Staff-based measurement instruments of person-centredness in settings of care for older people: A systematic review

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2024-01-31 DOI:10.1111/opn.12601

Tinna Elfstrand Corlin PhD, Ali Kazemi PhD

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Abstract

Background

Person-centred care is widely endorsed as a promising approach for delivering high-quality care to older people. However, the multitude of existing definitions and measurement tools, coupled with the continuous emergence of new tools, can create confusion and hinder precision in assessing this concept. This review was undertaken with a recognition of the crucial role that assessment quality plays in evaluations and improvements, particularly within the context of person-centred care for older people.

Objectives

This study aimed to systematically review staff-based measures of person-centredness in settings of care for older people. More specifically, the objectives were to provide description, methodological evaluation and synthesis of diverse conceptual understandings of person-centredness encapsulated in these measurement tools.

Methods

We systematically searched the Cinahl, PsycInfo, PubMed, Scopus and Web of Science databases for English peer-reviewed journal articles between 2000 and 2021. These articles discussed the creation of staff-based questionnaires designed to assess the extent of person-centred care. We excluded questionnaires meant for clients, patients or families, as well as non-questionnaire scales. The measures were described, and their interpretations of person-centred care were synthesised through a critical interpretive synthesis method. We evaluated methodological quality using a condensed COSMIN risk of bias checklist and adhered to PRISMA guidelines.

Results

The review identified a total of 14 staff-based measures. These measures exhibited varying levels of comprehensiveness, encompassing anywhere between 2 and 17 components. Furthermore, the number of items within the measures ranged from 11 to 62, and the sample sizes exhibited significant diversity, spanning from 58 to 1428. In terms of the components scrutinised by the scales regarding person-centred care, our synthesis revealed the emergence of four distinct conceptual categories: care process, supportive care environment, relations and communication, and knowledge and attitudes. As for the methodological quality of the scales, it exhibited a notable degree of variation (i.e. from inadequate to very good).

Conclusions

Diverse measures of person-centredness vary in terms of comprehensiveness, aspects covered and methodological quality. Synthesising the concept through staff-based measures offers a novel approach for researchers and practitioners, illuminating nuanced perspectives in person-centred care.

Implications for practice

The synthesis enriches academic discussions and practical applications by dissecting components, ultimately enhancing care quality assessment and improvement. Further, this review is a valuable resource for unit managers and quality coordinators working in settings of care for older people, empowering them to make informed decisions tailored to their specific needs from a diverse array of available person-centred care measures.

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以工作人员为基础的老年人护理机构 "以人为本 "测量工具：系统回顾

背景以人为本的护理被广泛认为是为老年人提供高质量护理的一种可行方法。然而，现有的定义和测量工具繁多，再加上新工具的不断涌现，可能会造成混淆，妨碍对这一概念进行精确评估。本研究的目的是认识到评估质量在评估和改进中的关键作用，尤其是在以人为本的老年人护理中。研究目的本研究旨在系统性地审查以员工为基础的、针对老年人护理环境中 "以人为本 "的测量方法。更具体地说，目的是对这些测量工具中包含的以人为本的不同概念理解进行描述、方法评估和综合。方法我们在 Cinahl、PsycInfo、PubMed、Scopus 和 Web of Science 数据库中系统地检索了 2000 年至 2021 年间的英文同行评审期刊文章。这些文章讨论了如何设计基于员工的问卷，以评估以人为本的护理程度。我们排除了针对客户、患者或家属的问卷以及非问卷量表。我们对这些测量方法进行了描述，并通过批判性解释综合法对它们对 "以人为本的护理 "的解释进行了综合。我们使用精简的 COSMIN 偏倚风险检查表对方法学质量进行了评估，并遵守了 PRISMA 指南。结果本次审查共确定了 14 项基于员工的措施。这些方法的全面性各不相同，包括 2 到 17 个组成部分。此外，测量项目的数量从 11 个到 62 个不等，样本量也呈现出显著的多样性，从 58 个到 1428 个不等。就有关以人为本的护理的量表所审查的组成部分而言，我们的综合结果显示出现了四个不同的概念类别：护理过程、支持性护理环境、关系与沟通以及知识与态度。至于量表的方法质量，则表现出明显的差异（即从不足到非常好）。结论对 "以人为本 "的各种衡量标准在全面性、涵盖面和方法质量方面各不相同。通过以员工为基础的测量方法来综合这一概念，为研究人员和从业人员提供了一种新的方法，揭示了以人为本护理中的细微差别。对实践的启示本综述通过对各个组成部分的剖析，丰富了学术讨论和实际应用，最终加强了护理质量的评估和改进。此外，这篇综述对于在老年人护理环境中工作的单位管理人员和质量协调员来说也是一个宝贵的资源，使他们能够从现有的各种以人为本的护理措施中根据自己的具体需求做出明智的决定。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.