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The use of direct care in nursing home residents: A longitudinal cohort study over 3 years
Stavanger Univ Hosp, Ctr Age Related Med, Stavanger, Norway;Innlandet Hosp Trust, Ctr Old Age Psychiat Res, Ottestad, Norway.
Innlandet Hosp Trust, Ctr Old Age Psychiat Res, Ottestad, Norway;Vestfold Hosp Trust, Norwegian Natl Advisory Unit Ageing & Hlth, Tonsberg, Norway;Univ Oslo, Inst Hlth & Soc, Oslo, Norway.
Innlandet Hosp Trust, Ctr Old Age Psychiat Res, Ottestad, Norway;Univ Oslo, Inst Clin Med, Oslo, Norway;Akershus Univ Hosp, Hlth Serv Res Unit, Lorenskog, Norway.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Neurogeriatr, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden.ORCID iD: 0000-0003-0963-5750
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2019 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 34, no 2, p. 337-351Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate the trend in the use of direct care in a cohort of nursing home (NH) residents and explore its association with resident characteristics and organizational factors.

Methods/design: A total of 696 NH residents from 47 Norwegian NHs were included at admissions at NH. In 537 residents, the use of direct care was assessed every 6 months over a course of 3 years. A multiple model was estimated to identify demographic, clinical, and organizational characteristics associated with the use of direct care time.

Results: Six months after admission, on average, 76.2 hours of direct care were rendered to each resident per month, while this number was reduced to 50.3 hours per month at the end of the study period. Most residents (92%) showed a stable use of direct care time, while a small group of residents displayed a much higher and varying use of direct care time. Increasing dementia, neuropsychiatric symptoms, and decreasing function in activities of daily living were associated with higher use of direct care time. Direct care time constituted about 50% of the staff's working time.

Conclusion: In Norwegian NHs, high use of direct care time was associated with younger age, more severe dementia, and severe neuropsychiatric symptoms. By identifying factors that impact on direct care time, preventive measures might be put in place to the benefit of the residents and possibly to improve resource use. Further research should explore the association between direct care time, quality of care, and the residents' quality of life.

Place, publisher, year, edition, pages
2019. Vol. 34, no 2, p. 337-351
Keywords [en]
dementia, direct care, nursing home, nursing home residents, nursing home care
National Category
Nursing Geriatrics
Identifiers
URN: urn:nbn:se:uu:diva-378188DOI: 10.1002/gps.5026ISI: 000458818500017PubMedID: 30430646OAI: oai:DiVA.org:uu-378188DiVA, id: diva2:1293178
Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-03-04Bibliographically approved

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