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  • 1.
    Backman, Annica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Ahnlund, Petra
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    McGilton, Katherine S.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia .
    Leading towards person-centred care – Nursing home managers' experiences of leading person-centred care in highly person-centred Swedish nursing homesManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background:Although a growing body of research knowledge exists highlighting the importance of leadership for person-centred care, studies focused on nursing home managers’ own descriptions of leading their staff to provide person-centred care is lacking. This study aims to explore the process of nursing home managers’ leading person-centred care in Swedish nursing homes.

    Methods:The methods of the study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a national wide survey of nursing homes in Sweden. A qualitative content analysis was performed for data analyses.

    Results:The study revealed that the leading person-centred care in nursing homes can be outlined as comprising four processes: Embodying person-centred being and doing; promoting a person-centred atmosphere; maximizing person-centred team potential; and finally, optimizing person-centred support structures.

    Conclusion:This study contributes to the literature by providing concrete descriptions of how person-centred care can be operationalised and supported in everyday practice by the leadership of nursing home managers. The study is significant in that it provides evidence on how the provision of person centred care can be facilitated by managers and the important role they play in developing and maintaining this philosophy of care within nursing homes.

  • 2.
    Backman, Annica C.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe Univ, Melbourne, Vic, Australia.
    Leadership behavior in relation to person-centeredness and person-centered climate - a cross-sectional study in residential aged care in Sweden2015Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, s. 806-807Artikel i tidskrift (Övrigt vetenskapligt)
  • 3.
    Backman, Annica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.  School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
    Characteristics of highly rated leadership in Swedish nursing homes2016Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 56, s. 283-283Artikel i tidskrift (Övrigt vetenskapligt)
  • 4.
    Backman, Annica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Characteristics of highly rated leadership in nursing homes using item response theory2017Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, nr 12, s. 2903-2913Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To identify characteristics of highly rated leadership in nursing homes. Background: An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Design: Cross-sectional. Method: From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers' (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Results: Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. Conclusion: This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.

  • 5.
    Backman, Annica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifer y, La Trobe University, Melbourne, VIC, Australia.
    Towards person-centredness in aged-care: exploring the impact of leadership2016Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, nr 6, s. 766-774Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To explore the association between leadership behaviours among managers in aged care, and person‐centredness of care and the psychosocial climate.

    Background: Theory suggests that leadership is important for improving person‐centredness in aged care, however, empirical evidence is lacking.

    Methods: A cross‐sectional design was used to collect data from Swedish aged care staff (= 3661). Valid and reliable questionnaires assessing leadership behaviours, person‐centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms.

    Results: Leadership behaviours were significantly related to the person‐centredness of care and the psychosocial climate. The level of person‐centredness of care moderated the impact of leadership on the psychosocial climate.

    Conclusions and implications for nursing management: The leadership behaviour of managers significantly impacts person‐centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person‐centred care practice, thereby creating a positive psychosocial climate and high quality care.

  • 6.
    Backman, Annica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.
    Job strain in nursing homes: exploring the impact of leadership2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 7-8, s. 1552-1560Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: To explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes.

    Background: It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts.

    Design: This study had a cross‐sectional design.

    Methods: Participating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted.

    Results: Nursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain.

    Conclusions: Nursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff.

    Relevance to clinical practice: Promoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff.

  • 7.
    Baxter, Rebecca
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Björk, Sabine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Sköldunger, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Bergland, Ådel
    Winblad, Bengt
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.
    The Thriving of Older People Assessment Scale: Psychometric evaluation and short‐form development2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

    Background: The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

    Design: Cross‐sectional.

    Method: Staff members completed the 32‐item TOPAS as proxy‐raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 and September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

    Results: Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α=0.90) and strong correlation (r=0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

    Conclusion: The 32‐item and short‐form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.

    Impact: There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health promoting purposes in nursing homes.

