End-of-life care in nursing homes: the importance of CNA staff communication.
End-of-life care in nursing homes: the importance of CNA staff communication.
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疗养院的临终关怀：CNA 员工沟通的重要性。
DOI：
10.1016/j.jamda.2010.01.006
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发表时间：
2010
影响因子：
7.6
通讯作者：
Temkin-Greener,Helena
中科院分区：
文献类型：
--
作者：
Zheng,NanTracy;Temkin-Greener,Helena
工作人员的沟通已被证明会影响整体养老院（NH）的表现。然而，没有实证研究专门集中在CNA通信对生命结束（EOL）护理过程的影响。本研究旨在探讨CNA沟通与护理之家在临终关怀过程中的表现之间的关系，并对2006- 2007年进行的两次NH调查的二次数据进行分析。研究地点：纽约州107家护理之家。参与者：2636名CNA和107名护理主任（DON）。（5分Likert量表评分）-从107名DON提供的调查答复中获得。CNA通信的措施来自2636 CNA获得的调查答复。其他自变量包括工作人员的教育，临终关怀使用强度，人员配置比例，工作人员居民的种族重叠指数，设施的宗教信仰，和ownership. METHODS的可靠性和有效性的措施，EOL护理过程和CNA通信进行了测试，在当前的研究样本。使用了具有概率权重的多元线性回归模型。我们发现更好的CNA沟通与更好的EOL评估（P = 0.043）和护理提供（P = 0.098）显著相关。两个潜在的可修改的因素-工作人员的教育和临终关怀的使用强度-与NHs的性能在EOL护理过程中。工作人员和居民之间具有更大种族重叠的设施表现出更好的EOL评估（P = 0.051）和护理提供评分（P = 0.029）。我们的研究结果为NH领导者提供了具体的见解，这些领导者努力改善EOL护理流程，并最终提高临终居民的护理质量。
OBJECTIVEStaff communication has been shown to influence overall nursing home (NH) performance. However, no empirical studies have focused specifically on the impact of CNA communication on end-of-life (EOL) care processes. This study examines the relationship between CNA communication and nursing home performance in EOL care processes.DESIGNSecondary data analysis of 2 NH surveys conducted in 2006–2007.SETTINGOne hundred seven nursing homes in New York State.PARTICIPANTSParticipants were 2636 CNAs and 107 directors of nursing (DON).MEASUREMENTSThe measures of EOL care processes—EOL assessment and care delivery (5-point Likert scale scores)—were obtained from survey responses provided by 107 DONs. The measure of CNA communication was derived from survey responses obtained from 2636 CNAs. Other independent variables included staff education, hospice use intensity, staffing ratio, staff-resident ethnic overlap index, facility religious affiliation, and ownership.METHODSThe reliability and validity of the measures of EOL care processes and CNA communication were tested in the current study sample. Multivariate linear regression models with probability weights were used. The analysis was conducted at the facility level.RESULTSWe found better CNA communication to be significantly associated with better EOL assessment (P = .043) and care delivery (P = .098). Two potentially modifiable factors—staff education and hospice use intensity—were associated with NHs' performance in EOL care processes. Facilities with greater ethnic overlap between staff and residents demonstrated better EOL assessment (P = .051) and care delivery scores (P = .029).CONCLUSIONBetter CNA communication was associated with better performance in EOL care processes. Our findings provide specific insights for NH leaders striving to improve EOL care processes and ultimately the quality of care for dying residents.