Eating well, living with quality
Proyectos
The practice "Eating well, living with quality" is part of a process of institutional change of the care model and is developed from a participatory action-research approach. It is part of a broader institutional project in which actions at the organizational, architectural, training, etc. level have been incorporated in order to design "home-like" environments that improve the autonomy and well-being of residents and professionals. In this research, the objective was to identify and promote professional practices aimed at personalization and promotion and enhancement of well-being and quality of life in the dining rooms of residential centers. The practice was developed in the dining rooms of the dementia units of seven gerontological centers of the Matia Foundation in Guipúzcoa, where support teams were created for the assistants in order to generate from practice new behaviors in line with Person-Centered Care. The study was carried out through a methodology of observation and behavioral recording tools to record the behavior of the professionals recorded on video.
General objectives
- To identify and encourage professional practices aimed at personalization and the promotion and enhancement of well-being and quality of life in the dining rooms of residential centers.
- Increasing quality of life during mealtimes in people with dementia.
Specific objectives:
- Identify and implement with professionals (assistants, geroculturists, etc.) a series of desirable competencies from the Person-Centered Care (PCA) model in the dining rooms of residential centers, which promote nutrition and well-being of people with dementia.
- To develop an instrument based on direct observation for the assessment of professional practices in nursing home dining rooms.
- To analyze professional practices during meals obtained through video recordings in natural contexts of real healthcare practice.
- To develop training meetings with the assistants to promote the acquisition and practice of professional skills within the framework of ACP by viewing recordings of their own professional performance.
- Empower professionals to develop practices within the PCA framework.
- Analyze mealtime environments and professional competencies within the framework of person-centered care.
Results
The results showed an increase in verbal interactions related to Person Centered Care (dignity, attention to people's interests, enabling decision making...) of professionals with people with dementia.
Being a project with the intention of continuity, it is expected to collect data continuously and longitudinally, so the data presented below are those available towards the end of the first iteration of assessments during the baseline.
- Fifty-four one-and-a-half hour recordings of the professional practices developed during the meals were obtained.
- An instrument has been developed to assess the professional practices during the meal in the process of obtaining psychometric guarantees.
- Data on professional practices were obtained by means of the ACP practices instrument in relation to preferences (one rating for each of the 54 recordings). The most relevant information indicates that:
- The language used by the ancillaries is very often adjusted to the preferences of the users.
- Professional practices related to people's preferences according to the ACP model would be relatively well implemented, with a wide range of improvement up to full integration in professional development.
- There is great variability in the scores obtained through the internship assessment instrument among the centers.
- The practices that require the most attention and that would preferably require implementation were giving users options and responding to their requests.
- Through a descriptive analysis of the data, longitudinal graphs were generated of the evolution of the practices in terms of frequency in each of the centers (how often the behaviors occur in each center) and as an average of all the centers (how the implementation of the practices develops in the entire foundation as a whole), allowing monitoring the implementation of the practices in the centers and at the level of the foundation.
- A list of environment adaptations to the ACP model was developed with high inter-rater reliability. Through this instrument, measures of the degree of adaptation of the meal environment to an ACP environment were obtained in the centers during the baseline.
- The centers had different levels of adaptation to the ACP model, meeting between 50% and 75% of the characteristics of the ideal environment.
- The most frequent adaptations were those related to the architecture: a pleasant, spacious and adequate dining room for the number of people.
- The least frequent adaptations were those related to domestic appearance and quiet sound environment.
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Professionals
