Elderly Care in Transition - Perspectives of the Elderly and the Staff

Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
AgeNot listed
SponsorUniversity of Gavle

About this trial

Elderly care in Sweden faces several significant challenges. The number of older people is increasing at the same time as there are fewer of working age. Elderly care staff, such as nurses, care assistants and nurses, have on average more sick days than many other professional groups and often experience high work-related stress. In some municipalities, there are also problems with high staff turnover and a lack of formal competence. At the same time, research shows that many employees experience work in elderly care as meaningful and valuable. Taking advantage of and strengthening these positive aspects is central to creating good conditions for the health and well-being of staff and for the quality of care and care for older people. An important area of development in elderly care is person-centred care, which means that care is based on the individual person's needs, wishes, life history and resources. Person-centred practice emphasises the relationship between the older person, the staff and, if the person so wishes, relatives. Although person-centered care is often seen as an obvious part of good care, research shows that it is not fully implemented in practice and that the introduction of person-centered working methods can be complex and demanding.

This study is being carried out in collaboration between municipalities and the University of Gävle and is linked to the establishment of nursing homes for the elderly that will function as academic nursing homes. In these nursing homes, person-centered care will be a pronounced focus area. Through recurring measurements, the activities will be monitored and developed in close collaboration between practice and research. The overall aim of the study is to investigate older people's experience of academic nursing homes with a focus on person-centered care and nursing, outdoor environment, health and well-being, and to investigate the staff's experience of person-centered working methods, learning, structural conditions and work-related well-being. The study also aims to analyze the relationship between older people's experiences of person-centered care, outdoor environment, health and well-being, both among older people living in academic nursing homes and among older people living in their own homes. The study has a longitudinal design and data will be collected at several points in time using questionnaires and interviews, which enables both statistical analyses and an in-depth understanding of the participants' experiences over time. By highlighting the perspectives of both older people and staff, the study can contribute new knowledge about how person-centered care can be developed and maintained in practice. In the long term, the results can contribute to a more health-promoting, sustainable and attractive elderly care for both older people and staff.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Living in nursing homes - academic or standard

Able to complete a questionnaire independently or with reading assistance

Employed at an Academic nursing home or a regular nursing home (comparison unit)

Belonging to care, nursing, or rehabilitation staff, including registered nurses, occupational therapists, and physiotherapists

Disqualifiers

Individuals receiving only safety alarm services and/or meal delivery (no ongoing care contact)

Individuals unable to provide informed consent

Individuals unable to complete a questionnaire, even with reading assistance

Individuals with acute medical conditions that make participation inappropriate (as judged by care staff)

Trial population

1)Older people in two municipalities who lives in nursing homes (either academic or regular) 2) staff working in nursing homes (either academic or regular) in these two municipalities

Trial design

Design model

Other

Time perspective

Prospective

Treatments tested in this trial

  • Academic nursing homes

    Other intervention

    This study is conducted in collaboration between two municipalities and the University of Gävle and is linked to the establishment of a new nursing home for older adults that will operate as academic nursing homes. In one municipality, a newly built nursing hom will open as an academic nursing home, while in the other municipality an existing nursing home will be transformed into an academic unit. Within these Academic settings, person-centred care and support will constitute a central focus, alongside the development and use of structured supervision and learning models. All decisions regarding changes to care practices, organisational processes, or the implementation of person-centred approaches are made solely by the municipal services themselves. The research group does not participate in operational decision-making and does not influence the practical design or delivery of care within the units.

Treatment groups

600 Participants
are divided into 4 treatment groups
Group A: Older people living in academic nursing homes - intervention group1 intervention
Group B: Older people living in regular nursing homes - comparison group0 interventions
Group C: Staff working in academic nursing homes - intervention group1 intervention
Group D: Staff working in regular nursing homes - comparison group0 interventions

Trial outcomes

Primary outcomes

1

Older peoples' rating of Person-centered care

Older peoples' experiences of person-centred care measured with the Person-Centred Practice Inventory - Care (PCPI-C), covering domains such as participation, shared decision-making and respect for individual needs. Score range: Min: 1, Max: 5. Interpretation: Higher scores = more person-centred care.

Time frame
Baseline, 6 months, 12 months, 24 months
2

Person-Centred Care Practice (PCPI-S)

Staff perceptions of person-centred care practices measured using the Person-Centred Practice Inventory - Staff (PCPI-S). The instrument assesses values, care processes, and organisational prerequisites for person-centred care. Score Range: Min: 1-Max: 5. Higher scores indicate stronger alignment with person-centred principles.

Time frame
Baseline, 12 months, 24 months.

Secondary outcomes

1

Well-being

Self-reported well-being and life satisfaction measured with LSQ, covering domains such as physical and mental well-being, social relations, and activities. Higher scores indicate greater life satisfaction. Score range: Min: 1-Max: 6. Interpretation: Higher scores = better well-being.

Time frame
Baseline, 6 months, 12 months, 24 months.
2

Symptoms of Depression and Anxiety

Psychological distress measured with the 4-item Patient Health Questionnaire (PHQ-4), capturing core symptoms of anxiety and depression. Score Range: Min: 0 - Max: 12. Interpretation: Higher scores = worse psychological distress.

Time frame
Baseline, 6 months, 12 months, 24 months
3

Health - EQ-5D-5L Index Score

Overall health status measured using the EQ-5D-5L instrument, including five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Outcomes reflect self-reported health. Score Range from 0 (health states worse than death, depending on valuation set) to 1.00. Interpretation: Higher scores = better health.

Time frame
Baseline, 6 months, 12 months, 24 months
4

Health - EQ-5D-5L Visual Analogue Scale (VAS)

Self-rated health on a visual analogue scale ranging from 0 to 100. Score range from 0 (worst imaginable health) to 100 (best imaginable health). Interpretation: Higher scores = better health.

Time frame
Baseline, 6 months, 12 months, 24 months.

Other outcomes

Locations

This trial has no locations.

Sponsors and contacts

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