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Exploring environmental variation in residential care facilities for older people
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. karolinska institutet.
Dalarna University, School of Education, Health and Social Studies, Social Work.ORCID iD: 0000-0002-8795-7555
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.ORCID iD: 0000-0001-7044-8896
2017 (English)In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, no 2, 49-65 p.Article 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.

Place, publisher, year, edition, pages
2017. Vol. 10, no 2, 49-65 p.
Keyword [en]
assessment; long-term care facility; older people; person-centered care; physical environment
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-21601DOI: 10.1177/1937586716648703ISI: 000400141500005PubMedID: 27240564OAI: oai:DiVA.org:du-21601DiVA: diva2:933071
Available from: 2016-06-03 Created: 2016-06-03 Last updated: 2017-05-18Bibliographically approved
In thesis
1. The quality of the physical environment and its association with activities and well-being among older people in residential care facilities
Open this publication in new window or tab >>The quality of the physical environment and its association with activities and well-being among older people in residential care facilities
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The physical environment can influence older people’s health and well-being, and is often mentioned as being an important factor for person-centred care. Due to high levels of frail health, many older people spend a majority of their time within care facilities and depend on the physical environment for support in their daily life. However, the quality of the physical environment is rarely evaluated, and knowledge is sparse in terms of how well the environment meets the needs of older people. This is partly due to the lack of valid and reliable instruments that could provide important information on environmental quality. Aim: The aim of this thesis was to study the quality of the physical environment in Swedish care facilities for older people, and how it relates to residents’ activities and well-being. Methods: The thesis comprises four papers where both qualitative and quantitative methods were used. Study I involved the translation and adaptation of the Sheffield Care Environment Assessment Matrix (SCEAM) into a Swedish version (S-SCEAM). Several methods were used including forward and backward translation, test of validity via expert consultation and reliability tests. In Study II, S-SCEAM was used to assess the quality of the environment, and descriptive data were collected from 20 purposively sampled residential care facilities (RCFs). Study III was a comparative case study conducted at two RCFs using observations, interviews and S-SCEAM to examine how the physical environment relates to older people’s activities and interactions. In study IV, multilevel modeling was used to determine the association between the quality of the physical environment and the psychological and social well-being of older people living in RCFs. The data in the thesis were analysed using qualitative content analysis, and descriptive, bivariate and multilevel statistics. Results: A specific result was the production of the Swedish version of SCEAM. The instrument contains 210 items structured into eight domains reflecting the needs of older people. When using S-SCEAM, the results showed a substantial variation in the quality of the physical environment between and within RCFs. In general, private apartments and dining areas had high quality, whereas overall building layout and outdoor areas had lower quality. Also, older people’s safety was supported in the majority of facilities, whereas cognitive support and privacy had lower quality. Further, the results showed that environmental quality in terms of cognitive support was associated with residents’ social well-being. Specific environmental features, such as building design and space size, were also noted, through observation, as influencing residents’ activities, and several barriers were found that seemed to restrict residents’ full use of the environment. Conclusions: This thesis contributes to the growing evidence-based design field. The S-SCEAM can be used in future research on the association between the environment and people’s health and well-being. The instrument could also serve as a guide in the planning and design process of new RCFs.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, Dept of Neurobiology, Care Sciences and Society, 2016
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-23790 (URN)978-91-7676-404-6 (ISBN)
Public defence
2016-12-08, Hörsal H3, Karolinska Institutet, Huddinge, 09:00
Opponent
Supervisors
Available from: 2016-12-29 Created: 2016-12-29 Last updated: 2016-12-29Bibliographically approved

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