Effects of person-centered care on residents and staff in aged-care facilities: a systematic review

Abstract

BackgroundSeveral residential aged-care facilities have replaced the institutional model of care to one that accepts person-centered care as the guiding standard of practice. This culture change is impacting the provision of aged-care services around the world. This systematic review evaluates the evidence for an impact of person-centered interventions on aged-care residents and nursing staff.MethodsWe searched Medline, Cinahl, Academic Search Premier, Scopus, Proquest, and Expanded Academic ASAP databases for studies published between January 1995 and October 2012, using subject headings and free-text search terms (in UK and US English spelling) including person-centered care, patient-centered care, resident-oriented care, Eden Alternative, Green House model, Wellspring model, long-term care, and nursing homes.ResultsThe search identified 323 potentially relevant articles. Once duplicates were removed, 146 were screened for inclusion in this review; 21 were assessed for methodological quality, resulting in nine articles (seven studies) that met our inclusion criteria. There was only one randomized, controlled trial. The majority of studies were quasi-experimental pre-post test designs, with a control group (n = 4). The studies in this review incorporated a range of different outcome measures (ie, dependent variables) to evaluate the impact of person-centered interventions on aged-care residents and staff. One person-centered intervention, ie, the Eden Alternative, was associated with significant improvements in residents’ levels of boredom and helplessness. In contrast, facility-specific person-centered interventions were found to impact nurses’ sense of job satisfaction and their capacity to meet the individual needs of residents in a positive way. Two studies found that person-centered care was actually associated with an increased risk of falls. The findings from this review need to be interpreted cautiously due to limitations in study designs and the potential for confounding bias.ConclusionTypically, person-centered interventions are multifactorial, comprising: elements of environmental enhancement; opportunities for social stimulation and interaction; leadership and management changes; staffing models focused on staff empowerment; and assigning residents to the same care staff and an individualized philosophy of care. The complexity of the interventions and range of outcomes examined makes it difficult to form accurate conclusions about the impact of person-centered care interventions adopted and implemented in aged-care facilities. The few negative consequences of the introduction of person-centered care models suggest that the introduction of person-centered care is not always incorporated within a wider “hierarchy of needs” structure, where safety and physiological need are met before moving onto higher level needs. Further research is necessary to establish the effectiveness of these elements of person-centered care, either singly or in combination.

Validity and Reliability of the Person-centered Care Assessment Tool in Long-term Care Facilities in Korea

“…또한 인간중심돌봄의 실천은 노인에게 제공되는 돌 봄의 질을 향상시키며 신체적 · 정서적 · 사회적 측면에서 노인의 삶의 질을 높여준다 [6,10]. 뿐만 아니라 노인요양시설에 대한 가족들의 만족도를 높이며, 직원들에게 직무의 만족도 증가, 이직률의 저하 등 긍정적인 효과가 있다 [9,10].…”

The Relationship Between Positive Patient Experience in Acute Hospitals and Person-Centred Care

“…Early research was hampered by poorly defined terms, small scale studies or a reliance on qualitative research methods and is of limited empirical value (Slater, 2006). In a recent systematic review of the evidence (Brownie and Nancarrow, 2013), person-centred care is reported to have a positive impact on staff job satisfaction (Lehuluante et al, 2012), staff capacity to meet the needs of patients (Brownie and Nancarrow, 2013), cost effectiveness (Olsson et al, 2009), better levels of staff autonomy and empowerment (Williams et al, 2007). For patients, significant improvements are reported in physical outcomes and reduction in boredom (Brownie and Nancarrow, 2013).…”

“…In a recent systematic review of the evidence (Brownie and Nancarrow, 2013), person-centred care is reported to have a positive impact on staff job satisfaction (Lehuluante et al, 2012), staff capacity to meet the needs of patients (Brownie and Nancarrow, 2013), cost effectiveness (Olsson et al, 2009), better levels of staff autonomy and empowerment (Williams et al, 2007). For patients, significant improvements are reported in physical outcomes and reduction in boredom (Brownie and Nancarrow, 2013). However the bulk of the evidence is limited to older person settings and there are additional challenges to its implementation within acute hospital settings (Clisset et al, 2013).…”

Dementia care mapping to support staff in the care of people with intellectual disability and dementia: a feasibility study

“…DCM aims at different levels: at the individual (residents and care givers), at the group (care giving teams) and at multidisciplinary teams and management (Van de Ven et al, 2013). Furthermore, person-centred methods, like DCM, are associated with (psychosocial) benefits for both people with dementia (whether or not with intellectual disability) and their care staff, by improving the quality of care (Brown et al, 2016;Brownie & Nancarrow, 2013;Edvardsson, Sandman, & Borell, 2014; Van der Meer, Nieboer, Finkenflügel, & Cramm, 2017;Willemse et al, 2015).…”