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      Work environment and person‐centred dementia care in nursing homes—A cross‐sectional study

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          Abstract

          Aim

          This study aims to explore the relationship between work environment, job characteristics and person‐centred care for people with dementia in nursing homes.

          Background

          Person‐centred care approaches have become a dominant indicator for good quality of care in nursing homes. Little is known about the relationship between work environment, job characteristics and person‐centred care in nursing homes.

          Method(s)

          Cross‐sectional data from the LAD study were used. Direct care staff ( n = 552) of nursing homes ( n = 49) filled an online questionnaire about work environment characteristics and person‐centred care. To examine relationships, multilevel linear regression analyses were conducted.

          Results

          Associations were found between a higher transformational leadership style, less social support from a leader, a higher unity in philosophy of care, higher levels of work satisfaction, more development opportunities, better experienced teamwork and staff‐reported person‐centred care.

          Conclusion(s)

          In a complex nursing home environment, person‐centred care is influenced by organisational and work characteristics, shared values and interpersonal relationships.

          Implications for Nursing

          Leaders may consider facilitating collaboration and creating unity between care staff, clients and family members in order to provide person‐centred care. Therefore, a transformational leadership style, educational programmes and coaching for leaders are recommended.

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          Most cited references65

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          A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

          Intraclass correlation coefficient (ICC) is a widely used reliability index in test-retest, intrarater, and interrater reliability analyses. This article introduces the basic concept of ICC in the content of reliability analysis.
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            Stages of Small-Group Development Revisited

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              Understanding and measuring quality of care: dealing with complexity

              Abstract Existing definitions and measurement approaches of quality of health care often fail to address the complexities involved in understanding quality of care. It is perceptions of quality, rather than clinical indicators of quality, that drive service utilization and are essential to increasing demand. Here we reflect on the nature of quality, how perceptions of quality influence health systems and what such perceptions indicate about measurement of quality within health systems. We discuss six specific challenges related to the conceptualization and measurement of the quality of care: perceived quality as a driver of service utilization; quality as a concept shaped over time through experience; responsiveness as a key attribute of quality; the role of management and other so-called upstream factors; quality as a social construct co-produced by families, individuals, networks and providers; and the implications of our observations for measurement. Within the communities and societies where care is provided, quality of care cannot be understood outside social norms, relationships, trust and values. We need to improve not only technical quality but also acceptability, responsiveness and levels of patient–provider trust. Measurement approaches need to be reconsidered. An improved understanding of all the attributes of quality in health systems and their interrelationships could support the expansion of access to essential health interventions.
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                Author and article information

                Contributors
                johanna.rutten@maastrichtuniversity.nl
                Role: Professor
                Role: Professor
                Journal
                J Nurs Manag
                J Nurs Manag
                10.1111/(ISSN)1365-2834
                JONM
                Journal of Nursing Management
                John Wiley and Sons Inc. (Hoboken )
                0966-0429
                1365-2834
                27 June 2021
                October 2021
                : 29
                : 7 ( doiID: 10.1111/jonm.v29.7 )
                : 2314-2322
                Affiliations
                [ 1 ] Department of Health Services Research Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
                [ 2 ] Living Lab in Ageing and Long‐Term Care Maastricht The Netherlands
                [ 3 ] Department of Methodology and Statistics CAPHRI School for Public Health and Primary Care Maastricht University Maastricht The Netherlands
                [ 4 ] Department on Aging Netherlands Institute of Mental Health and Addiction (Trimbos‐institute) Utrecht The Netherlands
                Author notes
                [*] [* ] Correspondence

                Johanna E. R. Rutten, Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.

                Email: johanna.rutten@ 123456maastrichtuniversity.nl

                Author information
                https://orcid.org/0000-0003-1575-9821
                https://orcid.org/0000-0002-0817-9872
                Article
                JONM13386
                10.1111/jonm.13386
                8597031
                34053141
                7be316f8-8fdc-4d5e-85ab-99558e52dd21
                © 2021 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 11 May 2021
                Page count
                Figures: 0, Tables: 4, Pages: 0, Words: 16918
                Funding
                Funded by: ZonMw , doi 10.13039/501100001826;
                Award ID: 516012515
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                October 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:17.11.2021

                job characteristics,nursing homes,person‐centred care,transformational leadership,work environment

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