Author: Lung, Chi Chi
Title: Nurse assistants' and elderly residents' perspectives on their daily interactions in nursing homes : a qualitative study
Degree: M.Sc.
Year: 2015
Subject: Nurses' aides -- Psychology.
Medical personnel and patient.
Nursing homes.
Hong Kong Polytechnic University -- Dissertations
Department: School of Nursing
Pages: ix, 143 pages : illustrations ; 30 cm
Language: English
Abstract: Aim: To explore the perspectives of nurse assistants and residents on residents' psychosocial well-being related to their daily interactions in nursing homes, during both care delivery and residents' leisure time. Background: Psychosocial well-being has been identified as pivotal to nursing home residents' overall health and is positively associated with their interactions with nursing home staff that include good relationships and social support. As the primary caregivers who responsible for most of residents' direct personal care, nurse assistants interact more frequently with residents than other nursing home staff and account for the majority of residents' daily interactions in nursing homes. However, little is known about the perspectives of these two parties on residents' psychosocial well-being in relation to their daily interactions. Design: This study used a descriptive exploratory design involving in-depth interviews with nurse assistants and residents. Method: A convenience sample of 18 nurse assistants and 15 residents from 6 non-profit nursing homes participated in unstructured interviews from July to December 2013. Individual interviews were tape-recorded and transcribed verbatim. Data from the two groups were analyzed separately using inductive content analysis. Data saturation was achieved. Results: Two main categories were generated from the perspectives of nurse assistants, namely "Fulfilling psychosocial needs is beyond the nurse assistant's role" and "From acquaintances to mutual friends with increasing psychosocial input". From the residents' perspectives, three main categories were derived: "Sociable and harmonious yet with limited social support", "Physical needs dominate and there is no room for closer relationships" and "Nothing goes how I want".
Conclusion: Two main perspectives of nurse assistant-resident daily interactions with different levels of closeness were identified from the two groups. First, findings indicated that physiologically-oriented interactions hindered residents' psychosocial well-being due to difficulty in building rapport and rare social support. Despite residents' general acceptance, findings revealed that lack of security and a sense of belonging in nursing homes lowered their intentions to establish rapport and seek support from nurse assistants. Second, findings revealed discrepancies on the perceived closeness of friendly interactions between the two parties in that some nurse assistants claimed to develop closer interactions with residents, encompassing good rapport and greater social support, while the latter considered their interactions as harmonious yet with little social support. This reflects the possibility of nurse assistants overestimating their rapport with residents and their provision of social support, possibly due to their inadequate understanding of residents' perspectives on their daily interactions and the nurse assistant role. This highlights the risk of residents' unexpressed non-physical needs going unrecognized by nurse assistants. Implications for clinical practice: The study indicated that difficulty in establishing rapport and lack of social support in physical need-driven interactions, as well as nurse assistants' inadequate understanding of residents' views on their daily interactions pose risks to residents' psychosocial well-being. Modifications on training and institutional policies are suggested so as to give nurse assistants greater awareness and competences to establish closer interactions with residents. This offers residents one more platform for gaining social support in nursing homes, thereby enhancing their overall health.
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