The relation between resident-related factors and care problems in nursing homes: a multi-level analysis.

Autor: Bouchmal S; Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands. suleyman.bouchmal@maastrichtuniversity.nl.; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands. suleyman.bouchmal@maastrichtuniversity.nl., Goërtz YMJ; Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands.; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands., Hacking C; Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands.; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands., Winkens B; Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands., Aarts S; Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands.; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, The Netherlands.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2024 Nov 19; Vol. 24 (1), pp. 1435. Date of Electronic Publication: 2024 Nov 19.
DOI: 10.1186/s12913-024-11915-y
Abstrakt: Background: Care problems such as decubitus and fall incidents are prevalent in nursing homes. Yet, research regarding explanatory factors on these care problems is scarce. The aim of this study is twofold: (1) to identify the degree to which a diverse set of resident-related factors (e.g., care dependency levels) are associated with the sum of six care problems (pressure ulcers, incontinence, malnutrition, falls, freedom restriction, and pain), and (2) to investigate which resident-related factors are associated with each of these six care problems individually.
Methods: Data were collected (2016-2023) using the International Prevalence Measurements of Care Quality (LPZ). Factors such as age, number of diagnoses, and length of stay were included. While respecting nested data within eight organizations, the associations between thirteen resident-related factors and the six care problems were determined using multilevel analyses.
Results: A total of 3043 residents were included (mean age 81.9; SD: 10.5). The most prevalent care problem was incontinence (n = 1834; 60.3%). Nurse proxy-rated confusion (r = 0.227; p < 0.001) and aggression (r = 0.285; p = 0.001) were associated strongest with the sum of the six care problems; and higher after correcting for the residents' care dependency levels (respectively r = 0.504; 0.584 - both p < 0.001). Pre-admission risk assessments for pressure ulcers (OR 7.03), malnutrition (OR 3.57), and falls (OR 3.93) were strongest associated with individual care problems such as pressure ulcers, and falls.
Conclusions: This study shows the association between several resident-related factors and care problems such as gender, years since admission, and care dependency level. Factors such as proxy-rated aggression and confusion were strongest associated with the presence of care problems, while pre-admission risk assessments were strongest associated with several individual care problems. The findings underscore the importance of prioritizing early pre-assessments, as they empower care professionals to take into account resident-specific factors and their influence on the emergence of care problems.
Competing Interests: Declarations Ethics approval and consent to participate The Medical Research Ethics Committee of Maastricht University and Maastricht University Medical Centre approved the LPZ study. All nursing homes that were included in the LPZ study participated on a strictly voluntary basis, with no financial compensation. Each resident was informed of the study and the measurements, and each resident or their representative had to give informed verbal consent. All data were collected and processed anonymously. Consent for publication Not applicable. Competing interest The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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