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- Zoffmann, Vibeke, et al.
(author)
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Translating person-centered care into practice : a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination
- 2016
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In: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 99:3, s. 400-407
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Journal article (peer-reviewed)abstract
- Objective: Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. Methods: Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. Results: Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. Conclusion: Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. Practice Implications: Professionals must critically consider the context in their choice of approach. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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- Alnes, Rigmor Einang, et al.
(author)
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Marte meo counselling : a promising tool to support positive interactions between residents with dementia and nurses in nursing homes
- 2011
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In: Journal of Research in Nursing. - : SAGE Publications. - 1744-9871 .- 1744-988X. ; 16:5, s. 415-433
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Journal article (peer-reviewed)abstract
- Marte Meo Counselling (MMC) is an educational video-based counselling method developed to improve interactions between persons. This study aimed at investigating whether changes could be identified in the interactions between people with dementia and their nurses during morning care, following MMC. An intervention study based on video recordings before and after a MMC intervention was used. Thirteen nurses and 10 residents from six dementia-specific care units at six different institutions in Norway participated. Data were collected through video recording of six pairs (nurse and resident) in interaction before and after the staff received MMC. Four pairs participated as controls. The findings suggest that nurses who received MMC succeeded, to a greater degree than did the comparison nurses, in providing care consistent with promoting positive interactions. We found clearer indications of increased positive interactions and a reduction in inappropriate interactions in the intervention group. In the control group, the variation was greater, with both good and poor interactions present in the same cases.This study indicates that MMC can serve as a facilitator for positive interactions and can also lead to a reduction in inappropriate interactions. Further research is needed to evaluate the effect of MMC.
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- Alnes, Rigmor Einang, et al.
(author)
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The influence of the learning climate on learning outcomes from Marte Meo counselling in dementia care
- 2013
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In: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 21:1, s. 130-140
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Journal article (peer-reviewed)abstract
- AIM: To identify factors that affected the learning outcomes from Marte Meo counselling (MMC).BACKGROUND: Although MMC has shown promising results regarding learning outcomes for staff working in dementia-specific care units, the outcomes differ.METHOD: Twelve individual interviews and four focus group interviews with staff who had participated in MMC were analysed through a qualitative content analysis.RESULTS: The learning climate has considerable significance for the experienced benefit of MMC and indicate that this learning climate depends on three conditions: establishing a common understanding of the content and form of MMC, ensuring staff's willingness to participate and the opportunity to do so, and securing an arena in the unit for discussion and interactions.CONCLUSION: Learning outcomes from MMC in dementia-specific care units appear to depend on the learning climate in the unit. Implication for nursing management The learning climate needs attention from the nursing management when establishing Marte Meo intervention in nursing homes. The learning climate can be facilitated through building common understandings in the units regarding why and how this intervention should take place, and by ensuring clarity in the relationship between the intervention and the organization's objectives.
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- Bergland, Adel, et al.
(author)
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Person-centred ward climate as experienced by mentally lucid residents in long-term care facilities
- 2015
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:3-4, s. 406-414
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Journal article (peer-reviewed)abstract
- Aims and objectives. To assess the content validity and reliability of the Person-centred Climate Questionnaire-Patient version in long-term care facilities, to describe residents' perceptions of the extent to which their ward climate was person-centred and to explore whether person-centredness was associated with facility and resident characteristics, such as facility and ward size, having a sensory garden and having a primary caregiver.Background. The importance of the physical environment to persons with dementia has been investigated. However, research is lacking regarding the extent to which mentally lucid residents experience their physical and psycho-social ward climate as person-centred and the factors influencing their experience.Design. Cross-sectional survey design.Methods. The Person-centred Climate Questionnaire-Patient version was translated into Norwegian with forward and backward translation. The content validity index for scales was assessed. The Person-centred Climate Questionnaire-Patient version was completed by 145 mentally lucid residents in 17 Norwegian long-term care facilities. Reliability was assessed by Cronbach's alpha and item-total correlations. Test-retest reliability was assessed by paired samples t-test and Spearman's correlation. To explore differences based on facility and resident characteristics, independent-samples t-test and one-way ANOVA were used.Results. The content validity index for scales was satisfactory. The Person-centred Climate Questionnaire-Patient version was internally consistent and had satisfactory test-retest reliability. The climate was experienced as highly person-centred. No significant differences were found, except that residents in larger facilities experienced the climate as more person-centred in relation to everyday activities (subscale 2) than residents in smaller facilities.Conclusion. The Norwegian version of the Person-centred Climate Questionnaire-Patient version can be regarded as reliable in a long-term care facility context. Perceived degree of person-centredness was not associated with facility or resident characteristics, such as the number of residents, having a sensory garden or knowing that one has a primary caregiver.Relevance to clinical practice. A person-centred climate can be attained in different kinds of long-term care facilities.