  • 8.
    Corneliusson, Laura
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sköldunger, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Wimo, Anders
    Winblad, Bengt
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Heidelberg, Vic., Australia; Austin Health, Melbourne, Vic., Australia.
    Residing in sheltered housing versus ageing in place: population characteristics, health status and social participation2019Ingår i: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 27, nr 4, s. E313-E322Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sheltered housing is a housing model that provides accessible apartments with elevated social possibilities for older people, which is expected to increase resident health and independence, reducing the need for care. As previous research on sheltered housing is scarce, the aim of this study was to explore the characteristics, health status and social participation of older people living in sheltered housing, compared to ageing in place. The study utilised baseline data from a matched cohort study survey on a nationally representative total population of residents in all sheltered housings in Sweden, and a matched control group (n = 3,805). The data collection took place between October 2016 and January 2017. The survey assessed functional capability using the Katz ADL and Lawton IADL scale, self-rated health using the EQ5D scale, and depressive mood using the GDS-4 scale. Descriptive statistics, frequencies, mean scores, independent t tests, p-values and effect sizes were utilised to compare the two groups. The results of the study show that older people living in sheltered housing, compared to ageing in place, had lower self-reported health (M = 64.68/70.08, p = <0.001), lower self-reported quality of life (M = 0.73/0.81, p = <0.001), lower functional status concerning activities of daily living (M = 5.19/5.40, p = <0.001), lower functional status concerning instrumental activities of daily living (M = 4.98/5.42 p = <0.001,), and higher probability of depressive mood (M = 0.80/0.58, p = <0.001). The results imply that residents in sheltered housing may have more care needs than those ageing in place. Further longitudinal comparative studies are needed to explore the impact residence in sheltered housing has on resident health and well-being.

  • 9.
    Edvardsson, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Australia.
    Backman, Annica
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bergland, Ådel
    Björk, Sabine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bölenius, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Kirkevold, Marit
    Lindkvist, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lood, Qarin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Australia.
    Lämås, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden; Department of Health Sciences, Luleå University of Technology, Sweden.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sköldunger, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Wimo, Anders
    Winblad, Bengt
    The Umeå Ageing and health research programme (U-age): exploring person-centred care and health promoting living conditions for an ageing population2016Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, nr 3, s. 168-174Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this article is to describe the Umeå ageing and health research programme that explores person-centred care and health-promoting living conditions for an ageing population in Sweden, and to place this research programme in a national and international context of available research evidence and trends in aged care policy and practice. Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umeå ageing and health research programme consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.

  • 10.
    Edvardsson, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Juthberg, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Björk, L. S.
    Umeå universitet.
    Backman, A. C.
    Umeå universitet.
    Staffing, skill mix, quality of care and resident outcomes in swedish residential aged care2014Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, nr Suppl 2, s. 152-152Artikel i tidskrift (Övrigt vetenskapligt)
  • 11.
    Edvardsson, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe University/Austin Health Clinical School of Nursing, La Trobe University, Melbourne, Australia.
    Petersson, Lisa
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, Per-Olof
    Division of Nursing, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Everyday activities for people with dementia in residential aged care: associations with person-centredness and quality of life.2014Ingår i: International journal of older people nursing, ISSN 1748-3743, Vol. 9, s. 269-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Providing everyday activities is central to high quality residential aged care, but further research is needed on the association between activity participation, person-centred care and quality of life. AIMS AND OBJECTIVES: To explore the point-prevalence of participation in everyday activities for residents with dementia within a national sample of Swedish residential aged care units and to explore if residents participating in everyday activities lived in more person-centred units and/or had higher quality of life as compared to residents not participating in everyday activities. DESIGN AND METHODS: A cross-sectional design was used to collect valid and reliable questionnaire data on activity participation, unit person-centredness and quality of life in a sample of residents in residential aged care (n = 1266). RESULTS: Only 18% of residents participated in everyday activities such as making coffee, setting or clearing the table, cleaning or watering plants, 62% participated in outdoor walks, 27% participated in parlour games, and 14% and 13% participated in excursions and church visits, respectively. Those residents who had participated in everyday activities lived in more person-centred units, had significantly higher quality of life and higher cognitive scores as compared to those residents who had not participated in everyday activities. CONCLUSIONS: Even though the prevalence of resident participation in everyday activities was low, resident participation was significantly associated with unit person-centredness and resident quality of life. It seems that everyday activities that are routine and commonplace to residential aged care can be potent nursing interventions for promoting resident quality of life. IMPLICATIONS FOR PRACTICE: The study indicates that residents can benefit from participation in everyday activities that are commonly occurring in aged care practice. It seems that such everyday tasks and procedures can provide fruitful ways to make person-centred care happen in clinical practice, and ways to increasingly involve residents with cognitive impairment need to be further developed.

