Residents' experiences of interpersonal factors in nursing home care: a qualitative study

Abstract

Background: With life expectancy lengthening, the number of those who will require care in a nursing home will increase dramatically in the next 20 years. Nursing home residents are frail older adults with complex needs, dependent on advanced nursing care. Long-term residents in nursing homes have long-term relationships with the nurses, which require a unique approach to the interpersonal aspects of nursing care. Understanding what is experienced as care quality, including quality of interpersonal processes, requires insight into the residents' perspectives for best value in care to be realized.

Objective: Main objective was to describe the nursing home residents' experience with direct nursing care, related to the interpersonal aspects of quality of care.

Design: A descriptive, exploratory design was used.

Settings: Four public municipal nursing homes in Norway with long-term residents were purposely selected for the study.

Participants: Fifteen mentally lucid residents were included. The inclusion criteria were aged 65 and over, being a resident of the nursing home for one month or longer, and physical and mental capacity to participate in the interview.

Method: In-depth interviews with the residents were performed. The transcribed interviews were analyzed using meaning categorizing.

Results: The residents emphasized the importance of nurses acknowledging their individual needs, which included need for general and specialized care, health promotion and prevention of complications, and prioritizing the individuals. The challenging balance between self-determination and dependency, the altered role from homeowner to resident, and feelings of indignity and depreciation of social status were key issues in which the residents perceived that their integrity was at risk in the patient-nurse interaction and care. Psychosocial well-being was a major issue, and the residents expressed an important role of the nursing staff helping them to balance the need for social contact and to be alone, and preserving a social network.

Conclusions: Quality nursing care in nursing home implies a balanced, individual approach to medical, physical and psychosocial care, including interpersonal aspects of care. The interpersonal relationship between resident and nurse implies long-term commitment, reciprocal relationship on a personal level and interpersonal competence of the nurses to understand each resident's needs.