Staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes

Abstract

Aims and objectives: To explore and compare staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes.

Background: Staff and residents in ethno-specific and mainstream nursing homes in most developed countries have shown increased cultural and linguistic diversity. This socio-demographic change poses significant challenges for staff to support resident self-determination of their own care. In-depth understanding of those challenges in the two types of nursing homes is much needed to inform practice in nurse-led nursing home care settings.

Method: A qualitative description approach with thematic analysis was used in the study. Data were collected through five focus groups with 29 various direct care workers from two ethno-specific nursing homes and a mainstream nursing home in Australia between March-September 2020. The study report followed the COREQ checklist.

Results: Four themes were identified from focus group data. First, participants perceived communication challenges in identifying residents' preferences, especially in ethno-specific nursing homes. Second, team efforts that included residents and their family members were highly valued as a way to meet residents' preferences. Third, participants described various levels of staff engagement in residents' care planning. In addition, staff in ethno-specific nursing homes possessed richer resources to maintain meaningful relationships for residents compared with their counterparts in the mainstream nursing home.

Conclusions: Staff in ethno-specific nursing homes experience more challenges in supporting resident self-determination but have richer resources to develop culturally safe and culturally competent care compared with their counterparts in the mainstream nursing home.

Relevance to clinical practice: Findings provide new insights into challenges and practical solutions in supporting residents to self-determine their own care in cross-cultural aged care.

Patient or public contribution: This study was co-designed with three aged care organisations who funded the study. Staff employed by these organisations participated in the study.

Keywords: care plan; cross-cultural care; cultural competency; cultural safety; nursing home; residential aged care; self-determination; staff; teamwork.