  • 12.
    Edvardsson, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Melbourne, Australia.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Taylor, Michael
    Melbourne, Australia.
    Edvardsson, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, P. O.
    Stockholm, Sweden.
    Person-centred climate questionnaire (PCQ-S): establishing reliability and cut-off scores in residential aged care2015Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, nr 3, s. 315-323Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AimThis study aimed to establish reliability and cut-off scores for the person-centred climate questionnaire - staff version (PCQ-S) in residential aged care. BackgroundA number of tools have emerged recently to measure person-centredness, and these need psychometric evaluation and cut-off scores to enhance utilisation and interpretation. MethodA cross-sectional survey design was employed in a Swedish sample of residential aged care staff (n=1237). Psychometric evaluation using Cronbach's alpha and item-total correlation was used, together with establishing cut-off scores based on quartile scores. ResultThe PCQ-S had satisfactory psychometric properties and the following total scale cut-off scores for unit person-centredness were suggested: 49 (well below average'), 50-56 (below average'), 57-62 (above average') and 63 (well above average'). These cut-off scores were clinically meaningful as they separated the sample into four groups in which staff in more person-centred units reported significantly higher work satisfaction, social support and less stress of conscience. ConclusionThe PCQ-S has reliability in residential aged care samples, and cut-off scores are provided that provide important fundaments for comparative studies and aggregation of data to explore person-centredness care further. Implications for nursing managementThe study enables managers with ways to measure, interpret and compare levels of person-centredness between units and facilities for research, practice development and/or benchmarking purposes.

  • 13.
    Edvardsson, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg 3084, VIC, Australia..
    Sjögren, Karin
    College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg 3084, VIC, Australia..
    Lood, Qarin
    College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg 3084, VIC, Australia..
    Bergland, Adel
    Kirkevold, Marit
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Division of Caring Sciences, Depart Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, University of Technology, Luleå, Sweden.
    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 trial2017Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, artikel-id 22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The 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.

    Methods: The 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.

    Discussion: The 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.

  • 14.
    Lood, Qarin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Australia.
    Björk, Sabine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sköldunger, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Backman, Annica
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Australia.
    The relative impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations: cross-sectional findings from U-Age Swenis2017Ingår i: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 24, nr 3, s. 327-337Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Social occupations have been described as meaningful occupations, and a determinant of health in old age. With ageing populations, and increased need for nursing home care, it is therefore important to support participation in social occupations in nursing homes. However, the limited evidence on factors that may have an impact on nursing home residents’ participation in social occupations makes it difficult to know how and when to support their participation and who to target. Therefore, the aim of this study was to explore the impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations. In a sample of 4,451 nursing home residents, the average number of social occupations participated in during the week preceding data collection was 5.8. Additionally, participation in social occupations was positively influenced by fewer symptoms of cognitive impairment, female sex, shorter length of stay, and living in a dementia specific care unit. The study thereby contributes with knowledge on populations at risk for occupational deprivation, and implications for understanding who to target with interventions to promote social occupations and when. However, very little is known about how to design interventions to support nursing home residents’ occupational opportunities, and what occupations they desire and need. Further research is therefore needed to identify nursing home residents’ occupational opportunities, wishes and needs in relation to environmental barriers, individual characteristics, and individual choice.

