Transcript Slide 1

Anne Raleigh
Master of Health Sciences
(Nursing)
2012
National University of Ireland
Galway
School of Nursing and Midwifery
RESEARCH TITLE
“We’re sorta one family”. The value that
older people place on their relationships
with fellow-residents in long term care:
A qualitative descriptive exploratory study.
OUTLINE OF PRESENTATION
• Background to the study
• Why Qualitative Descriptive Methodology?
• The Interview Guide
• Sample and Setting
• The Findings
AIM OF STUDY
To explore and describe the value that
older people place on their relationships
with fellow-residents in long term care
from the perspective of those people
themselves.
BACKGROUND TO STUDY
• Author interest
• People growing older in Ireland wish to grow old in their
own home (Garavan et al., 2001)
• “An enforced relationship”? (Hauge & Heggen, 2008)
• The number of older people in Ireland is increasing
(Connell & Pringle, 2004; C.S.O., 2007)
• Quality of life studies (Murphy et al., 2006)
BACKGROUND TO STUDY (contd)
• H.I.Q.A. (2009)
• Person-centred care - “knowing” the older person’s
social context (McCormack, 2004)
• Older people are asked directly about their experiences
(Evans et al., 2000; Tester et al., 2003; Murphy et al.,
2006)
• Best judge of their quality of life (Fiveash, 1998; Age &
Opportunity, 2003; Kane et al., 2004)
• Staff attitudes and understanding
Why Qualitative Descriptive Methodology?
Qualitative Description “could never be described as any
one method that any one person invented”
(Sandelowski, 2010, p. 78).
• Distinct method of naturalistic inductive inquiry - low
inference interpretation (Sandelowski, 2000)
• Presents of the facts of the case in everyday language
(Sandelowski, 2000)
• Data - multiple sources including in-depth interviews and
observations (Sullivan-Bolyai et al., 2005, p. 127)
• Obtains direct answers to questions of special relevance
to the practitioner (Sandelowski, 2000)
Why Qualitative Descriptive Methodology?
(contd)
• First-hand knowledge of patients’ experiences
(Neergaard et al., 2009)
• Broader and deeper understanding of one’s own practice
(Magilvy & Thomas, 2009)
• Stay close to the rich description provided by the study
participants (Sullivan-Bolyai et al., 2005)
•
Data that can be readily understood by the general
community (Sullivan-Bolyai et al., 2005)
• An important methodological tool for nurse researchers
working among vulnerable populations. (Sullivan-Bolyai
et al., 2005)
INTEVIEW GUIDE
How long has this been your home and what are
the good things about this being your home?
•
•
•
•
•
•
•
•
•
Company of the other residents
Social gatherings
Group activity
Dining
Male/female company
Sharing your worries or concerns
Helping
Other residents’ visitors.
Challenges
Sample and Setting
• Seven participants volunteered to take
part in the study
• The setting- a long term care facility in the
West of Ireland
• Data were generated through semistructured interviews and processed by
means of qualitative thematic analysis
FINDINGS
The themes as a cycle
FINDINGS (contd)
Conquering Loneliness and Helping Make Time Pass
“was living alone at home and the company is wonderful…oh, yes,
to be on your own, it’s sad you know.” [Eileen]
“I’m quite happy here, you know, and when I weigh up the situation,
would I be as happy at home, I wouldn’t ‘cos I’d have nobody to talk
to, nobody to converse with, you know, whereas here, I have, I have
patients who I deal with, you know, talk to…I’m really enjoying the
company here. I’d have no company at home, just myself and the
television of course… you’d get bored with television, you get more
you know when you’ve the presence of people, one-to-one, it’s
much better... Yeah, that’s the whole thing.” [Derek]
“I meet people when I come down to the dayroom…and I do have a
chat with them and I don’t find the time going. And then I go to the
physiotherapy and occupational therapy and that takes up
time…and it’s great to have a chat…I don’t find the day going
then…it is a help. It [talking] is a help. You pass the time that
way…the days would be very long if you were sitting down there
doing nothing.”
[Peg]
FINDINGS (contd)
Conquering Loneliness and Helping Make Time Pass
“…if I did [move to a single room] I’d be in the grave now… oh, I’d die from
lonesomeness, ah, I would. Well, it’s great you know not to be lonesome or
anything…oh wonderful. Oh definitely, sure that’d be worse than being at home on
your own to be in a single ward again. Wouldn’t it now! [Eileen]
Derek had been in “… other nursing homes before I came here… You were put in
a private room and you saw nobody except your visitors… But I wouldn’t like to be
there now. You close the door and that’s it. There’s no real communication with
staff or with other patients.”
“I picked that ward inside the door and so I can see everyone.” [Eileen]
“She [staff nurse] offered me to go into a single room and I wouldn’t go…Oh I
wouldn’t handle it…Ah I’m used to the people in the room. And you know you get
more people coming in and out…I’d find it very hard to be in a room on my own
now.” [Harry]
FINDINGS (contd)
Social Togetherness
Described in terms of stimulation, motivation, jollity, distraction,
communication, comfort and camaraderie.
“We’ve music here twice a week. [I have] interest in it. And different activities…It passes
the time. And it keeps your mind trying to work a little bit.”
[Harry]
“We all sit around for the music… Oh we chat alright and one of them [the other
residents] might be able to sing...Well you forget about everything when you hear the
music and when there’s somebody singing.”
[Jack]
“Oh, it [group activity] does definitely [motivate] oh it does. Oh it’s much better, I think so.
Well you have more company and you can ask them about a thing, you can ask them,
well what way would you do it, you know and they’ll give you their opinion.” [Peg]
I’ve great auld crack with that man…arah, he’s a nice fellow.” [Sean]
“Oh yes you’re all communicating with each other…Oh yeah, a bit of fun, a bit of crack,
oh yeah.”
