Health and quality of care from older peoples' and formal caregivers' perspective

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Fältnamn	Indikatorer	Metadata
000		06086nam a2200589 4500
001		oai:DiVA.org:kau-8847
003		SwePub
008		111201s2011 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:DiVA.org:du-15765
020		a 9789170634024q print
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-88472 URI
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:du-157652 URI
040		a (SwePub)kaud (SwePub)du
041		a engb eng
042		9 SwePub
072	7	a vet2 swepub-contenttype
072	7	a dok2 swepub-publicationtype
100	1	a From, Ingrid,d 1953-u Högskolan Dalarna,Karlstads universitet,Avdelningen för omvårdnad,Omvårdnad,Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper4 aut0 (Swepub:du)ifr
245	1 0	a Health and quality of care from older peoples' and formal caregivers' perspective
264	1	a Karlstad :b Karlstads universitet,c 2011
300		a 78 s.
338		a electronic2 rdacarrier
490	0	a Karlstad University Studies,x 1403-8099 ;v 2011:63
520		a Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I). The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Omvårdnad0 (SwePub)303052 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Nursing0 (SwePub)303052 hsv//eng
653		a Older people
653		a community care
653		a dependency
653		a health
653		a adaptation
653		a compensation
653		a phenomenology
653		a quality of care
653		a organizational climate
653		a stress of conscience
653		a competence
653		a health
653		a sense of coherence
653		a formal caregivers
653		a Nursing Science
653		a Omvårdnad
653		a Hälsa och välfärd
700	1	a Johansson, Inger,c Docentu Karlstads universitet,Avdelningen för omvårdnad,Karlstads universitet, Avdelningen för omvårdnad4 ths
700	1	a Nordström, Gun,c Professoru Karlstads universitet,Avdelningen för omvårdnad,Karlstads universitet, Avdelningen för omvårdnad4 ths
700	1	a Wilde Larsson, Bodil,c Professoru Karlstads universitet,Avdelningen för omvårdnad,Karlstads universitet, Avdelningen för omvårdnad4 ths
700	1	a Lundman, Berit,c Professoru Umeå universitet4 opn
710	2	a Karlstads universitetb Avdelningen för omvårdnad4 org
856	4	u https://kau.diva-portal.org/smash/get/diva2:460966/FULLTEXT01.pdfx primaryx Raw objecty fulltext
856	4	u https://du.diva-portal.org/smash/get/diva2:747422/FULLTEXT01.pdfx primaryx Raw objecty fulltext
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-8847
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:du-15765

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Av lärosätet: Karlstads universitet; Högskolan Dalarna

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