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Resident-oriented care in nursing homes: effects on nurses
Afke J M B Berkhout1, Nicolle P G Boumans, Gerard P J Van Breukelen
1Coordinating Body of the Dutch Organisations for the Elderly, Utrecht, The Netherlands. aberkhout@ouderenorganisaties.nl
Journal of Advanced Nursing
|March 12, 2004
Summary
Resident-oriented care models partially succeeded in Dutch nursing homes. While patient assignment and nursing process use increased, effects on nurses' work characteristics and outcomes were limited, with job autonomy showing some improvement.
Area of Science:
- Nursing
- Organizational Psychology
- Healthcare Management
Background:
- Resident-oriented care models assign patients to primary nurses responsible for total care using the nursing process.
- Job demand-control models suggest enriched jobs with autonomy positively influence worker outcomes.
Purpose of the Study:
- To investigate the implementation of resident-oriented care features in Dutch nursing homes.
- To assess the effects of this model on nurses' work characteristics and psychological/behavioral outcomes.
Main Methods:
- A quasi-experimental design with experimental and control groups over 22 months.
- Data collected via pretest/post-tests using questionnaires, interviews, and qualitative observations.
Main Results:
- Increased resident assignment and nursing process variables observed.
- Qualitative data revealed incomplete task delegation and a persistent task-oriented labor division.
- Limited effects on work perceptions, though job autonomy increased in the experimental group.
Conclusions:
- The resident-oriented care intervention was only partially successful.
- Expected improvements in work characteristics and psychological/behavioral outcomes were largely not realized.
- Theoretical and methodological considerations are discussed based on the findings.