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- Bergland, Adel, et al.
(author)
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Psychometric properties of the Norwegian Person-centred Climate Questionnaire from a nursing home context
- 2012
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:4, s. 820-828
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Journal article (peer-reviewed)abstract
- Background: The physical and psychosocial environments in nursing homes influence the residents everyday life as well as their well-being and thriving. The staffs perceptions of and relationships with the residents are crucially important to quality care. Quality care is described often as person-centred. Few measurement tools exist that focus on person-centred care in nursing homes.Objective: The aim of this study was to evaluate the psychometric properties of the Norwegian version of the Person-centred Climate QuestionnaireStaff version (PCQ-S).Design: This study had a cross-sectional survey design.Participants and Settings: Two hundred and nine healthcare and support staff in five nursing homes in the eastern part of Norway.Methods: The Swedish PCQ-S was translated into Norwegian with forward and backward translation. The relevance of the items included in the questionnaire was assessed by an expert panel of 10 nursing home care staff, because the questionnaire has not been used in this context previously. A psychometric evaluation using statistical estimates of validity and reliability was performed. The discriminatory capacity of the questionnaire was also tested.Results: The content validity index was satisfactory (0.78). The PCQ-S showed high internal consistency reliability in that Cronbachs a was satisfactory for the total scale (0.92) and the three subscales (0.81, 0.89 and 0.87). The testretest reliability was also satisfactory as evident from a Spearmans correlation coefficient of 0.76 (p < 0.01) between the total PCQ scores at test and retest. The Norwegian version retained the original factor structure of the Swedish version.Conclusion: As the psychometric evaluation showed satisfactory validity and reliability scores, this study supports the Norwegian version of the PCQ-S when applied to a sample of nursing home staff.
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- Bergland, Adel, et al.
(author)
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Thriving in long-term care facilities : instrument development, correspondence between proxy and residents' self-ratings and internal consistency in the Norwegian version
- 2014
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In: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 70:7, s. 1672-1681
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Journal article (peer-reviewed)abstract
- Aims. To develop an instrument for measuring thriving among residents in long-term care facilities, to assess the correspondence between proxy ratings and self-report and the internal consistency of the Norwegian version. Background. The instrument was developed from the life-world concept of thriving and thereby has a different theoretical basis than existing 'dementia related' quality-of-life instruments. Thriving relates the experience of older persons to the place where they live. Proxy instruments need to be developed for residents in long-term care facilities who are not able to report their subjective experiences. Design. Instrument development using cross-sectional survey design. Methods. The instrument was developed in three versions (resident, family and staff) from a theory on thriving. Forty-eight triads consisting of a resident, family member and primary nurse from 12 Norwegian nursing homes participated. Data collection took place between March-December 2011. Inter-rater agreement between the groups was assessed by Cohen's kappa coefficient (weighted). Internal consistency was evaluated by Cronbach's alpha. Homogeneity was explored through item-total correlations. Results. Agreement between residents, family members and staff was poor or fair (<0.41) in six of 38 items. These items were excluded. The 32-items instrument had satisfactory Cronbach's alpha values in each of the three samples and satisfactory homogeneity as item-total correlations was substantial without being excessive and thus indicated that items were measuring the same construct. Conclusion. The instrument appears to have internal consistency and enable reliable proxy measures of the thriving construct. Further psychometric assessment including checking for possible item redundancy is needed.
