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McKee, K., Nordin, S. & Elf, M. (2019). Developmentand initial validation of the Staff Perception Of Residential care Environments(SPORE) instrument. In: : . Paper presented at The International Association of Gerontology and Geriatrics European Region Congress 2019 (IAGG-ER). 23-25 May 2019 in Gothenburg.
Open this publication in new window or tab >>Developmentand initial validation of the Staff Perception Of Residential care Environments(SPORE) instrument
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Staff perceptions of the health care environment influence the delivery of person-centred care.  Little research has examined staff perceptions of health care environments, in part because of a lack of validated instruments.  This study reports the development and initial validation of the Staff Perception Of Residential care Environments (SPORE) instrument for use in residential care facilities for older people (RCFs).

Items developed in a British project on the design of care environments were translated and adapted for the Swedish care context as SPORE (24 items, 5 sub-scales).  In a study of the physical environment and quality of care, 200 staff recruited from 20 RCFs sampled from across Sweden completed a questionnaire containing SPORE, the Person-centred Care Assessment Tool (PCAT), the Person-centred Climate Questionnaire – staff version (PCQ-S), and the Sheffield Care Environment Assessment Matrix –Sweden (SCEAM-S).

All SPORE sub-scales were normally distributed with good internal consistency reliability (Cronbach αs=.85-.88). Correlations between SPORE and PCAT sub-scales ranged from .301-.503, and between SPORE and PCQ-S sub-scales from .353-.557.  RCF-level analyses (N=20) indicated that scores on SCEAM overall environment quality correlated significantly with all SPORE sub-scales (range=.496-.700).  The SCEAM Comfort sub-scale was correlated with all SPORE sub-scales (range=.509-.721), while the SCEAM Privacy sub-scale was correlated (r=.428) with the SPORE Staff Facilities sub-scale.  The SPORE Working and Caring for Residents sub-scale was correlated with SCEAM cognitive support (r=.502) and physical support (r=.566) sub-scales.

The SPORE instrument demonstrated good psychometric properties and its sub-scales an excellent range of associations with staff perceptions of person-centred care and with objective assessments of the physical environment.  Further validation is required, but the SPORE instrument has potential for understanding how staff perceptions of the RCF environment relate to the delivery of person-centred care.

National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30275 (URN)
Conference
The International Association of Gerontology and Geriatrics European Region Congress 2019 (IAGG-ER). 23-25 May 2019 in Gothenburg
Available from: 2019-06-18 Created: 2019-06-18 Last updated: 2019-06-19Bibliographically approved
Nordin, S., Dahlberg, L., McKee, K. & Elf, M. (2019). Technology to support decision-making for older people with dementia. In: : . Paper presented at IAGG 2019 The International Association of Gerontology and Geriatrics European Region Congress 2019, 23-25 May, Gothenburg.
Open this publication in new window or tab >>Technology to support decision-making for older people with dementia
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29866 (URN)
Conference
IAGG 2019 The International Association of Gerontology and Geriatrics European Region Congress 2019, 23-25 May, Gothenburg
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-04-11Bibliographically approved
Nordin, S., McKee, K. & Elf, M. (2018). Staff perceptions of the design of care environments for older people – a qualitative study. In: : . Paper presented at 24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018..
Open this publication in new window or tab >>Staff perceptions of the design of care environments for older people – a qualitative study
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Staff perceptions of the design of care environments for older people – a qualitative study

Background: Although research has shown the important role played by the physical care environment for residents and staff of residential care facilities (RCFs) for older people, few studies have taken the care staff perspective regarding how the environment influences their ability to provide high quality care. This paper considers care staff perceptions of older people’s RCFs.

Methods: Twenty RCFs in Sweden were purposively sampled to obtain facilities with varying building design, type of ownership, year of construction, building size and geographic location. From each RCF, ten staff were randomly selected and recruited by the care home managers. Staff completed the Staff Perception of Older People’s Residential Care Environments (SPORE) questionnaire. Written responses to open-ended questions on the care environment were analysed using qualitative content analysis.

Results: Several needs and deficiencies in the care environment were identified. The participants described problems with limited spaces and non-functional building design, and restricted access to outside areas. They also expressed the need for physical and cognitive support in the care environment such as handrails, hoists, adequate lighting and colour coding.

Conclusions: There is potential for improving the design of RCFs for older people to provide safe and supportive care environments for residents and to facilitate care delivery, by taking  the needs of the building users into account in future planning and design processes.

