Nurses’ Perceptions of Outcomes of Quality of Care in Thai Nursing Homes: A Qualitative Study
DOI:
https://doi.org/10.60099/prijnr.2024.267065Keywords:
Nursing Homes, Outcomes of care, Qualitative description, Quality of care, Registered nursesAbstract
The quality of care in nursing homes is distinctive and vital due to the unique characteristics and individual needs of older adults and dependent residents. This study aimed to describe the quality of care outcomes in nursing homes in Thailand. Qualitative description was applied to interview ten registered nurses working in several private nursing homes using semi-structured questions, observation, and audio recordings. Participants were selected through purposive and snowball sampling. Data analysis was conducted utilizing content analysis, and trustworthiness was ensured through member checking and peer debriefing. The findings revealed six major themes perceived by nurses as indicative of quality care in nursing homes: Physical well-being, Psycho-cognitive status, Social well-being, Nutrition and fluid intake status, Safety and health risks, and Satisfaction. These findings suggest that nursing home nurses must provide care emphasizing the residents’ overall well-being, minimize risks, improve safety measures, and increase satisfaction to achieve quality of care. Among these themes, the status of nutrition, fluid intake, safety, and health risks can cause life-threatening conditions. So, the study provides a guideline for quality improvement in nursing homes. Moreover, future research should describe the outcomes from the perspectives of residents, relatives, or caregivers to extend the phenomenological insight.
References
United Nations. World social report 2023: leaving no one behind in an ageing world [Internet]. 2023 Jan 31 [cited 2023 Oct 25]. Available from: https://desapublications.un.org/publications/world-social-report-2023-leaving-no-one-behind-ageing-world
World Health Organization. Thailand’s leadership and innovations towards healthy ageing [Internet]. 2023 Feb 9 [cited 2023 Oct 25]. Available from: https://www.who.int/southeastasia/news/feature-stories/detail/thailands-leadership-and-innovation-towards-healthy-ageing
Department of Older Persons. Aging situation in Thailand 2005 [Internet]. 2026 June 2 [cited 2024 Apr 14]. Available from: https://www.dop.go.th/th/know/side/1/2/65 (in Thai).
Department of Older Persons. Report of Thai older adults [Internet]. 2023 Dec 31 [cited 2024 Apr 14]. Available from: https://www.dop.go.th/th/know/side/1/1/2449 (in Thai).
Aging Asia and the Pacific. Lesson from Thailand’s national community-based long-term care program for older persons [Internet]. 2020 May 16 [cited 2023 Nov 7]. Available from: https://www.adborgsitesdefaultfilespublication/651546/thailand-long-term-care-older-persons.pdf
World Health Organization. Long-term care [Internet]. 2022 Dec 1 [cited 2023 Oct 30]. Available from: https:// www.who.int/europe/news-room/questions-and-answers/item/long-term-care
Srithumsuk W, Prachusilpa G, Thummapol O, Kasemsuk W. A study of home healthcare nursing outcomes quality indicators for older people in Thailand using Delphi technique. Home Healthc Now. 2021;39(3):154-9. doi: 10.1097/NHH. 0000000000000956. DOI: https://doi.org/10.1097/NHH.0000000000000956
Department of Health Support Service. Number of registered nursing homes in Thailand [Internet]. 2024 Jan 15 [cited 2024 Feb 5]. Available from: https://esta.hss.moph.go.th/ (in Thai).
National Institute on Aging. Nursing homes [Internet]. 2023 Apr 21 [cited 2023 Oct 31]. Available from: https://medlineplus.gov/nursinghomes.html
National Academies of Sciences, Engineering, and Medicine. The national imperative to improve nursing home quality: honoring our commitment to residents, families, and staff. Washington (DC): National Academies Press; 2022.
Ngernthaisong C, Oumtanee A. Running a nursing home business: risk, opportunity or challenge for nurse entrepreneurs. J Health Res. 2017;31(3):199-208. Available from: https://he01.tci-thaijo.org/index.php/jhealthres/article/view/89083
Institute of Medicine, Committee on the Adequacy of Nursing Staff in Hospitals and Nursing Homes. Nursing staff in hospitals and nursing homes: is it adequate? National Washington (DC): Academies Press (US); 1996.
World Health Organization. Quality of care [Internet]. 2023 May 6 [cited 2023 Nov 1]. Available from: https://www.who.int/health-topics/quality-of-care#tab=tab_1
Harrington C. Quality of care in nursing home organizations: establishing a health services research agenda. Nurs Outlook. 2005;53(6):300-4. doi: 10.1016/j.outlook.2005.10.002. DOI: https://doi.org/10.1016/j.outlook.2005.10.002
Wiener JM. An assessment of strategies for improving quality of care in nursing homes. Gerontologist. 2003;43(2):19- 27. doi: 10.1093/geront/43.suppl_2.19. DOI: https://doi.org/10.1093/geront/43.suppl_2.19
Institute of Medicine (US) Committee on Nursing Home Regulation. Improving the quality of care in nursing homes. Washington (DC): National Academies Press (US); 1986.
Spilsbury K, Hewitt C, Stirk L, Bowman C. The relationship between nurse staffing and quality of care in nursing homes: a systematic review. Int J Nurs Stud. 2011;48(6):732- 50. doi: 10.1016/j.ijnurstu.2011.02.014. DOI: https://doi.org/10.1016/j.ijnurstu.2011.02.014
Asante BL, Zúñiga F, Favez L. Quality of care is what we make of it: a qualitative study of managers’ perspectives on quality of care in high-performing nursing homes. BMC Health Serv Res. 2021;21(1):1090. doi: 10.1186/s12913-021-07113-9.