  • 15.
    Lood, Qarin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health – AgeCap, University of Gothenburg, Gothenburg, Sweden; College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Heidelberg, Vic., Australia.
    Kirkevold, Marit
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bergland, Ådel
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden; Department of Health Sciences, Luleå University of Technology, Sweden.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Heidelberg, Vic., Australia.
    Associations between person-centred climate and perceived quality of care in nursing homes: a cross-sectional study of relatives' experiences2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 16.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Personcentrerad vård i särskilda boenden för äldre2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Bakgrund: Andelen äldre i befolkningen ökar nationellt och internationellt, och med ökande ålder ökar både fysisk och psykisk ohälsa. Äldre personer med ohälsa i form av kognitiv svikt (oftast demenssjukdom) kan bli beroende av vård och omsorg i särskilda boenden för äldre för att kunna känna trygghet och välbefinnande samt ha ett gott liv, i gemenskap med andra. Dock visar utvärderingar av särskilda boenden för äldre att vården ofta kan vara uppgiftscentrerad och inte motsvara de äldres individuella behov och önskemål. Personcentrerad vård är en vårdmodell som beskrivs kunna tillgodose äldre personers multidimensionella behov och önskemål, genom att personens livshistoria, personlighet, kapacitet och perspektiv uppmärksammas, respekteras och inkluderas i vården. Den vetenskapliga litteraturen inom området visar dock att det finns begränsad kunskap om förekomsten av personcentrerad vård i särskilda boenden för äldre i Sverige och internationellt, liksom om vilka faktorer som är mest betydelsefulla för att särskilda boenden för äldre ska bedriva en personcentrerad vård.

    Syfte: Syftet med denna avhandling var att beskriva faktorer som samvarierar med förekomst av personcentrerad vård i särskilda boenden för äldre i Sverige.

    Metod: Samtliga delstudier var tvärsnittstudier och data samlades in genom enkäter till äldre med kognitiv svikt och personal i särskilda boenden för äldre i Sverige. I studie I bestod insamlad data av skattningar av personcentrerad vård från vårdpersonal (n=1465) i 182 särskilda boendeenheter. I studie II insamlades data i form av vårdpersonalens (n=1169) skattningar av personcentrerad vård och proxyskattningar av de äldres (n=1261) livskvalitet, ADL-förmågor, smärta, depressiva symtom och agitation i 151 särskilda boendeenheter. Delstudie III baserades på data i form av personalskattningar (n=1169) av personcentrerad vård, tillfredställelse med arbete och vård, samvetsstress, arbetsbelastning och psykosocialt klimat i samma 151 särskilda boendeenheter. Även delstudie IV baserades på data från de 151 särskilda boendeenheterna och inkluderade skattningar av de äldre och vårdpersonal, men också skattningar av organisation och miljö vid dessa enheter (n=151). Samtliga studiernas data analyserades med hjälp av statistiska analyser, beskrivande, bivariata och multivariata analysmetoder.

    Resultat: Studie I visade att enkätinstrumentet The Person-Centred Care Assessment Tool (P-CAT) har tillfredställande psykometriska egenskaper för intern konsistens och test-retest-reliabilitet. Instrumentet består av två subskalor: Individualisering av vården och Stöd från organisation och miljö. Delstudie II visade att de boendes ADL-förmågor och livskvalitet skattades bättre vid enheter som kan beskrivas som mer personcentrerade. Delstudie III visade att en mer personcentrerad vård har samband med att personalen upplever ett positivt psykosocialt klimat, mindre samvetsstress, lägre arbetsbelastning samt högre tillfredställelse med vård och arbete. Studien visade också att personcentrerad vård var positivt relaterat till i vilken omfattning vårdarna hade vidareutbildning i demensvård. Delstudie IV visade att vårdmiljön var mest betydelsefull för förekomsten av personcentrerad vård vid boendeenheterna och att en gynnsam vårdmiljö innebar att personal upplevde att det var ett positivt psykosocialt klimat på enheten, att de hade tid att prata med eller bara vara med de boende samt att de upplevde sig ha en gemensam värdegrund, låg arbetsbelastning och en fysisk miljö som var anpassad till de boendes behov.

