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User-oriented elderly care: a validation study in two different settings using observational data
- Authors:
- KAZEMI Ali, KAJONIUS Petri J.
- Journal article citation:
- Quality in Ageing and Older Adults, 16(3), 2015, pp.140-152.
- Publisher:
- Emerald
Purpose: User-oriented care, defined as individualised assisting behaviours, is the dominant approach within elderly care today. Yet, there is little known about its conceptual structure. This paper proposes that user-oriented care has a bi-partite structure which may be decomposed into the two dimensions of task and relation. Design/methodology/approach: Care workers were “shadowed” (i.e. observed) at their work (n=391 rated interactions). User-oriented care was assessed along ten process quality indicators targeting the acts of caregiving (i.e. task focus, relation focus, involvement, time-use, body language, autonomy, respect, warmth, encouragement, and information) in two elderly care settings, i.e. home care and nursing home. Observations added up to 45 hours. Findings: Principal component analyses confirmed the proposed two-factor structure of user-oriented care. Specifically, the user-oriented care indicators loaded on two distinct factors, i.e. task and relation. The underlying structure of user-oriented care revealed to be invariant across the two settings. However, the results revealed interesting structural differences in terms of explained variance and the magnitude of factor loadings in the home care and nursing home settings. Differences also emerged specifically pertaining to the indicators of autonomy and time-use. These findings suggest that user-oriented behaviour may to some extent denote different acts of caregiving and what may be called task- and relation-orientation may be loaded with different meanings in these two care settings. Originality/value: This is the first study investigating user-oriented behaviour in the context of elderly care using a quantitative observational approach. The authors propose that the observed differences between the two care settings are primarily not due to better elderly care work in home care, but due to some inherent differences between these two contexts of care (e.g. better health and living at home). (Edited publisher abstract)
The older person as a client, customer or service user?
- Authors:
- CORLIN Tinna Elfstrand, KAZEMI Ali
- Journal article citation:
- Working with Older People, 24(1), 2020, pp.19-26.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to describe three different approaches to work in elderly care (i.e. professional, market-oriented and person-centred) and examine whether these theoretically derived approaches can be confirmed empirically. Additional aims were to examine the endorsement of these approaches and whether there were differences in the endorsement of these approaches in nursing home vs home care and municipality vs privately run care units. Design/methodology/approach: Data were collected using a cross-sectional survey study of frontline care staff (n=1,342). Exploratory factor analysis was used to investigate the empirical validity of the proposed approaches to work in elderly care. A series of paired and independent samples t-tests were conducted to analyse mean differences between the proposed approaches to work. Findings: A principal axis factoring analysis yielded three theoretically meaningful factors as proposed. These results indicated that the respondents were able to differentiate between three distinct but related approaches to work with older persons. The results also showed that the professional care approach was the highest endorsed and the market-oriented the lowest endorsed approach. No notable differences in approaches to work were observed in nursing home vs home care and municipality vs privately run care units. Originality/value: This is the first study to examine multiple approaches to work in elderly care as previous research studies mainly have investigated the person-centred care approach. Current findings indicate that these approaches to work often coexist in various combinations and that the care staff adopts all these approaches but to varying degrees. The approaches differ in several important respects (e.g. legitimacy and view of the older person) and most likely affect the way care staff treats the older person and how the older person perceives their relationship with the care staff. Knowledge about these differences facilitates management of the care staff’s work situation and helps to improve the quality of care. (Publisher abstract)
Safeness and treatment mitigate the effect of loneliness on satisfaction with elderly care
- Authors:
- KAJONIUS Petri J., KAZEMI Ali
- Journal article citation:
- Gerontologist, 56(5), 2016, pp.928-936.
- Publisher:
- Oxford University Press
Maximising satisfaction among the older persons is the goal of modern individualised elderly care and how to best achieve this is of relevance for people involved in planning and providing elderly care services. Purpose of the Study: What predicts satisfaction with care among older persons can be conceived as a function of process (how care is performed) and the older person. Inspired by the long-standing person versus situation debate, the present research investigated the interplay between person- and process-related factors in predicting satisfaction with elderly care. Design and Methods: A nationwide sample was analysed, based on a questionnaire with 95,000 individuals using elderly care services. Results: The results showed that person-related factors (i.e., anxiety, health, and loneliness) were significant predictors of satisfaction with care, although less strongly than process-related factors (i.e., treatment, safeness, and perceived staff and time availability). Among the person-related factors, loneliness was the strongest predictor of satisfaction among older persons in nursing homes. Interestingly, a path analysis revealed that safeness and treatment function as mediators in linking loneliness to satisfaction. Implications: The results based on a large national sample demonstrate that the individual ageing condition to a significant degree can be countered by a well-functioning care process, resulting in higher satisfaction with care among older persons. (Edited publisher abstract)