Sasat S, Choowattanapakorn T, Pukdeeprom T, Lertrat P, Aroonsang P. Long-term care institutions in Thailand. J Health Res. 2017;27(6):413-8. Available from: https://he01.tci-thaijo.org/index.php/jhealthres/article/view/88736
Wisesrith W, Soonthornchaiya R, Sasat S, Sakunphanit T. Care service model for dependent older persons in long-term care institutions in Thailand. J Royal Thai Army Nurs. 2019;20(3):422-31 (in Thai).
Shin JH, Hyun TK. Nurse staffing and quality of care of nursing home residents in Korea. J Nurs Scholarsh. 2015;47(6): 555-64. doi: 10.1111/jnu.12166. DOI: https://doi.org/10.1111/jnu.12166
Royal Thai Government Gazette. Ministerial regulation of healthcare services for older adults and dependent persons [Internet]. 2020 July 31 [cited 2023 Nov 10]. Available from: https://download.asa.or.th/03media/04law/swfa/mr63.pdf (in Thai).
Sandelowski M. What’s in a name? Qualitative description revisited. Res Nurs Health. 2010;33(1):77–84. doi: 10.1002/nur.20362. DOI: https://doi.org/10.1002/nur.20362
Turale S. A brief introduction to qualitative description: a research design worth using. Pacific Rim Int J Nurs Res. 2020;24(3):289-91. Available from:https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/243180
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245–51. doi: 10.1097/ACM.0000000000000388. DOI: https://doi.org/10.1097/ACM.0000000000000388
Fusch PI, Ness LR. Are we there yet? Data saturation in qualitative research. Qual Rep. 2015;20:1408-16. doi: 10.46743/2160-3715/2015.2281. DOI: https://doi.org/10.46743/2160-3715/2015.2281
Doyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443-55. doi: 10.1177/1744987119880234. DOI: https://doi.org/10.1177/1744987119880234
Colorafi KJ, Evans B. Qualitative descriptive methods in health science research. HERD. 2016;9(4):16-25. doi: 10.1177/1937586715614171. DOI: https://doi.org/10.1177/1937586715614171
Lincoln YS, Guba EG. Naturalistic inquiry. Thousand Oaks (CA): Sage; 1985. doi: 10.1016/0147-1767(85)90062-8. DOI: https://doi.org/10.1016/0147-1767(85)90062-8
Donabedian A. The quality of care. How can it be assessed? JAMA. 1988;260(12):1743-8. doi:10.1001/jama.1988.03410120089033. DOI: https://doi.org/10.1001/jama.260.12.1743
Park Y, Min D. Registered nurses’ perspective of systemic factors affecting nursing home care quality decline: a qualitative descriptive study. Nurs Open. 2023;10(3):1900-8. doi: 10.1002/nop2.1474. DOI: https://doi.org/10.1002/nop2.1474
Chuang YH, Abbey JA, Yeh YC, Tseng IJ, Liu MF. As they see it: a qualitative study of how older residents in nursing homes perceive their care needs. Collegian. 2015;22(1): 43-51. doi: 10.1016/j.colegn.2013.11.001. DOI: https://doi.org/10.1016/j.colegn.2013.11.001
Jadidi A, Sadeghian E, Khodaveisi M, Fallahi-Khoshknab M. Spiritual needs of the Muslim elderly living in nursing homes: a qualitative study. J Relig Health. 2022;61(2):1514-28. doi: 10.1007/s10943-021- 01263-0. DOI: https://doi.org/10.1007/s10943-021-01263-0
Harouni MD, Tabrizi KN, Fallahi-Khoshknab M, Fadayevatan R, Maddah SS. Older people’s perceptions of intergenerational relationships in nursing homes: a qualitative content analysis. J Family Med Prim Care. 2022;11(8):4395-403. doi: 10.4103/jfmpc. jfmpc_273_22. DOI: https://doi.org/10.4103/jfmpc.jfmpc_273_22
Sion KYJ, Verbeek H, de Boer B. et al. How to assess experienced quality of care in nursing homes from the client’s perspective: results of a qualitative study. BMC Geriatr. 2020;20:67. doi: 10.1186/s12877-020- 1466-7. DOI: https://doi.org/10.1186/s12877-020-1466-7
Nakrem S, Kvanneid K. How is quality of care in home healthcare created? A qualitative study of health professionals’ perspectives. Healthcare (Basel). 2022;10(6):1021. doi: 10.3390/healthcare10061021. DOI: https://doi.org/10.3390/healthcare10061021
Stokke R, Wibe T, Sogstad M. Forming nursing home practices that support quality of care for residents. A qualitative observational study. J Multidiscip Healthc. 2023;16:2667-80. doi: 10.2147/JMDH.S426913. DOI: https://doi.org/10.2147/JMDH.S426913
Zhao Y, Sazlina SG, Rokhani FZ, Su J, Chew BH. The expectations and acceptability of a smart nursing home model among Chinese older adults and family members: a qualitative study. Asian Nurs Res (Korean Soc Nurs Sci). 2023;17(4):208-18. doi: 10.1016/j.anr.2023.08. 002. DOI: https://doi.org/10.1016/j.anr.2023.08.002
Asante BL, Zúñiga F, Favez L. Quality of care is what we make of it: a qualitative study of managers’ perspectives on quality of care in high-performing nursing homes. BMC Health Serv Res. 2021;21(1):1090. doi: 10.1186/ s12913-021-07113-9. DOI: https://doi.org/10.1186/s12913-021-07113-9
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