    Slutsatser: Resultaten i avhandlingen visar att den svenska versionen av P-CAT kan användas för valida och reliabla utvärderingar av personcentrerad vård samt att den kan rekommenderas för fortsatt forskning och vårdutveckling inom särskilda boenden för äldre. Resultatet visar också att den vård- och arbetsmiljö som omger de äldre och vårdpersonal i särskilda boenden för äldre är betydelsefull för förekomsten av personcentrerad vård. Dessa aspekter behöver fokuseras ytterligare för att kunna erbjuda en personcentrerad vård. Vidare är det psykosociala klimatet och förekomsten av en upplevd gemensam värdegrund viktig att förstå och prioritera om vården ska utvecklas mot en ökad personcentrering. Fortsatt forskning och kliniskt utvecklingsarbete behövs för att operationalisera och implementera de komponenter som bidrar till ett positivt psykosocialt klimat och en personcentrerad värdegrund på särskilda boenden för äldre. Dessutom behövs en ökad förståelse för hur en sådan värdegrund kan omsättas i personcentrerade interaktioner, handlingar, aktiviteter och prioriteringar. Det vore alltså önskvärt att äldrevården utvecklades mot ett mer personcentrat förhållningssätt, eftersom avhandlingens resultat visar att högre grad av personcentrerad vård i särskilda boenden för äldre var positivt relaterat till välbefinnande och tillfredställelse för såväl de äldre som för vårdpersonal.

  • 17.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, Per-Olof
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutetet.
    Zingmark, Karin
    Research Department, County Council of Norrbotten.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Characteristics of person-centred residential aged care unitsManuskript (preprint) (Övrigt vetenskapligt)
  • 18.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden ; Division of Caring Sciences, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Zingmark, Karin
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study2017Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, artikel-id 44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Few studies have empirically investigated factors that define residential aged care units that are perceived as being highly person-centred. The purpose of this study was to explore factors characterising residential aged care units perceived as being highly person-centred, with a focus on organisational and environmental variables, as well as residents' and staff' characteristics.

    METHODS: A cross-sectional design was used. Residents (n = 1460) and staff (n = 1213) data from 151 residential care units were collected, as well as data relating to characteristics of the organisation and environment, and data measuring degree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents. Descriptive and comparative statistics, independent samples t-test, Chi(2) test, Eta Squared and Phi coefficient were used to analyse data.

    RESULTS: Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a satisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementia-friendly physical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care units with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia care, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of person-centred care.

    CONCLUSIONS: It is important to target organisational and environmental factors, such as a shared philosophy of care, staff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to improve person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in daily practice need to consider their own role in supporting, encouraging, and supervising staff.

  • 19.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, Per-Olof
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutetet.
    Zingmark, Karin
    Research Department, County Council of Norrbotten.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Person-centredness and its association with resident well-being in dementia care units2013Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, nr 10, s. 2196-2205Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To report a study of the relationship between person-centred care and ability to perform activities of daily living, quality of life, levels of pain, depressive symptoms, and agitated behaviours among residents with dementia in residential care facilities.

    Background: Standardized measurements of person-centred care have not previously been used to investigate the relationship between person-centred care and well-being for residents with dementia in residential aged care units.

    Design: This study had a cross-sectional design.

    Method: Staff and resident surveys were used in a sample of 1261 residents with dementia and 1169 staff from 151 residential care units throughout Sweden. Valid and reliable scales were used to measure person-centredness and ability to perform activities of daily living, quality of life, levels of pain, depressive symptoms, and agitated behaviours in residents. All data were collected in May 2010.

    Findings: Person-centred care was correlated with residents' ability to perform activities of daily living. Furthermore, residents in units with higher levels of person-centred care were rated as having higher quality of life and better ability to perform activities of daily living compared with residents in units with lower levels of person-centred care.

    Conclusions: There seems to be a relationship between person-centredness, residents' ability to perform activities of daily living, and residents' quality of life. Further studies are needed to explain the variation of person-centredness between units and the extent and ways this might impact on the quality of life and well-being of frail older residents with cognitive impairments in clinical practice.

