U-AGE: health-promoting living conditions and person-centred care of older people
Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umea ageing and health research programme (U-AGE) consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme consists of four projects designed to provide experimental, cross-sectional and longitudinal data on different types of housing models and person-centred care interventions. The aims and research questions for the four projects are as follows:
- U-Age Home Care aims to evaluate the effects and meanings of person-centred home care services from the perspective of older people, family caregivers and home care service staff. The main research question is the extent to which a person-centred and health-promoting home care intervention can result in better health, thriving, and satisfaction with care, compared to traditional home care services. A non-randomised controlled trial with before-and-after design is used in this study to determine the effects of person-centred home care service on: a) older people’s perceived health status (primary endpoint), thriving, and satisfaction with care (secondary endpoints); b) family caregiver’s strain, resource utilisation and care satisfaction (secondary endpoints); and c) stress of conscience and job satisfaction among care staff (secondary endpoints).
- U-Age TryBo aims to compare characteristics and health outcomes between sheltered housing for older people and ageing in place. The main research question is the extent to which sheltered housing for older people facilitates older people’s health, thriving and quality of life compared to ageing in place. A prospective case-control design is used to determine whether the new Swedish form for sheltered housing for older people has beneficial outcomes on older people’s quality of life (primary endpoint), thriving, and depression (secondary endpoints) as compared to ageing in place. A nationally representative sample of 5000 older people (>70 years) living in sheltered housing (case) and ageing in place (age-matched controls) has been invited through national registers.
- U-Age Nursing Home aims to evaluate the effects, meaning and significance of a person-centred and thriving-promoting intervention in nursing homes. The main research question is whether a person-centred and thriving-promoting care model for nursing homes can increase thriving for residents, satisfaction with care for relatives, and job satisfaction for staff. A multi-centre, non-equivalent controlled group before and-after design with participating sites in Melbourne (Australia), Oslo (Norway) and Vasterbotten (Sweden) is used to evaluate effects of a person-centred and thriving-promoting care model for nursing homes on: a) residents’ thriving (primary endpoint) and experiences of the caring environment (secondary endpoint); b) relatives’ satisfaction with care (primary endpoint), experience of visiting the facility, and experience of the caring environment (secondary endpoints); and c) staff’s job satisfaction (primary endpoint), stress of conscience, experience of the caring environment, and perceived person-centredness (secondary endpoints).
- U-Age SWENIS aims to initiate longitudinal monitoring of care and health in Swedish nursing homes. The main research question is what are the prevalence of symptoms, involvement in daily activities quality of life and thriving for older people in Swedish nursing homes, as well as what are the characteristics and experiences of care provision and structure in a nationally representative sample of Swedish nursing homes. A longitudinal design with a point prevalence initial measurement is used to collect: a) demographic data and data on cognitive status, pain, depression, neuropsychiatric symptoms, functional status and ability, participation in activities, thriving and health-related quality of life among residents; and b) data on person-centredness of care, staff working situation and organisational aspects of nursing homes. The U-Age Svenis group has developed a valid, reliable and internationally comparable Swedish nursing home survey, and baseline data were collected in 2014 from a randomised Swedish nationally representative sample of nursing home residents (n=4831) staff (n=3661), and managers (n=191) in 188 nursing homes from 38 municipalities. The baseline data is analysed by descriptive and inferential analyses, and longitudinal repeated measures are ongoing to explore trends and predictors of resident health outcomes as well as care models and quality in nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.
Chief Investigator: Prof. David Edvardsson
Collaborators: Karolinska Institute, Oslo University, Umea University, Lovisenberg Diaconal College, Gothenburg University
Project publications to date:
- Nilsson A, Edvardsson D, Rushton C. Nurses’ descriptions of person-centred care for older people in an acute medical ward—On the individual, team and organisational levels’ Journal of Clinical Nursing 01 Jan 2019
- Corneliusson, L., Sköldunger, A., Sjögren, K., Lövheim, H., Wimo, A., Winblad, B., Sandman, P-O & Edvardsson, D. (2019). Residing in sheltered housing versus aging in place - population characteristics, health status and social participation. Health & Social Care in the Community, in Press.
