Determinants of the quality of care relationships in long-term care

A participatory study

A. Scheffelaar*, M. Hendriks, N. Bos, K.G. Luijkx, S. van Dulmen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background:
The quality of the care relationship between a client and a professional is important in long-term care, as most clients depend on support for a lengthy period. The three largest client groups who receive long-term care in the Netherlands are older adults who are physically or mentally frail, people with mental health problems and people with intellectual disabilities. There is little clarity about how generic and variable the determinants of the quality of care relationships are across these client groups. The aim of this study is to explore and compare the determinants of the quality of care relationships in these three client groups in long-term care.

Methods:
This participatory study involving clients as co-researchers was held in three healthcare organizations, each providing long-term care to one client group. The research was conducted by three teams consisting of researchers and co-researchers. We interviewed clients individually and professionals in focus groups. The focus was on care relationships with professionals where there is weekly recurring contact for at least 3 months. Clients and professionals were selected using a convenience sample. The interviews were coded in open, axial and selective coding. The outcomes were compared between the client groups.

Results:
The study sample consisted of 30 clients and 29 professionals. Determinants were categorized into four levels: client, professional, between client and professional, and context. The findings show that the majority of the determinants apply to the care relationships within all three client groups. At the professional level, eleven generic determinants were found. Eight determinants emerged at the client level of which two were found in two client groups only. At the level between a client and a professional, six determinants were found of which one applied to mental healthcare and disability care only. Five determinants were found at the contextual level of which two were specific for two client groups.

Conclusions:
The study yielded a variety of determinants that came to the fore in all three client groups in long-term care. This suggests that including a homogenous client group from a single care setting is not necessary when studying the quality of long-term care relationships.
Original languageEnglish
Article number389
Number of pages14
JournalBMC Health Services Research
Volume19
DOIs
Publication statusPublished - 2019

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Long-Term Care
Delivery of Health Care
Disabled Persons
Focus Groups
Netherlands
Mental Health
Interviews

Keywords

  • Aged
  • Communication
  • Female
  • Frail Elderly
  • Humans
  • Long-Term Care/standards
  • Male
  • Netherlands
  • Patient Satisfaction
  • Personal Autonomy
  • Professional-Patient Relations
  • Quality of Health Care
  • Respect
  • AGED CARE
  • Client perspective
  • EXPERIENCES
  • PERSPECTIVES
  • NURSING-HOMES
  • Qualitative research
  • PROFESSIONALS
  • Client participation
  • WORKERS
  • Professional perspective
  • Client-professional relationship
  • Long-term care
  • MENTAL-HEALTH-SERVICES
  • RESIDENTS
  • Care relationship
  • ENCOUNTERS
  • Quality of care
  • PERCEPTIONS

Cite this

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title = "Determinants of the quality of care relationships in long-term care: A participatory study",
abstract = "Background: The quality of the care relationship between a client and a professional is important in long-term care, as most clients depend on support for a lengthy period. The three largest client groups who receive long-term care in the Netherlands are older adults who are physically or mentally frail, people with mental health problems and people with intellectual disabilities. There is little clarity about how generic and variable the determinants of the quality of care relationships are across these client groups. The aim of this study is to explore and compare the determinants of the quality of care relationships in these three client groups in long-term care.Methods: This participatory study involving clients as co-researchers was held in three healthcare organizations, each providing long-term care to one client group. The research was conducted by three teams consisting of researchers and co-researchers. We interviewed clients individually and professionals in focus groups. The focus was on care relationships with professionals where there is weekly recurring contact for at least 3 months. Clients and professionals were selected using a convenience sample. The interviews were coded in open, axial and selective coding. The outcomes were compared between the client groups.Results: The study sample consisted of 30 clients and 29 professionals. Determinants were categorized into four levels: client, professional, between client and professional, and context. The findings show that the majority of the determinants apply to the care relationships within all three client groups. At the professional level, eleven generic determinants were found. Eight determinants emerged at the client level of which two were found in two client groups only. At the level between a client and a professional, six determinants were found of which one applied to mental healthcare and disability care only. Five determinants were found at the contextual level of which two were specific for two client groups.Conclusions: The study yielded a variety of determinants that came to the fore in all three client groups in long-term care. This suggests that including a homogenous client group from a single care setting is not necessary when studying the quality of long-term care relationships.",
keywords = "Aged, Communication, Female, Frail Elderly, Humans, Long-Term Care/standards, Male, Netherlands, Patient Satisfaction, Personal Autonomy, Professional-Patient Relations, Quality of Health Care, Respect, AGED CARE, Client perspective, EXPERIENCES, PERSPECTIVES, NURSING-HOMES, Qualitative research, PROFESSIONALS, Client participation, WORKERS, Professional perspective, Client-professional relationship, Long-term care, MENTAL-HEALTH-SERVICES, RESIDENTS, Care relationship, ENCOUNTERS, Quality of care, PERCEPTIONS",
author = "A. Scheffelaar and M. Hendriks and N. Bos and K.G. Luijkx and {van Dulmen}, S.",
year = "2019",
doi = "10.1186/s12913-019-4195-x",
language = "English",
volume = "19",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BMC",

}

Determinants of the quality of care relationships in long-term care : A participatory study. / Scheffelaar, A.; Hendriks, M.; Bos, N.; Luijkx, K.G.; van Dulmen, S.

