0 avis
End-of-life culture change practices in U.S. nursing homes in 2016 / 2017
Article indépendant
CONTEXT: The Nursing Home (NH) culture change (CC) movement, which emphasizes person-centered care, is particularly relevant to meeting the unique needs of residents near the end-of-life (EOL).
OBJECTIVES: We aimed to evaluate the NH-reported adoption of person-centered EOL-CC practices and identify NH characteristics associated with greater adoption.
METHODS: We used NH and state policy data for 1,358 NHs completing a nationally representative 2016/17 NH Culture Change Survey. An 18-point EOL-CC score was created by summarizing responses from six survey items related to practices for residents who were dying/had died. NHs were divided into quartiles reflecting their EOL-CC score, and multivariable ordered logistic regression was used to identify NH characteristics associated with having higher (quartile) scores.
RESULTS: The mean EOL-CC score was 13.7 (standard deviation=3.0). Correlates of higher scores differed from those previously found for non-EOL-CC practices. Higher NH leadership scores and non-profit status were consistently associated with higher EOL-CC scores. For example, a three-point leadership score increase was associated with higher odds of a NH performing in the top EOL-CC quartile (OR=2.0, 95% CI:1.82, 2.30), while for-profit status was associated with lower odds (OR=.0.7, 95% CI:0.49,0.90). The availability of palliative care (PC) consults was associated with a greater likelihood of EOL-CC scores above the median (OR=1.5, 95%CI: 1.10,1.93), but not in the top or bottom quartiles.
CONCLUSION: NH-reported adoption of EOL-CC practices varies, and the presence of PC consults in NHs explains only some of this variation. Findings support the importance of evaluating EOL-CC practices separately from other culture change practices.
http://dx.doi.org/10.1016/j.jpainsymman.2018.12.330
Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»
Autres numéros de la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»
Consulter en ligne
Suggestions
Du même auteur
De la même série