- Grealish L, Simpson T, Soltau D, Edvardsson D. Assessing and providing person-centred care of older people with cognitive impairment in acute settings: threats, variability, and challenges Collegian Apr 2018
- Vassbo TK, Kirkevold M, Edvardsson D, Sjogren K, Lood Q, Sandman PO, Bergland A. Associations between job satisfaction, person‐centredness, and ethically difficult situations in nursing homes—A cross‐sectional study Journal of Advanced Nursing 10 pages 2018
- Bjork S, Lindkvist M, Lovheim H, Bergland Å, Wimo A, Edvardsson D. Exploring resident thriving in relation to the nursing home environment: A cross‐sectional study Journal of Advanced Nursing 74(12):2820-2830 2018
- Backman A, Sjögren K, Lövheim H, Edvardsson D. Job strain in nursing homes-Exploring the impact of leadership Journal of Clinical Nursing 27(7-8):1552-1560 Apr 2018
- Sandberg L, Borell L, Edvardsson D, Rosenberg L, Boström A-M. Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services Journal of Multidisciplinary Healthcare Volume 11:255-266 2018
- Sköldunger A, Wimo A, Sjögren K, Björk S, Backman A, Sandman PO, Edvardsson D. Resource use and its association to cognitive impairment, ADL functions, and behavior in residents of Swedish nursing homes: Results from the U-Age program (SWENIS study) International Journal of Geriatric Psychiatry 34(1):130-136 01 Jan 2019
- Balash, L., Sköldunger, A., Sjögren, K., Lövheim, H. & Edvardsson, D. (2018). Health-related Quality of Life and Social Participation of Residents in Sheltered Housing. Innovation in Aging, Volume 2, Issue suppl_1, 1 November 2018, Pages 307–308. doi: https://doi.org/10.1093/geroni/igy023.1128
- Edvardsson D, Sjögren K, Lood Q, Bergland Å, Kirkevold M, Sandman P-O. A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial BMC Geriatrics 17(1) Dec 2017
- Backman A, Sjögren K, Lindkvist M, Lövheim H, Edvardsson D. Characteristics of highly rated leadership in nursing homes using item response theory Journal of Advanced Nursing 73(12):2903-2913 Dec 2017
- Bölenius K, Lämås K, Sandman P-O, Edvardsson D. Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial BMC Geriatrics 17(1) Dec 2017
- Sjögren K, Lindkvist M, Sandman P-O, Zingmark K, Edvardsson D. Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study BMC Nursing 16(1) Dec 2017
- Cai L, Ahlström G, Tang P, Ma K, Edvardsson D, Behm L, Fu H, Zhang J, Yang J. Psychometric evaluation of the Chinese version of the Person-centred Climate Questionnaire - Staff version (PCQ-S) BMJ Open 7(8):e017250-e017250 Aug 2017
- Vrbnjak D, Pahor D, Povalej Bržan P, Edvardsson D, Pajnkihar M. Psychometric testing of the Slovenian Person-centred Climate Questionnaire - staff version Journal of Nursing Management 25(6):421-429 Sep 2017
- Rushton C, Edvardsson D. Reconciling concepts of space and person-centred care of the older person with cognitive impairment in the acute care setting Nursing Philosophy 18(3):e12142-e12142 Jul 2017
- Rushton C, Edvardsson D. Reconciling conceptualisations of the body and person-centred care of the older person with cognitive impairment in the acute care setting Nursing Philosophy 18(4):e12160-e12160 Oct 2017
- Rushton C, Edvardsson D. Reconciling conceptualizations of ethical conduct and person-centred care of older people with cognitive impairment in acute care settings Nursing Philosophy 19(2):e12190-e12190 Apr 2018
- Rushton C, Edvardsson D. Reconciling conceptualizations of relationships and person-centred care for older people with cognitive impairment in acute care settings Nursing Philosophy 19(2):e12169-e12169 Apr 2018
- Björk S, Lindkvist M, Wimo A, Juthberg C, Bergland Å, Edvardsson D. Residents’ engagement in everyday activities and its association with thriving in nursing homes Journal of Advanced Nursing 73(8):1884-1895 Aug 2017
- Grealish L, Chaboyer W, Harbeck E, Edvardsson D. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale - psychometric evaluation Journal of Nursing Management 25(2):139-147 Mar 2017
- Lood Q, Björk S, Sköldunger A, Backman A, Sjögren K, Edvardsson D. The relative impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations: Cross-sectional findings from U-Age Swenis Journal of Occupational Science 24(3):327-337 03 Jul 2017
- Björk S, Lövheim H, Lindkvist M, Wimo A, Edvardsson D. Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents International Journal of Geriatric Psychiatry 33(1):e49-e57 Jan 2018