Organisational opportunities for person-centred care in residential aged care: a focus group study with managers and staff
Roar Hermansen Østby, Synneve Dahlin-Ivanoff, Jenna Najar, Qarin LoodObjectives
To explore organisational opportunities for person-centred care in residential aged care facilities from the perspectives of managers and staff.
Design
A qualitative study using focus group discussions and inductive thematic analysis followed by a deductive interpretation guided by a theoretical framework.
Setting
Residential aged care facilities providing long-term care for older people in Sweden.
Participants
A total of 23 participants were recruited using purposive sampling and participated in five focus groups. Participants included assistant nurses, occupational therapists, physiotherapists, registered nurses, social service managers and healthcare managers working in residential aged care. To be included, participants had to have experience of working in residential aged care.
Results
The analysis generated two interconnected themes. The inductively developed theme, Creating foundations for person-centred care , described organisational conditions perceived as necessary for enabling person-centred care in residential aged care. Three subthemes highlighted the importance of establishing a safe and supportive environment, maintaining continuity of care and ensuring responsiveness to older persons’ desires and needs. The deductively developed theme, Turning foundations for person-centred care into action, interpreted these organisational foundations in relation to the three routines of the University of Gothenburg Centre for Person-Centred Care framework: initiating, working and safeguarding the partnership. Partnership was understood as a way in which organisational foundations could be enacted in everyday care, rather than as a separate inductive finding.
Conclusions
Person-centred care in residential aged care was described to require organisational conditions that support safe and supportive environments, continuity of care and responsiveness to older persons’ preferences and needs. The findings suggest that workforce stability, managerial support, clear responsibilities, communication and active use of documentation are important for enabling person-centred care in everyday practice. Future initiatives should focus on developing and evaluating organisational approaches that support person-centred care in collaboration with older persons, relatives and staff.