hig.sePublications
Change search
ReferencesLink to record
Permanent link

Direct link
An intervention targeting fundamental values among caregivers at residential facilities: Effects of a cluster-randomized controlled trial on residents' self-reported empowerment, person-centered climate and life satisfaction.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. 2Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. 2Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. 2Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. 2Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0002-9912-5350
2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, no 1, 130Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In Sweden the national fundamental values for care of older people state that care should ensure that they can live in dignity and with a sense of well-being. Our hypothesis was that a caregiver intervention targeting the national fundamental values would improve perceived empowerment, person-centered climate and life satisfaction among older people living in residential facilities.

METHODS: The study was a cluster-randomized controlled trial with a pre- and one post-test design, conducted in 27 units (17 study units) at 12 residential facilities for older people in five municipalities in central Sweden. The units in each municipality were randomly assigned to intervention or control group. The caregiver intervention was carried out using an interpretative approach with eight guided face-to-face seminars, where self-reflection and dialogue were used. Data were collected using questionnaires. The number of residents was 43 (78 %) in the intervention group and 37 (71 %) in the control group. The Chi-square test and Mann-Whitney U-tests were performed to detect differences between groups and Wilcoxon signed rank tests to explore differences in change over time within groups. Furthermore, generalized estimating equation (GEE) models were used to study effects of the intervention controlling for clustering effects.

RESULTS: Primary outcome measures were empowerment, person-centered climate and life satisfaction. In the intervention group, improvements at follow-up were found in residents' self-reported empowerment (n = 42; p = 0.001, Median difference 4.0, 95 % CI 1.5;6.0), person-centered climate (n = 42; p ≤0.001, Median difference 8.0, 95 % CI 4.5;11.4) and life satisfaction regarding the factor quality of everyday activities (n = 40; p = 0.033, Median difference 9.7, 95 % CI 1.0;21.9) while disempowerment decreased (n = 43; p = 0.018, Median difference -1.3, 95 % CI -2.0;0.0). In the control group person-centered climate decreased (n = 37; p = 0.002, Median difference -8.5, 95 % CI -13.6;-3.0) and quality of everyday activities (n = 36; p = 0.012, Median difference -11.6, 95 % CI-21.7;-3.4). Change over time between groups was significant for empowerment (p = 0.001, Median difference 6.0, 95 % CI 3.0;9.0), disempowerment (p = 0.006, Median difference -2.0, 95 % CI -4.0;-1.0) and person-centered climate (p ≤ 0.001, Median difference 16.0, 95 % CI 9.7;23.0) and for life satisfaction regarding the factor quality of everyday activities (p = 0.002, Median difference 22.1, 95 % CI 8.2;37.4). Results of GEE confirmed earlier results; revealed interaction effects for empowerment (parameter estimate -5.0, 95 % CI -8.3;-1.8), person-centered climate (parameter estimate -16.7, 95 % CI -22.4;-10.9) and life satisfaction regarding the factor quality of everyday activities (parameter estimate -25.9, 95 % CI -40.3;-11.5).

CONCLUSION: When the Swedish national fundamental values were put into practice increases in empowerment, person-centered climate and quality of everyday activities were found among older people with intact cognitive ability living in residential facilities. Limitations to consider are the differences between the two groups at baseline, drop-outs and that neither the data collector nor the outcome assessors were blinded to group assignment of participants.

TRIAL REGISTRATION: The study was registered in ISRCTN92658034 in January 2013.

Place, publisher, year, edition, pages
2016. Vol. 16, no 1, 130
Keyword [en]
A sense of well-being, Empowerment, Experimental design, Life satisfaction, Living in dignity, Person-centered climate, Residential facilities for older people
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-22156DOI: 10.1186/s12877-016-0306-2ISI: 000379253200003PubMedID: 27387954ScopusID: 2-s2.0-84977266195OAI: oai:DiVA.org:hig-22156DiVA: diva2:948987
Available from: 2016-07-14 Created: 2016-07-14 Last updated: 2017-01-10Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedScopus

Search in DiVA

By author/editor
Roos, CharlotteSilén, MaritSkytt, BerniceEngström, Maria
By organisation
Department of Health and Caring Sciences
In the same journal
BMC Geriatrics
Nursing

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 112 hits
ReferencesLink to record
Permanent link

Direct link