In: BMC Health Services Research, Vol. 19, 389, 2019.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Determinants of the quality of care relationships in long-term care

T2 - A participatory study

AU - Scheffelaar, A.

AU - Hendriks, M.

AU - Bos, N.

AU - Luijkx, K.G.

AU - van Dulmen, S.

PY - 2019

Y1 - 2019

N2 - Background: The quality of the care relationship between a client and a professional is important in long-term care, as most clients depend on support for a lengthy period. The three largest client groups who receive long-term care in the Netherlands are older adults who are physically or mentally frail, people with mental health problems and people with intellectual disabilities. There is little clarity about how generic and variable the determinants of the quality of care relationships are across these client groups. The aim of this study is to explore and compare the determinants of the quality of care relationships in these three client groups in long-term care.Methods: This participatory study involving clients as co-researchers was held in three healthcare organizations, each providing long-term care to one client group. The research was conducted by three teams consisting of researchers and co-researchers. We interviewed clients individually and professionals in focus groups. The focus was on care relationships with professionals where there is weekly recurring contact for at least 3 months. Clients and professionals were selected using a convenience sample. The interviews were coded in open, axial and selective coding. The outcomes were compared between the client groups.Results: The study sample consisted of 30 clients and 29 professionals. Determinants were categorized into four levels: client, professional, between client and professional, and context. The findings show that the majority of the determinants apply to the care relationships within all three client groups. At the professional level, eleven generic determinants were found. Eight determinants emerged at the client level of which two were found in two client groups only. At the level between a client and a professional, six determinants were found of which one applied to mental healthcare and disability care only. Five determinants were found at the contextual level of which two were specific for two client groups.Conclusions: The study yielded a variety of determinants that came to the fore in all three client groups in long-term care. This suggests that including a homogenous client group from a single care setting is not necessary when studying the quality of long-term care relationships.

AB - Background: The quality of the care relationship between a client and a professional is important in long-term care, as most clients depend on support for a lengthy period. The three largest client groups who receive long-term care in the Netherlands are older adults who are physically or mentally frail, people with mental health problems and people with intellectual disabilities. There is little clarity about how generic and variable the determinants of the quality of care relationships are across these client groups. The aim of this study is to explore and compare the determinants of the quality of care relationships in these three client groups in long-term care.Methods: This participatory study involving clients as co-researchers was held in three healthcare organizations, each providing long-term care to one client group. The research was conducted by three teams consisting of researchers and co-researchers. We interviewed clients individually and professionals in focus groups. The focus was on care relationships with professionals where there is weekly recurring contact for at least 3 months. Clients and professionals were selected using a convenience sample. The interviews were coded in open, axial and selective coding. The outcomes were compared between the client groups.Results: The study sample consisted of 30 clients and 29 professionals. Determinants were categorized into four levels: client, professional, between client and professional, and context. The findings show that the majority of the determinants apply to the care relationships within all three client groups. At the professional level, eleven generic determinants were found. Eight determinants emerged at the client level of which two were found in two client groups only. At the level between a client and a professional, six determinants were found of which one applied to mental healthcare and disability care only. Five determinants were found at the contextual level of which two were specific for two client groups.Conclusions: The study yielded a variety of determinants that came to the fore in all three client groups in long-term care. This suggests that including a homogenous client group from a single care setting is not necessary when studying the quality of long-term care relationships.

KW - Aged

KW - Communication

KW - Female

KW - Frail Elderly

KW - Humans

KW - Long-Term Care/standards

KW - Male

KW - Netherlands

KW - Patient Satisfaction

KW - Personal Autonomy

KW - Professional-Patient Relations

KW - Quality of Health Care

KW - Respect

KW - AGED CARE

KW - Client perspective

KW - EXPERIENCES

KW - PERSPECTIVES

KW - NURSING-HOMES

KW - Qualitative research

KW - PROFESSIONALS

KW - Client participation

KW - WORKERS

KW - Professional perspective

KW - Client-professional relationship

KW - Long-term care

KW - MENTAL-HEALTH-SERVICES

KW - RESIDENTS

KW - Care relationship

KW - ENCOUNTERS

KW - Quality of care

KW - PERCEPTIONS

U2 - 10.1186/s12913-019-4195-x

DO - 10.1186/s12913-019-4195-x

M3 - Article

VL - 19

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

M1 - 389

ER -