National Category
Health Sciences
Research subject
Health and Welfare; Health and Welfare
Identifiers
urn:nbn:se:du-27971 (URN)
Conference
24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018.
Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-06-20Bibliographically approved
Nordin, S. & Elf, M. (2018). The Importance of the Physical Environment to Support Individualised Care. In: Riitta Suhonen, Minna Stolt and Evridiki Papastavrou (Ed.), Individualized Care - Theory, Measurement, Research and Practice: (pp. 207-215). USA: Springer
Open this publication in new window or tab >>The Importance of the Physical Environment to Support Individualised Care
2018 (English)In: Individualized Care - Theory, Measurement, Research and Practice / [ed] Riitta Suhonen, Minna Stolt and Evridiki Papastavrou, USA: Springer, 2018, p. 207-215Chapter in book (Other academic)
Abstract [en]

The physical environment is an important part of individualised care. Creating care environments tailored towards the individual person’s needs is essential for high-quality care and is increasingly recognized as being associated with improved health and well-being among older people. Today, care should be holistic and view the person behind the disease, taking that person’s perspective and treating the patient as a unique individual. Despite the emerging focus on individualised care approaches, the physical environment is still not considered as an integral part of care, and relatively little attention has been paid to environmental aspects. However, the physical environment has a great potential to facilitate or restrict care processes in a broad range of care settings, not least in residential care facilities for older people. The present chapter focuses on ways to support the individual in terms of the physical environment.

Place, publisher, year, edition, pages
USA: Springer, 2018
Keywords
Care environment, Design, Health outcomes, Individual needs, Individualised care
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27973 (URN)10.1007/978-3-319-89899-5_19 (DOI)2-s2.0-85064825293 (Scopus ID)978-3-319-89899-5 (ISBN)9783319898988 (ISBN)
Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2019-05-14Bibliographically approved
Elf, M., Nordin, S., Wijk, H. & McKee, K. (2017). A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare. Journal of Advanced Nursing, 73(12), 2796-2816
Open this publication in new window or tab >>A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare
2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2796-2816Article in journal (Refereed) Published
Abstract [en]

AIM: To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties.

BACKGROUND: The physical healthcare environment is regarded as a quality factor for healthcare. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment.

DESIGN: Systematic psychometric review.

DATA SOURCES: A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016).

REVIEW METHOD: COSMIN guidelines were used to evaluate psychometric data reported.

RESULTS: Twenty-three instruments were included. Most of the instruments are intended for for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.

CONCLUSIONS: Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators is user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required. 

Keywords
evidence-based design; healthcare facilities; measurement instruments; nursing; older adults; physical healthcare environment; systematic psychometric review
National Category
Nursing Social Work
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-24413 (URN)10.1111/jan.13281 (DOI)28207946 (PubMedID)
Note

Open Access APC beslut 5/2017

Available from: 2017-02-21 Created: 2017-02-21 Last updated: 2017-12-01Bibliographically approved
Anåker, A., Heylighen, A., Nordin, S. & Elf, M. (2017). Design quality in the context of healthcare environments: a scoping review. Health Environments Research & Design Journal, 10(4), 136-150
Open this publication in new window or tab >>Design quality in the context of healthcare environments: a scoping review
2017 (English)In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, no 4, p. 136-150Article in journal (Refereed) Published
Abstract [en]

Objective:

We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare.

Background:

High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects.

Method:

The basic principles of Arksey and O’Malley’s model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context.

Results:

Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition.

Conclusions:

Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

Keywords
design quality, evidence-based design, healthcare architecture, hospital design and construction, physical environment
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-23357 (URN)10.1177/1937586716679404 (DOI)000404161700013 ()28643560 (PubMedID)
Available from: 2016-11-15 Created: 2016-11-15 Last updated: 2017-08-01Bibliographically approved
Nordin, S., McKee, K., Wijk, H. & Elf, M. (2017). Exploring environmental variation in residential care facilities for older people. Health Environments Research & Design Journal, 10(2), 49-65
Open this publication in new window or tab >>Exploring environmental variation in residential care facilities for older people
2017 (English)In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, no 2, p. 49-65Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of this study was to explore variation in environmental quality in Swedish residential care facilities (RCFs) using the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM).

BACKGROUND: Well-designed physical environments can positively impact on health and well-being among older persons with frail health living in RCFs and are essential for supporting person-centered care. However, the evidence base for informing the design of RCFs is weak, partly due to a lack of valid and reliable instruments that could provide important information on the environmental quality.

