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Promoting the person-centred aspects of dignity and well-being: learning from older persons’ experiences of living in residential care facilities
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0003-4449-2417
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0001-8069-9402
Dalarna University, School of Health and Welfare, Caring Science/Nursing. Karolinska Institute, Stockholm; Mälardalen University, Västerås.ORCID iD: 0000-0003-2511-9502
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2023 (English)In: Working with Older People, ISSN 1366-3666, E-ISSN 2042-8790, Vol. 27, no 3, p. 219-229Article in journal (Refereed) Published
Abstract [en]

Purpose – Dignity and well-being are key aspects of the legislation and policies that regulate care of olderpersons worldwide. In addition, care of older persons should be person-centred. Dignity and well-being aredescribed as results of person-centred care (PCC). The purpose of this study was to gain an understanding ofimportant aspects for older persons to experience dignity and well-being in residential care facilities (RCFs).

Design/methodology/approach – This study had a qualitative approach, and individual semi-structuredinterviews were conducted with 20 older persons living in RCFs. Data were analysed using inductive contentanalysis.

Findings – To experience dignity and well-being older persons emphasized the importance ofpreserving their identity. To do this, it was important to be able to manage daily life, to gain support andinfluence and to belong to a social context. However, the findings indicate a need for improvements.

Practical implications – Insights into older persons’ experiences of important aspects for experiencingdignity and well-being in RCFs can be used by first-line managers and registered nurses when designingimprovement strategies to promote PCC.

Originality/value – Dignity and well-being are described as results of PCC. The findings provide anunderstanding of what older persons perceive as important for experiencing dignity and well-being inRCFs. The findings are useful when designing improvement strategies to promote PCC.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2023. Vol. 27, no 3, p. 219-229
Keywords [en]
Care, Dignity, Older persons, Person-centred care, Person-centred practice framework, Residential care facility, Well-being, Residential care
National Category
Nursing
Identifiers
URN: urn:nbn:se:du-42824DOI: 10.1108/wwop-08-2022-0034Scopus ID: 2-s2.0-85137680136OAI: oai:DiVA.org:du-42824DiVA, id: diva2:1703357
Note

Tidigare version, i manusform, med titeln “'I want to be treated like I still matter': older persons' perceptions and experiences regarding important aspects of experiencing dignity and well-being in residential care facilities" inkluderad som paper i doktorsavhandling "Promoting dignity and well-being in residential care facilities: Older persons’ perceptions and experiences of important aspects and associated factors" (http://urn.kb.se/resolve?urn=urn:nbn:se:du-39632)

Available from: 2022-10-13 Created: 2022-10-13 Last updated: 2023-09-18Bibliographically approved
In thesis
1. Promoting dignity and well-being in residential care facilities: Older persons’ perceptions and experiences of important aspects and associated factors
Open this publication in new window or tab >>Promoting dignity and well-being in residential care facilities: Older persons’ perceptions and experiences of important aspects and associated factors
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objective: The overall aim of this thesis was to increase knowledge regarding the perceptions and experiences of aspects and factors associated with perceived dignity and well-being among older persons living in residential care facilities. Study I describes residents’ perceptions and experiences regarding important aspects of experiencing dignity and well-being. Study II examines the associations between perceptions of dignity and well-being and the attitudes of staff, the indoor-outdoor-mealtime environments and individual factors for residents. Study III examines the same associations as Study II over a three-year period. Study IV examines residents’ perceptions of empowerment, person-centred climate and life satisfaction before and after a caregiver intervention concerning the Swedish national fundamental values of dignity and well-being. 

Methods: The studies were performed in residential care facilities in Sweden. The participants were residents living in these facilities. Study I is a qualitative study that used semi-structured interviews to collect data. Data were analysed using qualitative content analysis. Study II, a cross-sectional study, and Study III, a longitudinal study, are based on national questionnaire data from the Swedish National Board of Health and Welfare. Data from 2016, 2017 and 2018 were used and analysed using descriptive statistics and ordinal logistic regression models. Study IV is a cluster-randomized controlled trial with a pre-and post-test design. Data were collected using the Patient Empowerment Scale, the Person-centred Climate Questionnaire – patient version, the Life Satisfaction Questionnaire and the EQ-5D questionnaire. Data were analysed using descriptive statistics, the Chi-square test, the Wilcoxon signed-rank test, the Mann-Whitney U test and generalized estimating equation models.

Findings: To experience dignity and well-being it was important for residents to feel that they still matter. To feel this, it was vital to be able to manage daily life, to have influence and to belong to a social context (I). Residents who had experienced disrespectful attitudes of staff, who did not thrive in the indoor-outdoor-mealtime environments, who rated their health and mobility as poor, and who were diagnosed with dementia had higher odds of being dissatisfied with aspects of dignity and well-being (II). These associations were persistent over a three-year period (III). After an intervention concerning the Swedish national fundamental values of dignity and well-being, the residents in the intervention group reported higher scores for perceived empowerment, person-centred climate and life satisfaction (IV).

Conclusion: To promote dignity and well-being, the attitudes of staff, the indoor-outdoor-mealtime environments and the individual factors of poor health, poor mobility and a dementia diagnosis need to be targeted. The Person-centred practice framework, targeting the prerequisites of staff and the care environment, could be used as a theoretical framework for designing improvement strategies that aim to promote dignity and well-being. First-line managers and registered nurses in residential care facilities have different knowledge and skills. They therefore need to work together as a team when developing improvement strategies that aim to promote the dignity and well-being of residents. In addition, residents should be included on the team given their knowledge regarding what is important for promoting dignity and well-being.

Place, publisher, year, edition, pages
Falun: Dalarna University, 2022
Series
Dalarna Doctoral Dissertations ; 19
Keywords
dignity, intervention, older persons, person-centred care, person-centred practice framework, residential care facilities, well-being
National Category
Nursing
Identifiers
urn:nbn:se:du-39632 (URN)978-91-88679-34-5 (ISBN)
Public defence
2022-04-22, FÖ6, Falun, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2022-03-18 Created: 2022-02-21 Last updated: 2023-08-17Bibliographically approved

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Roos, CharlotteSwall, AnnaMarmstål Hammar, Lena

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