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.
DOCUMENT
BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. METHODS: We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. RESULTS: 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. CONCLUSIONS: In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was acceptable. No consistent evidence was found for a relationship between the presence of BRNs in wards and quality of care outcomes, controlling for background characteristics. Future studies should consider the mediating and moderating role of staffing-related work processes and ward environment characteristics on quality of care.
DOCUMENT
Background Anxiety and challenging behaviour (CB) often occur simultaneously in people with intellectual disabilities (ID). Understanding the associations between anxiety and CB may contribute to more accurate diagnoses and management of both anxiety and CB in this population. Aims To examine the relationship between anxiety and CB. Methods A literature review covering the period from January 2000 to January 2012. Results Seven studies about the relationship between psychiatric disorders, including anxiety, and CB were identified. These studies confirm the relationship between anxiety and CB in people with ID, although the precise nature of this relationship remains unclear. Conclusions The study points toward the existence of a moderate association between anxiety and CB. Further research is needed to clarify the complex nature of the association between anxiety and CB.
DOCUMENT
This research explores commercial friendship within Dutch pubs, focusing on the transition from transactional to personal interactions between bartenders and guests. The study uses semi-structured interviews and thematic analysis to reveal that commercial friendship shares many similarities with non-commercial friendship but differs in important aspects. We found six levels of commercial friendship that range from minimal interactions, categorized as 'guest,' to deep, personal connections identified as 'best friend.' We identified three dimensions of commercial friendship quality: activities, self-disclosure, and social support. A critical finding is the 'tipping point'—a stage in the relationship development where interactions shift from professional to personal, characterized by mutual personal disclosure and balanced social support, redefining professional relationships. These findings demonstrate that commercial environments can foster genuine friendships, and provide valuable insights for enhancing interpersonal relationships within the hospitality industry.
LINK
PURPOSE: The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.METHODS: A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).RESULTS: The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42-0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27-0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ (2) = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.CONCLUSIONS: The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.
LINK
Leisure travelling is known to be a contributor to visitors’ well-being and quality of life yet only little is known about the influence of tourism on the destination residents’ quality of life. Given rising imbalances and perceived conflicts of use between visitors and residents particularly in an urban context, research interest in residents’ perspectives have increased and new measures such as the tourism acceptance score have been developed to measure perceived tourism impacts over time. While tourism intensity has been proposed to be an indicator for low tourism acceptance and decreasing quality of life, little empirical evidence is existing. This study examines the relationship between tourism acceptance and perceived quality of life and the moderating role of tourism intensity. The data base used consisted of representative samples in 11 German cities. Results demonstrate a positive relationship between personal tourism acceptance and the residents’ quality of live. This relationship is moderated by the tourism intensity and is generally stronger in cities with higher tourism intensity.
LINK
from the article: Abstract Based on a review of recent literature, this paper addresses the question of how urban planners can steer urban environmental quality, given the fact that it is multidimensional in character, is assessed largely in subjective terms and varies across time. The paper explores three questions that are at the core of planning and designing cities: ‘quality of what?’, ‘quality for whom?’ and ‘quality at what time?’ and illustrates the dilemmas that urban planners face in answering these questions. The three questions provide a novel framework that offers urban planners perspectives for action in finding their way out of the dilemmas identified. Rather than further detailing the exact nature of urban quality, these perspectives call for an approach to urban planning that is integrated, participative and adaptive. ; ; sustainable urban development; trade-offs; quality dimensions
DOCUMENT
DOCUMENT
The benefits of having a high indoor environmental quality (IEQ) for a healthy life and optimal performance are well known. In addition, research has been executed on the effects of indoor environmental parameters such as (day)light, sound/ acoustics, temperature, and air quality on people living with dementia.
DOCUMENT
Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
MULTIFILE
