Nursing home managers' descriptions of multi-level barriers to leading person-centred care: A content analysis

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2023-10-20 DOI:10.1111/opn.12581

Annica Backman RN, PhD, Petra Ahnlund PhD, Hugo Lövheim MD, PhD, David Edvardsson RN, PhD

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Abstract

Background

Research suggests that person-centred care can be beneficially implemented and sustained, even though barriers remain that prevent uptake in clinical practice. Understanding barriers to person-centred care seems important, as this has an impact on care practices and resident outcomes. Moreover, there is limited knowledge about nursing home managers' descriptions of barriers when leading person-centred care.

Objectives

To explore barriers to leading person-centred care as narrated by nursing home managers.

Methods

A descriptive qualitative design was used to collect data using individual interviews with 12 nursing home managers in highly person-centred nursing homes. Data were analysed using content analysis.

Results

Multi-level barriers to leading person-centred care were identified on the (1) person level, (2) team level and (3) organisational level. Placing professional and family considerations ahead of resident considerations was described as a barrier on the personal level (1). Also, staff's divergent care values, processes, and priorities together with turnover and low foundational knowledge were identified as barriers on the team level (2). On an organisational level (3), constrained finances, functional building design and group level rostering were identified as barriers.

Conclusion

Multi-level barriers influence nursing home managers' ability to lead and promote person-centred care. Promoting the development of person-centred practices requires efforts to eliminate barriers on person, team and organisational level.

Implications for Practice

Identifying and overcoming barriers at various levels in nursing home care has the potential to promote person-centred practices. This study can inform stakeholders and policymakers of challenges and complexities in person-centred practices. Multi-level strategies are needed to target challenges at person-, team- and organisational level when striving to develop person-centred care.

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疗养院管理者对领导以人为本护理的多层次障碍的描述：内容分析。

背景：研究表明，以人为中心的护理可以得到有益的实施和持续，尽管在临床实践中仍然存在阻碍接受的障碍。了解以人为中心的护理障碍似乎很重要，因为这会影响护理实践和住院患者的结果。此外，对于养老院管理人员在领导以人为中心的护理时对障碍的描述，了解有限。目的：探讨养老院管理人员讲述的领导以人为本护理的障碍。方法：采用描述性定性设计，对高度以人为本的养老院的12名养老院管理人员进行个体访谈，收集数据。使用内容分析对数据进行分析。结果：在（1）个人层面、（2）团队层面和（3）组织层面发现了领导以人为本护理的多层面障碍。将专业和家庭考虑置于居民考虑之上被描述为个人层面的障碍（1）。此外，员工不同的护理价值观、流程和优先事项，以及人员流动和基础知识水平低，被确定为团队层面的障碍（2）。在组织层面（3），受限的财务、功能性建筑设计和集团层面的名册被确定为障碍。结论：多层次的障碍影响了养老院管理者领导和促进以人为本护理的能力。促进以人为中心的做法的发展需要努力消除个人、团队和组织层面的障碍。对实践的影响：识别和克服养老院护理各个层面的障碍有可能促进以人为本的实践。这项研究可以让利益攸关方和决策者了解以人为本做法的挑战和复杂性。在努力发展以人为本的护理时，需要多层次的策略来应对个人、团队和组织层面的挑战。

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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.