  • 20.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Sandman, Per-Olof
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutetet.
    Zingmark, Karin
    Research Department, County Council of Norrbotten.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Psychometric evaluation of the Swedish version of the Person-Centered Care Assessment Tool (P-CAT)2012Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 24, nr 3, s. 406-415Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Person-centered care is a multidimensional concept describing good care, especially within aged care and care for people with dementia. Research studies evaluating person-centered care interventions seldom use direct measurement of levels of person-centeredness. Existing scales that measure person-centeredness need further testing. This study evaluated the psychometric properties of the Swedish version of the Person-Centered Care Assessment Tool (P-CAT).

    Methods: A cross-sectional sample of 1465 staff from 195 residential care units for older people in Sweden participated in the study. Validity, reliability, and discrimination ability of the scale were evaluated.

    Results: Confirmatory factor analysis, parallel analysis and exploratory factor analysis supported the construct validity of a two-factor solution. Reliability and homogeneity were satisfactory for the whole P-CAT as demonstrated by a Cronbach's α of 0.75. Test-retest reliability showed temporal stability of the scale, and the discrimination ability of the scale was satisfactory.

    Conclusion: The Swedish version of the P-CAT was found to be valid, reliable, and applicable for further use. Two subscales are recommended for the Swedish version.

  • 21.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, Per-Olof
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutetet.
    Zingmark, Karin
    Research Department, County Council of Norrbotten.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    To what extent is the work environment of staff related to person-cented care? A cross-sectional study of residential aged care.Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background Person-centred care is often described as the model of choice in residential aged care and in the care of persons with dementia. Few empirical studies have reported on the relationship between person-centred care and how staff experience different aspects of their work.

    Aim To explore the relationship between person-centred care, staff characteristics and perceived work environment in residential aged care units.

    Method A cross sectional quantitative design was used. Staff in 151 residential aged care units in Sweden (n=1169) completed surveys which included questions about staff characteristics, valid and reliable measures of person-centred care, satisfaction with work and care, job strain, stress of conscience and psychosocial unit climate. Statistical analyses of correlations, group differences, and explanatory regression models were conducted.

    Results Higher levels of person-centred care was associated with higher levels of staff satisfaction, lower levels of job strain, lower levels of stress of conscience, higher levels of a supportive psychosocial unit climate, and a higher proportion of staff who had received continuing education in dementia care. A supportive psychosocial climate, i.e., where residents and staff experience safety, everydayness and community, explained most of the variation in person-centred care in the regression model.

    Conclusions This study shows that the work environment and psychosocial climate as perceived by staff, are associated with the extent to which staff perceive the care as being person-centred in residential aged care. These empirical findings support the theoretical postulation that the environment is an important aspect of person-centred care. Thus, promoting a positive and supportive psychosocial environment to enable person-centred care practice seems to be an important implication for managers and leaders in residential aged care.

    Keywords: Conscience, Cross sectional study, Environment, Job satisfaction, Nursing staff, Patient-centred care, Psychological stress, Residential facilities

  • 22.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindkvist, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sandman, Per-Olof
    Division of Nursing, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Zingmark, Karin
    Research Department, County Council of Norrbotten, Luleå, Sweden.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.
    To what extent is the work environment of staff related to person-centred care?: A cross-sectional study of residential aged care2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 9-10, s. 1310-1319Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the relationship between staff characteristics, perceived work environment and person-centred care in residential aged care units.

    BACKGROUND: Person-centred care is often described as the model of choice in residential aged care and in the care of persons with dementia. Few empirical studies have reported on the relationship between how staff experience different aspects of their work and person-centred care.

    DESIGN: The study had a cross-sectional quantitative design.

    METHODS: Staff in 151 residential aged care units in Sweden (n = 1169) completed surveys which included questions about staff characteristics, valid and reliable measures of person-centred care, satisfaction with work and care, job strain, stress of conscience and psychosocial unit climate. Statistical analyses of correlations, group differences and multiple linear regression analysis estimated with generalised estimating equation were conducted.

    RESULTS: Higher levels of staff satisfaction, lower levels of job strain, lower levels of stress of conscience, higher levels of a supportive psychosocial unit climate and a higher proportion of staff with continuing education in dementia care were associated with higher levels of person-centred care. Job strain and a supportive psychosocial climate, explained most of the variation in person-centred care.