METHODS: Twenty RCFs were purposively sampled from several regions, varying in their building design, year of construction, size, and geographic location. The RCFs were assessed using S-SCEAM and the data were analyzed to examine variation in environmental quality between and within facilities.

RESULTS: There was substantial variation in the quality of the physical environment between and within RCFs, reflected in S-SCEAM scores related to specific facility locations and with regard to domains reflecting residents' needs. In general, private apartments and dining areas had high S-SCEAM scores, while gardens had lower scores. Scores on the safety domain were high in the majority of RCFs, whereas scores for cognitive support and privacy were relatively low.

CONCLUSIONS: Despite high building standard requirements, the substantial variations regarding environmental quality between and within RCFs indicate the potential for improvements to support the needs of older persons. We conclude that S-SCEAM is a sensitive and unique instrument representing a valuable contribution to evidence-based design that can support person-centered care.

Keywords
assessment; long-term care facility; older people; person-centered care; physical environment
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-21601 (URN)10.1177/1937586716648703 (DOI)000400141500005 ()27240564 (PubMedID)
Available from: 2016-06-03 Created: 2016-06-03 Last updated: 2017-06-21Bibliographically approved
Nordin, S., McKee, K., Wijk, H. & Elf, M. (2017). The association between the physical environment and the well-being of older people in residential care facilities: a multilevel analysis. Journal of Advanced Nursing, 73(12), 2942-2952
Open this publication in new window or tab >>The association between the physical environment and the well-being of older people in residential care facilities: a multilevel analysis
2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2942-2952Article in journal (Refereed) Published
Abstract [en]

AIMS: To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities.

BACKGROUND: Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognised, more research is needed.

DESIGN: A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data was nested in the facilities, a multilevel analysis was conducted.

METHODS: Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument.

RESULTS: Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being.

CONCLUSION: Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high quality specifications. 

Keywords
long-term care, multi-level modelling, nursing, older people, physical environment, residential care facility, well-being
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-25123 (URN)10.1111/jan.13358 (DOI)28586513 (PubMedID)
Note

Open Access APC beslut 19/2017

Available from: 2017-06-08 Created: 2017-06-08 Last updated: 2017-12-01Bibliographically approved
Nordin, S., McKee, K., Wallinder, M., von Koch, L., Wijk, H. & Elf, M. (2017). The physical environment, activity and interaction in residential care facilities for older people: a comparative case study. Scandinavian Journal of Caring Sciences, 31(4), 727-738
Open this publication in new window or tab >>The physical environment, activity and interaction in residential care facilities for older people: a comparative case study
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2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 727-738Article in journal (Refereed) Published
Abstract [en]

The physical environment is of particular importance for supporting activities and interactions among older people living in residential care facilities (RCFs) who spend most of their time inside the facility. More knowledge is needed regarding the complex relationships between older people and environmental aspects in long-term care. The present study aimed to explore how the physical environment influences resident activities and interactions at two RCFs by using a mixed-method approach. Environmental assessments were conducted via the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM), and resident activities, interactions and locations were assessed through an adapted version of the Dementia Care Mapping (DCM). The Observed Emotion Rating Scale (OERS) was used to assess residents’ affective states. Field notes and walk-along interviews were also used. Findings indicate that the design of the physical environment influenced the residents’ activities and interactions. Private apartments and dining areas showed high environmental quality at both RCFs, whereas the overall layout had lower quality. Safety was highly supported. Despite high environmental quality in general, several factors restricted resident activities. To optimise care for older people, the design process must clearly focus on accessible environments that provide options for residents to use the facility independently.

Keywords
activities, case study, interactions, mixed-method, older people, physical environment, residential care facilities
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-23388 (URN)10.1111/scs.12391 (DOI)27862156 (PubMedID)
Note

Open Access APC beslut 16/2016

Available from: 2016-11-16 Created: 2016-11-16 Last updated: 2017-12-01Bibliographically approved
Shannon, M., Nordin, S., Anåker, A., Bernhardt, J. & Elf, M. (2017). Theoretical frameworks used in built environment research – a scoping review. In: : . Paper presented at ARCH17, International conference of health care architecture, Köpenhamn, Danmark, 25-28 April, 2017. Köpenhamn
Open this publication in new window or tab >>Theoretical frameworks used in built environment research – a scoping review
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2017 (English)Conference paper, Oral presentation only (Refereed)
Place, publisher, year, edition, pages
Köpenhamn: , 2017
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-25780 (URN)
Conference
ARCH17, International conference of health care architecture, Köpenhamn, Danmark, 25-28 April, 2017
Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2017-08-16Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3356-7583

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