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The objective of this study was to culturally adapt the Thriving of Older People Assessment Scale (TOPAS) instrument and evaluate its psychometric properties. The study was carried out in two phases: cross-cultural adaptation and psychometric validation and refinement through a cross-sectional study conducted between 2018 and 2020 with 314 participants. The refinement resulted in an abbreviated version of TOPAS, maintaining the original 5 factors with 16 items. Cronbach alpha was 0.91. Composite reliability (0.72–0.89) and average variance extracted (0.57–0.81), supporting discriminant validity. Maximum shared variance for the factors (0.22–0.50) and average shared variance (0.16–0.31), demonstrating discriminant validity. The abbreviated version of TOPAS showed evidence of being a valid and reliable instrument for measuring the adaptability of elderly residents in institutions. Implementing this instrument in Spanish nursing homes allows for a continuous evaluation of residents' well-being in relation to their environment, a construct not previously assessed with available scales.

In Sweden, sheltered housing is a housing model that provides accessible apartments with elevated social possibilities for older people. The environment within sheltered housing is expected to support resident health and reduce the need for care services. A previous study has shown that with increasing levels of depressive mood and decreasing levels of self-rated health and functional status, those residing in sheltered housing report higher levels of thriving compared to those ageing in place. Therefore, the aim of this study was to illuminate aspects of sheltered housing that are facilitators and/or barriers to thriving. Seven semi-structured group interviews in five different sheltered housing accommodations in Sweden were conducted between April 2019 and January 2020 (N = 38). The results, analysed using qualitative content analysis and presented in a model developed by Grol and Wensing, illuminate the four main categories of facilitators and barriers to thriving: individual factors, social context, environmental factors and organisational context. The results of this study show that the factors that influence experiences of thriving in sheltered housing are multifaceted and interconnected. Although the supportive environment provided in sheltered housing seems to contribute to thriving, the limited consideration towards the shifting health of residents is a barrier to thriving. The results of this study may assist in implementing tailored interventions to help support thriving on various levels.

Background: The relevance of person-centred care as an optimising approach to the quality of care provided to older adults has sparked the development of important instruments that measure this approach at residential care facilities and requires validation for the Portuguese population.

Objectives: This study aims to adapt and validate the Person-centered Care Assessment Tool (P-CAT) to the Portuguese population.

Methods: The P-CAT assesses the level of person-centred care provided by residential care facilities, according to staff. The process of adapting the P-CAT to the Portuguese population includes its translation, backtranslation and a pilot study. To recruit participants for the validation study, we contacted the Portuguese residential care facilities with emails provided in the official registries, and the study was also divulged on social media.

Results: The study had the participation of 573 staff members. The mean score of P-CAT was 50.76 (SD = 7.65). The exploratory factor analysis showed three dimensions: the extent of care personalisation, the amount of organisational support and the degree of environmental accessibility. The results show good internal consistency for the total scale (α = 0.809) and good temporal stability in the test–retest assessed by intraclass correlation coefficient (0.893).

Conclusions: This version of the P-CAT for the Portuguese population has shown adequate psychometric properties and contributes to the study of care provided at residential care facilities in Portugal through self-reporting from staff.

Implications for practice: The availability of this instrument is useful for professional practice and research purposes and supports technical and scientific advancements that are necessary for the evolution of care frameworks.

Background: Promoting healthy work environment as a manager in nursing homes is important to safeguard staff health and well-being as well as care quality when facing increasing demands. The impact of leadership on staff work environment needs further exploration.

Objectives: To describe longitudinal changes in nursing home leadership, direct care staff characteristics, job strain and social support.

Methods: This study has a repeated cross-sectional design, a five-year follow-up study. Nursing home staff in 181 corresponding units (n = 1253 in 2014 and n = 1176 in 2019) completed surveys about leadership, staff job strain and social support in a five-year follow-up study. Descriptive and regression analyses were conducted.

Results: A higher degree of leadership defined by coaching and providing direct feedback to care staff, handling conflicts in a constructive way and having control of the clinical work, was significantly associated with a lower degree of job strain and a higher degree of social support among staff, with stronger associations at follow-up. The proportion of enrolled nurses increased significantly at follow-up.

Conclusions: Leadership is increasingly important for staff work environment, especially in times of increased workload and decreasing collegiality and deteriorating work atmosphere at work. Implications for Practice: Stakeholder and policy makers in nursing home care may reflect on how managers' leadership is prioritised in these environments because such leadership is associated with staff job strain and social support. Managers striving to improve the work situation of staff may consider their own role and allow flexibility in how and when the work can be performed.

Background: Self-determination has been shown to be an important factor in mental health and wellbeing, but from the homecare recipients' point of view, autonomy and self-determination is not fully integrated into homecare services. The aim of this study was to explore older adults’ experiences of self-determination when needing homecare services.

Methods: In 2018, a qualitative descriptive study was conducted and a convenience sample of 15 older adults from 3 homecare service facilities were invited to participate in individual interviews. Data were analysed using qualitative content analyse.

Results: The theme Transitioning from self-determination as independence towards self-determination as shared decision-making emerged through the older adults' narratives. This ‘transition’ is one in which older adult’s understanding of self-determination and self-esteem was transitioning towards the acceptance of shared decision-making. The person's inner strength and willingness to make decisions was promoting to enact and preserve independence. Accepting one's dependence on others and being in a positive atmosphere were described as promoting self-determination and shared decision-making, and vice versa. The above overarching theme permeated all subthemes, which included: mobilising inner strength to enact independence; accepting increasing dependence on others; and being influenced by the atmosphere.

