Applying a palliative care approach in residential care: effects on nurse assistants' experiences of care provision and caring climate
Version of Record online: 5 FEB 2014
© 2014 Nordic College of Caring Science
Scandinavian Journal of Caring Sciences
Volume 28, Issue 4, pages 830–841, December 2014
How to Cite
Scand J Caring Sci;2014; 28; 830–841 Applying a palliative care approach in residential care: effects on nurse assistants' experiences of care provision and caring climate
- Issue online: 18 NOV 2014
- Version of Record online: 5 FEB 2014
- Manuscript Accepted: 28 DEC 2013
- Manuscript Received: 23 JUL 2013
- Swedish Institute for Health Sciences
- King Gustav V and Queen Victoria Foundation
- Kristianstad University
- Facutly of Medicine, Lund Univeristy
- palliative care;
- long-term care;
- nurse assistants;
- quality of care;
- person-centred care;
- caring climate
A palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care.
An intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time.
In the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care.
The intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.