation of staff-based questionnaires designed to assess the extent of person-centred care. We excluded questionnaires meant for clients, patients or families, as well as non-questionnaire scales. The measures were described, and their interpretations of person-centred care were synthesised through a critical interpretive synthesis method. We evaluated methodological quality using a condensed COSMIN risk of bias checklist and adhered to PRISMA guidelines.

    Results: The review identified a total of 14 staff-based measures. These measures exhibited varying levels of comprehensiveness, encompassing anywhere between 2 and 17 components. Furthermore, the number of items within the measures ranged from 11 to 62, and the sample sizes exhibited significant diversity, spanning from 58 to 1428. In terms of the components scrutinised by the scales regarding person-centred care, our synthesis revealed the emergence of four distinct conceptual categories: care process, supportive care environment, relations and communication, and knowledge and attitudes. As for the methodological quality of the scales, it exhibited a notable degree of variation (i.e. from inadequate to very good).

    Conclusions: Diverse measures of person-centredness vary in terms of comprehensiveness, aspects covered and methodological quality. Synthesising the concept through staff-based measures offers a novel approach for researchers and practitioners, illuminating nuanced perspectives in person-centred care.

    Implications for practice: The synthesis enriches academic discussions and practical applications by dissecting components, ultimately enhancing care quality assessment and improvement. Further, this review is a valuable resource for unit managers and quality coordinators working in settings of care for older people, empowering them to make informed decisions tailored to their specific needs from a diverse array of available person-centred care measures. 

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  • 4.
    Isaksson, Ulf
    et al.
    Umeå University, Department of Nursing.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Graneheim, Ulla H.
    Umeå University, Department of Nursing.
    Being flexible and tuning in: Professional caregivers’ reflections on management of violent behaviour in nursing homes2013In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, no 4, p. 290-298Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: This qualitative, descriptive study aimed to illuminate professional caregivers’ reflections on managing residents’ violent behaviour in nursing homes. Background: Violence towards caregivers in the care of older people is a challenge attracting increasing attention in nursing research. However, studies that focus on the approaches caregivers in nursing homes resort to and how they manage everyday care situations involving threats and violent situations are relatively few. Methods: The study was based on 41 interviews in which the caregivers reflected on their own courses of action in violent situations. The interviews were subjected to qualitative content analysis. Results: This study showed that caregivers were flexible and in tune with the resident by averting and defusing threatening and violent situations. The caregivers tried to give care in line with the residents’ condition, control their own spontaneous reactions and interpret the residents’ reactions as communicative signs indicating how they should interact with the resident in the situation. As a last resort, when previous approaches had been unsuccessful, the caregivers took a firm stand, confronted the resident and the violent behaviour more directly, but with respect and with the residents’ best interests in mind. Conclusions: These findings illuminate how caregivers successfully can manage threatening and violent behavior in nursing homes by being flexible and tuning in with the resident but also by taking a firm stand with the residents’ best interests in mind. To be flexible and in tune with residents, it is important to know the residents’ personal histories. This may mean involving stakeholders, such as family members and friends, in the care of residents with violent behaviour. Implications for practice: We believe that it is important to involve stakeholders in the care of threatening and violent residents in nursing homes as it is important to get information on the residents’ personal history. However, there are risks when interpreting residents’ behaviour in light of their personal histories as relatives experiences may be subjective and the information may give the caregivers preconceived ideas about the resident. © 2012 Blackwell Publishing Ltd.

  • 5.
    Kazemi, Ali
    et al.
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Kajonius, Petri
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Assessing person-centred care: An item response theory approach.2021In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 16, no 1, p. 1-15, article id e12352Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVES: Given recent advances in psychometric assessment, there is a need for assessment studies using modern test theory in the field of person-centred care, mainly due to the dominant use of analytical strategies based on classical test theory. The main objective of the present study was thus to examine whether selected items from commonly used instruments of person-centred care were able to differentiate between respondents with a reasonably even level of measurement precision across different regions of the construct range using item response theory (IRT).

    RESEARCH DESIGN AND METHODS: A Swedish sample of care staff in elderly care (N = 1342) completed a survey including a selection of items from three previously validated measures of person-centred care.

    RESULTS: All questionnaire items were submitted to IRT analyses to examine the extent to which the items produced information on the underlying construct. The items exhibited different levels of information. However, in general, for those items exhibiting some information, the pattern of information across the trait range was similar for most of them, that is, the items discriminated better in the lower levels of person-centredness.

    DISCUSSION AND IMPLICATIONS: Item response theory analyses are instrumental in creating shorter measurement instruments that may perform nearly as well as the original longer instruments. Given time and other resource constraints in questionnaire administration, there is a gain in only including the most informative items which efficiently and evenly tap the underlying construct along its entire range and in the context of person-centred care assessment this study was an initial step towards this goal. Thus, a set of ten items with satisfactory levels of psychometric quality, that is relatively high information levels across a relatively broad range of the underlying construct, is proposed.

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