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Residents' and relatives' experiences of acute situations: a qualitative study to inform a care model

Kornelia Basinska, Patrizia Künzler-Heule, Raphaëlle Ashley Guerbaai, Franziska Zúñiga, Michael Simon, Nathalie I H Wellens, Christine Serdaly & Dunja Nicca

abstract

BACKGROUND AND OBJECTIVES
As new models of care aiming to reduce hospitalizations from nursing homes emerge, their implementers must consider residents' and relatives' needs and experiences with acute changes in the residents' health situations. As part of the larger INTERCARE implementation study, we explored these persons' experiences of acute situations in Swiss nursing homes.

RESEARCH DESIGN AND METHODS
Three focus groups were conducted with residents and their relatives and analyzed via reflexive thematic analysis.

RESULTS
The first theme, the orchestra plays its standards, describes experiences of structured everyday care in nursing homes, which functions well despite limited professional and competency resources. The second theme, the orchestra reaches its limits, illustrates accounts of acute situations in which resources were insufficient to meet residents' needs. Interestingly, participants' perceptions of acute situations went well beyond our own professional view, i.e., changes in health situations, and included situations best summarized as "changes that might have negative consequences for residents if not handled adequately by care workers." Within the third theme, the audience compensates for the orchestra's limitations, participants' strategies to cope with resource limitations in acute situations are summarized.

DISCUSSION AND IMPLICATIONS
Our findings suggest differences between care providers' and participants' perspectives regarding acute situations and care priority setting. Alongside efforts to promote staff awareness of and responsiveness to acute situations, care staff must commit to learning and meeting individual residents' and relatives' needs. Implications for the development and implementation of a new nurse-led model of care are discussed.
   
citation Basinska K, Künzler-Heule P, Guerbaai R A, Zúñiga F, Simon M, Wellens N I H, Serdaly C, Nicca D. Residents' and relatives' experiences of acute situations: a qualitative study to inform a care model. Gerontologist 2021;.
   
type journal paper/review (English)
date of publishing 24-02-2021
journal title Gerontologist
ISSN electronic 1758-5341
PubMed 33624766
DOI 10.1093/geront/gnab027