Conclusions: The study contributes increased understanding of older adults' experiences of self-determination. The results can act as a guide when planning future person-centred care interventions in the context of homecare services and help improve homecare services' ability to meet the needs of older adults. To summarise, older adults' reflections on their own self-determination highlighted relationships with other people as important for shared decision-making, which could help preserve older adults’ autonomy and self-esteem.

Background: The number of Indonesian care staff working in hospitals and long-term care facilities caring for persons with dementia in Japan is increasing; however, there is no instrument available in the Indonesian language to assess their dementia care practice.

Objectives: This study aimed to translate the Person-centered Care Assessment Tool (P-CAT) and evaluate its psychometric properties in a sample of Indonesian care staff working in dementia care and long-term care facilities in Japan.

Methods: This is a descriptive, methodological, and cross-sectional study. The P-CAT was translated into the Indonesian language. The draft was administered to Indonesian care staff (n = 218) working at long-term care facilities in Japan. Data were analysed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), known-group validity, internal consistency, and test-retest reliability.

Results: EFA showed three-factor and CFA of the three-factor indicated that the model had an acceptable fit (chi-squared statistics/degree of freedom = 1.78, comparative fit index = 0.94, root mean square error of approximation = 0.06) with a slightly different structure compared to the original P-CAT. Regarding known-group validity, the P-CAT total score was significantly higher for those who had training in dementia, who knew about person-centred care, and who showed satisfaction in the job. Internal consistency (Cronbach's a) of the total scale was 0.68 which is considered acceptable, and the test-retest reliability intraclass correlation coefficient was 0.61 which is considered moderate.

Conclusion: The Indonesian P-CAT indicated sound validity and reliability to measure person-centred care among Indonesian care staff working in dementia care and long-term care facilities in Japan.

Implication for Practice: The development of Indonesian P-CAT allows the evaluation of dementia care, promotes and further improves person-centred care for persons with dementia provided by Indonesian care staff working in long-term care facilities in Japan.

A reported objective of Swedish sheltered housing is to postpone care needs and relocation. The aim of this study was to describe migration patterns and explore predictors of relocation to nursing homes and mortality, in a sample of residents in sheltered housing and aging in place. To explore longitudinal differences between groups, study data were combined with registry data. The results showed that a higher percentage of residents in sheltered housing had relocated to a nursing home and deceased over a three-year time period, compared to aging in place, implying further interventions may be required to promote health in sheltered housing.

Aim: To evaluate patients’ and family members’ perceived support from light and color before, compared with after an evidence-based design (EBD) intervention at an emergency department (ED) using a validated instrument—the Light and Color Questionnaire (LCQ).

Background: EDs offer acute care day and night. Thus, a supportive physical environment where light and color is crucial for how the milieu is experienced is vital. Research is limited on how care settings are perceived as supportive by users.

Methods: Quasi-experimental evaluation of the refurbishing and remodeling of an ED by an expert group of nurse managers, nursing staff, nursing researchers and architects in south Sweden. LCQ includes dimensions “maximizing awareness and orientation,” “maximizing safety and security,” “supporting functional abilities,” “providing privacy,” “opportunities for personal control” (not for LCQ-Color), and “regulation and quality of stimulation.” LCQ was analyzed and compared in 400 surveys from 100 patients and 100 family members before the intervention and 100 patients and 100 family members after the intervention.

Results: The LCQ total score significantly improved after the intervention for both patients and family members. Four of the six dimensions of LCQ Light subscale scores were significantly higher for family members, and three of the six dimensions were significantly higher for patients after the intervention. The LCQ Color subscale score showed significant improvements for all five dimensions for both patients and family members after the intervention.

Conclusion: This study showed improved perceived support from light and color in the physical environment for patients and family members after an EBD intervention at an emergency department using a validated instrument—the Light and Color Questionnaire.

Introduction: Previous research suggests that person-centred care is positive for people living in nursing homes, but less is known on what motivates people working in nursing homes to be person-centred. Previous research has focused on person-centred care in relation to people in need of care, which may lead to a risk of viewing person-centred care as a means to achieve quality of care, and not as a means in itself. Therefore, this study aimed to illuminate meanings of being person-centred as narrated by people working in nursing homes.

Methods: A total of 23 persons working in a nursing home in rural Australia participated in group and individual interviews, conducted and interpreted in respect to a phenomenological hermeneutic approach.

Results: The thematic structure as emerging from structural analyses of the text indicated that being person-centred involved a joint effort to think differently on what you do and why you do it interpreted as; Doing what you know and feel is the right thing to do, Being a person with and for another person, and Striving to do and be better together. The comprehensive understanding of these findings was that being person-centred means becoming part of an upwards spiral of doing person-centred actions and being person-centred to become even more person-centred and to feel a sense of belonging to a person-centred culture.

Conclusions: Denoting the importance of being more of a person in one's professional role, this study highlights health aspects of being person-centred from the perspective of people working in nursing homes, and complements previous research that describes the impact of person-centred care on people in need of care. The findings could be applied to facilitate person-centred care in nursing home contexts, and to develop prevention strategies to diminish negative impacts on person-centred doing, being, becoming and belonging.

Aim: To evaluate the effects of a person-centred and thriving-promoting intervention on nursing home residents´ experiences of thriving and person-centredness of the environment, and to evaluate if the effects varied between female and male residents.

Design: A multi-centre, non-equivalent controlled group before-after intervention design.

Methods: Six nursing homes in Australia, Norway and Sweden were allocated to either intervention or control group. The intervention comprised a staff educational programme. A survey using proxy-ratings by staff was administered before (T0), immediately after (T1) and six months after (T2) the intervention. The sample varied between 205 and 292 residents. Linear regression models were used to explore effects.

Results: Statistically significant effects were found on experiences of thriving and person-centredness of the environment. These effects were significant for male residents but not for female residents. The results emphasize the importance of individually tailored social and recreational activities.