Staffing practices in long-term care lack a clear evidence base and often seem to be guided by opinions instead of evidence. While stakeholders believe intuitively that there is a positive relationship between staffing levels and quality in nursing homes, the research literature is contradictory (1). In this editorial we consider the evidence found in a literature study that we conducted for the Dutch Ministry of Health, Welfare and Sports (VWS). The aim of this study was to summarize all available evidence on the relationship between staffing and quality in nursing homes. Specifically, we focused on the quantity and the educational background of staff and quality in nursing homes. The literature study has contributed to the recent Dutch quality framework for nursing homes (Kwaliteitskader verpleeghuiszorg in Dutch) of the National Health Care Institute. This quality framework was published in January 2017 and provides norms – among other quality aspects – for nursing home staffing. As well as a description of the main findings of the literature study, we present implications for different stakeholders charged with staffing issues in nursing homes.
This report is the second in a series of three reports named Value Added Planning, consisting of three unique, but interconnected tools, namely the Green Credit Tool, the Workbench Method and Value Added Planning, These tools have been developed and/or tested in the context of the European INTERREG programme: VALUE (INTERREG IVB North West Europe - Valuing Attractive Landscapes in the Urban Economy), in which the municipality of Amersfoort is involved. Aim of this programme is to understand how green space in urban centres can become more competitive with other urban functions. In this context, the municipality of Amersfoort has introduced the interactive method named Workbench Spatial Quality (Werkbank Ruimtelijke Kwaliteit in Dutch) in their spatial design in several areas in their municipality. The Workbench Spatial Quality (to be referred to as Workbench) has been applied on two cases in Amersfoort: Park Randenbroek and Vathorst NW. In this report the Workbench as applied in Amersfoort is evaluated. Research was done on the basis of literature research, case-material and interviews performed with several experts. Furthermore, research was done by students at the Wageningen University and Research Centre (WUR). Part of the evaluation in this report makes use of a quick scan of 19 Dutch cases. The question addressed in this report is: 1.How was the Workbench Spatial Quality applied in Amersfoort? 2.Can the Workbench contribute to sustainable spatial planning?
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BACKGROUND: Consideration of older adults' quality of life (QoL) is becoming increasingly important in the evaluation, quality improvement and allocation of health and social care services. While numerous definitions and theories of QoL have been proposed, an overall synthesis of the perspective of older adults themselves is lacking.METHODS: Qualitative studies were identified in PubMed, Ebsco/Psycinfo and Ebsco/CINAHL, through a search on 28 November 2018. Articles needed to meet all of the following criteria: (i) focus on perceptions of QoL, (ii) older adults living at home as main participants, (iii) use of qualitative methodology, (iv) conducted in a Western country and (v) published in English (vi) not focused on specific patient groups. A thematic synthesis was conducted of the selected studies, using the complete 'findings/results' sections from the papers.RESULTS: We included 48 qualitative studies representing the views of more than 3,400 older adults living at home in 11 Western countries. The QoL aspects identified in the synthesis were categorized into nine QoL domains: autonomy, role and activity, health perception, relationships, attitude and adaptation, emotional comfort, spirituality, home and neighbourhood, and financial security. The results showed that although different domains can be distinguished, these are also strongly connected.CONCLUSION: QoL can be expressed in a number of domains and related subthemes that are important for older adults living at home. The findings further support that the concept of QoL should be seen as a dynamic web of intertwined domains.