    CONCLUSIONS: This study shows that the work environment as perceived by staff is associated with the extent to which staff perceive the care as being person-centred in residential aged care. These empirical findings support the theoretical postulation that the work environment is an important aspect of person-centred care.

    RELEVANCE TO CLINICAL PRACTICE: Promoting a positive and supportive psychosocial climate and a work environment where staff experience balance between demands and control in their work, to enable person-centred care practice, seems to be important implications for managers and leaders in residential aged care.

  • 23.
    Sjögren, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Petersson, L
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Everyday activities are associated with higher resident quality of life2012Ingår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 52, nr S1, s. 451-451Artikel i tidskrift (Övrigt vetenskapligt)
  • 24.
    Sköldunger, Anders
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.
    Wimo, Anders
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Björk, Sabine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Backman, Annica C.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Resource use and its association to cognitive impairment, ADL functions, and behavior in residents of Swedish nursing homes: Results from the U-Age program (SWENIS study)2019Ingår i: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 34, nr 1, s. 130-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: We aimed to investigate resource use and its association to cognitive impairment, activities of daily living, and neuropsychiatric symptoms in residents of Swedish nursing homes.

    Methods: Data were collected in 2014 from a Swedish national sample of nursing home residents (n = 4831) and were collected by staff in the facility. The sample consists of all nursing homes in 35 of 60 randomly selected Swedish municipalities. Demographic data and data on resource use, cognitive and physical function as well as neuropsychiatric symptoms were collected through proxies. Descriptive statistics and regression modeling were used to investigate this association.

    Results: We found that cognitive impairment, activities of daily living, and neuropsychiatric symptoms were associated with 23 hours per week increase in total resource use versus cognitively intact persons. This was also the case for being dependent in activities of daily living. Being totally dependent increased the amount of resource use by 25 hours per week. The sex of a resident did not influence the resource use. Annual costs of resource use with no functional dependency were 359 685 SEK, and in severely cognitive impaired resident, the cost was 825 081 SEK.

    Conclusion: Being cognitively impaired as well as functionally dependent increases the resource use significantly in nursing homes. This has implications for differentiation of costs in institutional settings in health economic evaluations.

  • 25. Vassbø, Tove K.
    et al.
    Kirkevold, Marit
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe University, Melbourne, Vic., Australia.
    Sjögren, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lood, Qarin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe University, Melbourne, Vic., Australia; University of Gothenburg, Gothenburg, Sweden.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden.
    Bergland, Ådel
    Associations between job satisfaction, person-centredness, and ethically difficult situations in nursing homes: A cross-sectional study2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, nr 5, s. 979-988Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To explore the associations between job satisfaction and perceived person-centredness and ethically difficult situations among staff in nursing homes (NHs).

    BACKGROUND: Previous studies have indicated that person-centredness and few ethically difficult situations can contribute positively to NH staff's job satisfaction. However, empirical evidence of these associations is lacking.

    DESIGN: Cross-sectional survey design.

    METHOD: Nursing home staff (N = 341) in six NHs in Australia, Norway, and Sweden completed the questionnaire measuring job satisfaction, person-centredness, and ethically difficult situations. Data were collected between April - June 2016. Univariate analysis was used to describe the sample, one-way analysis of variance examined differences between variables. Bivariate correlation tested the relationships between variables and hierarchical multiple regression explored the extent to which person-centredness and ethically difficult situations could explain job satisfaction among staff.

    RESULTS: After controlling for socio-demographic variables in a regression model, three variables of person-centredness and "ethically difficult situations" were significantly associated with job satisfaction. A "climate of community" contributed the most, followed by the "amount of organizational and environmental support," "a climate of everydayness," and few "ethically difficult situations."

    CONCLUSION: The results support the theoretical foundation and previous findings suggesting that establishing NHs organizations based on person-centredness will increase staff job satisfaction. However, this is a cross-sectional study and the causality may go in both directions and should be further explored.

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