Nurses' perceptions regarding providing psychological care for older residents in long-term care facilities: A qualitative study

Abstract

Aims and objectives: To explore nurses' perceptions regarding providing psychological health care for older residents in long-term care facilities (LTCFs).

Background: Loneliness and depressive symptoms are commonly observed among older residents living in LTCFs. Nurses are expected to provide holistic care including physical, psychological and social care for older residents in LTCFs to fulfil their needs. Therefore, understanding nurses' feelings and thoughts regarding providing care for older residents who feel lonely, sad, unhappy or depressed is important for delivering better care.

Design: A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) was used to enhance for reporting quality.

Methods: Purposive sampling and snowball sampling were applied in Northern Taiwan. One-to-one in-depth interviews were conducted using a semi-structured interview guide. Twenty-one nurses with a mean age of 38.4 years were interviewed. Content analysis was performed for data analysis.

Findings: Four themes were generated from the data: "insufficient psychological healthcare competency," "having a willing heart but not adequate support," "families playing an essential role in residents' mood" and "physical-oriented care model."

Conclusions: Long-term care facilitie nurses felt that they were not adequately prepared for taking care of older adults' psychological problems before their nursing career or during their practice. Unreasonable nurse-to-resident ratios and an absence of care consensus among healthcare providers can make nurses feel that they have a willing heart but not adequate support. Family members are essential in older residents' emotional status within the Taiwanese cultural context. Physical care evaluation indicators emphasised by LTCF accreditation resulted in the current care practice model.

Implications for practice: This study provides valuable information for LTCF nurses, managers and directors to develop appropriate strategies to assist nurses in providing better psychological health care for older residents. Evaluation indicators required by LTCF accreditation in Taiwan must be re-examined at the earliest stage.

Keywords: depressive symptoms; feelings and thoughts; long-term care facilities; nurses; older residents; perceptions; psychological health.