Older peoples' lived experiences of personalised care in care homes: A meta-ethnography

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2023-10-29 DOI:10.1111/opn.12585

Gary Hodge PhD, RNMH, Iain Lang PhD, Richard Byng PhD, MB BCh, Susie Pearce PhD, RN

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Abstract

Background

Guidance and policy on personalised (or person-centred) care of older people living in care homes advocates that all residents must have their preferences considered, and that all care provided must be reasonably adjusted to meet the person's specific needs. Despite this, research that considers what matters to residents in terms of the care they receive is limited.

Objectives

Our review aims to explore care home residents' lived experiences of personalised care and understand what really matters to them.

Methods

Six electronic databases (CINHAL, Medline (Ovid), Embase, PubMed, Web of Science & PsychInfo) and Google Scholar (grey literature) were searched to identify qualitative studies relating to personalised care in care home settings, which also included resident (voices) quotes. The literature review and synthesis are reported using eMERGe guidance.

Results

Fifteen studies met the inclusion criteria for our meta-ethnography. Four conceptual categories (the challenge of fitting into institutional care, the passing of time, holding onto a sense of self and a desire to feel at home) and two key concepts (creating a culture of purposeful living and caring and forming and maintaining meaningful & empowering relationships) were identified. Finally, a conceptual framework of understanding represents what personally matters to residents in terms of their care.

Conclusion

Our meta-ethnography, guided by residents' lived experiences of personalised care, offers a new perspective of what personally matters to residents in terms of the care they receive. The conceptual framework of understanding highlights the importance of moving from an institutional position of doing for residents to a person-centred position of doing with residents.

Implications for practice

Our findings highlight the importance of understanding the differences between personalised and person-centred care for policy and practice. Further considerations are required on how this might be applied through nurse and care home professionals' education and work practices.

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老年人在养老院个性化护理的生活体验：元民族志。

背景：关于对居住在养老院的老年人进行个性化（或以人为中心）护理的指导和政策主张，必须考虑所有居民的偏好，并且必须合理调整所提供的所有护理，以满足个人的具体需求。尽管如此，考虑居民所接受的护理对他们来说重要的研究是有限的。目标：我们的综述旨在探索养老院居民的个性化护理生活体验，并了解对他们来说真正重要的是什么。方法：检索六个电子数据库（CINHAL、Medline（Ovid）、Embase、PubMed、Web of Science&PsychInfo）和Google Scholar（灰色文献），以确定与养老院个性化护理相关的定性研究，其中还包括住院医师（声音）的语录。文献综述和综合报告使用eMERGe指南。结果：15项研究符合我们的元民族志纳入标准。确定了四个概念类别（适应机构护理的挑战、时间的流逝、保持自我意识和宾至如归的愿望）和两个关键概念（创造有目的的生活和护理文化以及形成和保持有意义和赋权的关系）。最后，一个概念性的理解框架代表了在护理方面对居民个人重要的东西。结论：我们的元民族志以居民个性化护理的生活体验为指导，为居民个人所接受的护理提供了一个新的视角。理解的概念框架强调了从为居民做事的制度立场转变为与居民一起做事的以人为本的立场的重要性。对实践的启示：我们的研究结果强调了理解个性化和以人为本的政策和实践护理之间差异的重要性。需要进一步考虑如何通过护士和护理院专业人员的教育和工作实践来应用这一点。

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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.