BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.
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Aims and objectives. To compare a functioning assessment based on the International Classification of Functioning, Disabilityand Health (ICF) with a conventional medical assessment, in terms of their respective consequences for health professionals’clinical decision-making and the fit with patient’s own perspective of health.Background. In chronic diseases, pathogenic-oriented health care falls short in generating all the information required fordetermining healthcare provision to improve health. A broader, so-called salutogenic approach, by using the ICF, focusingon how to stay healthy, rather than on what causes diseases, seems more appropriate.Design. A cross-sectional comparative study using data from a randomised controlled trial.Methods. Data about patient problems and professional healthcare activities were collected from a total of 81 patients withsevere multiple sclerosis who were randomly assigned to one of two groups: the ICF group, assessed with a functioningassessment (n = 43), and the medical group, assessed with a conventional medical assessment (n = 38). Data were analysedstatistically using descriptive and inferential statistics.Results. A functioning assessment resulted in the registration of significantly more patient problems in the health components‘participation’ and ‘environmental factors’, as well as significantly more professional healthcare activities befitting thesecomponents. The ICF group had a significant positive correlation between registered problems by health professionals andpatients’ self-reported problems, whereas the medical group had several negative correlations.Conclusion. A functioning assessment resulted in a care plan that not only was broader and more complete but also reflectedthe patients’ self-reported problems more closely than a medical assessment, without a loss of focus on medical problems.Relevance to clinical practice. This study has shown that some health problems remain unnoticed by a medical assessmentalone, which is especially important for the chronically ill. A functioning assessment provides a strong foundation for identifyingall relevant information related to health.
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