[Derek]
FINDINGS (contd)
Social Togetherness
•
“If we don’t get down to the church on a Sunday, we can have the mass on the radio,
it’s on every morning and I do love that…and we say the prayers together.”
[Peg]
•
“Oh we do yeah, we have gatherings. We go out regular. Ah we go out to shows…
yeah oh yeah. One day we went up to …there were six of us. We went on the bus. It
was a fantastic day out. …we’re due to go out now next week. I think it’s this week
actually...we get a lot out of that oh yes.”
[Derek]
•
•
•
“Oh it is good [talking to the other men]… well we’d discuss about what went on in the
Dάil, the news and this, what’s this…the property tax.”
[Jack]
“Oh [we chat] on different things, sports and things like that … tell a few lies, [laughs]
harmless lies.”
[Harry]
“get more out of it [group activity] yes, ‘cos you are going with people that you know”
[Derek]
FINDINGS (contd)
Sense of belonging
•
“We’re sorta one family… I wouldn’t realise one time, but when you’re part of it, it
pans out very well you know.” [Harry]
•
“Tim’s wheelchair bound… he comes out with us when we’re going out. He is
definitely part of the group.” [Derek]
•
“I’m very happy here you know…I wouldn’t like to have to leave. [Harry]
•
“…thought somebody was going to be sick or something I’d call a nurse … you
know…Oh yes, yes. I’d be the first one to ring the bell. Yeah… I suppose living with
Geoffrey… I realise the need he has, a need kinda to converse... And if I can help I’ll
help, I would.” [Derek]
•
“I go to the same place [in the dining room] all the time…I don’t know why and
Michael goes the other side…It is sort of part of life really in here…I’ve got into that
pattern going to the same place.” [Harry]
•
“ all [all the residents] have the same story, every one of them.” [Sean].
•
“Everyone in here has a problem of their own. You know what I mean. They
understand we are all, the one bunch, you know” [Harry]
FINDINGS (contd)
Sense of belonging
The opportunity to embrace visitors provided for a more profound sense of belonging:
•
“There’s different visitors in to see the patients and I chat them of course…it’s very
important.”
[Eileen]
•
“They are getting to know us now, [residents’ visitors] they might bring me a few
sweets or something... I like that!”
[Jack]
•
“Yeah they [visitors] get to know you and speak to you, all that.”
•
“Oh I do I love them [others’ visitors]. We had a birthday party the other day, a lady
had her birthday and I got very friendly with that family... And she comes in to see me
every time she comes in to see her own relative. And it is lovely to meet people like
that…”
[Peg]
•
“I do yeah [meet other people’s visitors]. I was up there today now and I met Tom Mc
Sweeney and he comes from the next town to here…” [Sean]
[Harry]
Implications for Practice
• Screening for loneliness/single rooms
• Addressing friendship structures in the care-planning
process
• Sense of Belonging Instrument [SOBI] and ‘ Ordinary
living’
• Integrating visitors into the social life
• Role of the staff
The greatest suffering is being lonely, feeling
unloved, having no one. I have come more
and more to realise that it is being unwanted
that is the worst disease that any human
being can ever experience.
Mother Teresa (1910-1998).
THANK YOU. QUESTIONS??
References
•
•
•
•
•
•
•
•
•
•
•
•
•
Age & Opportunity (2003) ‘‘Home from Home?’ The Views of Residents on Social Gain and Quality of Life’, A
Study in Three Care Centres for Older People. Dublin.
Central Statistics Office [C.S.O] (2007) Cork, Ireland.
Connell, P. & Pringle, D. (2004) Population Ageing in Ireland: Projections 2002-2021. National Council on Ageing
and Older People. Dublin [Report No. 81].
Evans, D.S., Ni Mhuircheartaigh, J. & O’Neil, S. (2000). Older People in Long-Term Care: A Qualitative Study. The
Department of Public Health Western Health Board.
Hauge, S. & Heggen, K. (2008) ‘The nursing home as a home: A field study of residents’ daily life in the common
living rooms’, Journal of Clinical Nursing, 17, pp. 460-467.
Health Information and Quality Authority [HIQA] (2009) National Quality Standards for Residential Care Settings
for Older People in Ireland. Cork: Health Information and Quality Authority.
Magilvy, J.K. & Thomas, E. (2009) ‘A first qualitative project: qualitative descriptive design for novice researchers’,
Journal for Specialists in Pediatric Nursing, 14 (4), pp. 298-300.
McCormack, B. (2004) ‘Person-centerdness in gerontolgical nursing: an overview of the literature’, International
Journal of Older People, 13 (3a), pp. 31-8.
Murphy, K., O’Shea, E., Cooney, A., Shiel, A. & Hodgins, M. (2006) Improving Quality of Life for Older People in
Long-Stay Care Settings in Ireland. National Council on Ageing and Older People. Dublin. [Report No. 93].
Sandelowski, M. (2000) ‘Whatever happened to qualitative description?’ Research in Nursing & Health, 23, pp.
334-340.
Sandelowski, M. (2010) ‘What’s in a Name? Qualitative Description Revisited’, Research in Nursing & Health, 33,
pp. 77-84.
Sullivan-Bolyai, S., Bova, C. & Harper, D. (2005) ‘Developing and refining interventions in persons with health
disparities: The use of Qualitative Description’, Nursing Outlook, 53 (3), pp. 127-133.
Tester, S., Hubbard, G., Downs, M., MacDonald, C. & Murphy, J. (2003) Exploring Perceptions of Quality of Life of
Frail Older People During and After their Transition to Institutional Care. E.S.R.C., University of Sheffield [Report
No.24].