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- Bergland, Ådel, et al.
(author)
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The thriving of older people assessment scale : validity and reliability assessments
- 2015
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In: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:4, s. 942-951
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Journal article (peer-reviewed)abstract
- AimTo explore construct validity and reliability of the Thriving of Older People Assessment Scale. BackgroundThe concept of thriving emphasizes person-environment interaction in relation to well-being. The Thriving of Older People Assessment Scale has been developed and evaluated as a self-report and proxy scale based on the theory of thriving. DesignCross-sectional survey design. MethodThe Thriving of Older People Assessment Scale was completed by a sample of 259 residents, 146 family members and 52 staff from 13 long-term care facilities in Norway and Sweden. Data were collected between April 2010-December 2011. Exploratory factor analysis was applied to explore construct validity in terms of factor structure and dimensionality of the 32-item scale in relation to the thriving theory. Reliability was explored through internal consistency estimation using Cronbach's alpha and through homogeneity evaluation using corrected item-total correlations. ResultsExploratory factor analysis resulted in five factors (subscales) that corresponded meaningfully with the thriving theory and were labelled 1: Resident' attitudes towards being in long-term care; 2: Quality of care and caregivers; 3: Resident engagement and peer relationships; 4: Keeping in touch with people and places; and 5: Quality of the physical environment. The scale had satisfactory internal consistency and homogeneity estimates. ConclusionThe 32-item Thriving of Older People Assessment Scale can be regarded as construct valid and reliable. Its factor structure corresponded logically to the thriving theory and its factors showed satisfactory internal consistency and homogeneity. Nevertheless, the TOPAS would benefit from further testing in other populations and contexts.
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- Bragstad, Line Kildal, et al.
(author)
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Psychometric properties of a short version of Lee Fatigue Scale used as a generic PROM in persons with stroke or osteoarthritis : assessment using a Rasch analysis approach
- 2020
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In: Health and Quality of Life Outcomes. - : BioMed Central. - 1477-7525. ; 18:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Fatigue is a common symptom associated with a wide range of diseases and needs to be more thoroughly studied. To minimise patient burden and to enhance response rates in research studies, patient-reported outcome measures (PROM) need to be as short as possible, without sacrificing reliability and validity. It is also important to have a generic measure that can be used for comparisons across different patient populations. Thus, the aim of this secondary analysis was to evaluate the psychometric properties of the Norwegian 5-item version of the Lee Fatigue Scale (LFS) in two distinct patient populations.METHODS: The sample was obtained from two different Norwegian studies and included patients 4-6 weeks after stroke (n = 322) and patients with osteoarthritis on a waiting list for total knee arthroplasty (n = 203). Fatigue severity was rated by five items from the Norwegian version of the LFS, rating each item on a numeric rating scale from 1 to 10. Rasch analysis was used to evaluate the psychometric properties of the 5-item scale across the two patient samples.RESULTS: Three of the five LFS items ("tired", "fatigued" and "worn out") showed acceptable internal scale validity as they met the set criterion for goodness-of-fit after removal of two items with unacceptable goodness-of-fit to the Rasch model. The 3-item LFS explained 81.6% of the variance, demonstrated acceptable unidimensionality, could separate the fatigue responses into three distinct severity groups and had no differential functioning with regard to disease group. The 3-item version of the LFS had a higher separation index and better internal consistency reliability than the 5-item version.CONCLUSIONS: A 3-item version of the LFS demonstrated acceptable psychometric properties in two distinct samples of patients, suggesting it may be useful as a brief generic measure of fatigue severity.TRIAL REGISTRATION: Clinicaltrials.gov: NCT02338869; registered 10/04/2014 (stroke study).
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