Show simple item record

dc.contributor.authorSchwartz, Margot L.
dc.contributor.authorLima, Julie C.
dc.contributor.authorClark, Melissa A.
dc.contributor.authorMiller, Susan C.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:39Z
dc.date.available2022-08-23T17:13:39Z
dc.date.issued2019-03-01
dc.date.submitted2019-01-23
dc.identifier.citation<p>J Pain Symptom Manage. 2019 Mar;57(3):525-534. doi: 10.1016/j.jpainsymman.2018.12.330. Epub 2018 Dec 20. <a href="https://doi.org/10.1016/j.jpainsymman.2018.12.330">Link to article on publisher's site</a></p>
dc.identifier.issn0885-3924 (Linking)
dc.identifier.doi10.1016/j.jpainsymman.2018.12.330
dc.identifier.pmid30578935
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46778
dc.description.abstractCONTEXT: The nursing home (NH) culture change (CC) movement, which emphasizes person-centered care, is particularly relevant to meeting the unique needs of residents near the end of life. OBJECTIVES: We aimed to evaluate the NH-reported adoption of person-centered end-of-life culture change (EOL-CC) practices and identify NH characteristics associated with greater adoption. METHODS: We used NH and state policy data for 1358 NHs completing a nationally representative 2016/17 NH Culture Change Survey. An 18-point EOL-CC score was created by summarizing responses from six survey items related to practices for residents who were dying/had died. NHs were divided into quartiles reflecting their EOL-CC score, and multivariable ordered logistic regression was used to identify NH characteristics associated with having higher (quartile) scores. RESULTS: The mean EOL-CC score was 13.7 (SD = 3.0). Correlates of higher scores differed from those previously found for non-EOL-CC practices. Higher NH leadership scores and nonprofit status were consistently associated with higher EOL-CC scores. For example, a three-point leadership score increase was associated with higher odds of an NH performing in the top EOL-CC quartile (odds ratio [OR] = 2.0, 95% CI: 1.82-2.30), whereas for-profit status was associated with lower odds (OR = 0.7, 95% CI: 0.49-0.90). The availability of palliative care consults was associated with a greater likelihood of EOL-CC scores above the median (OR = 1.5, 95% CI: 1.10-1.93), but not in the top or bottom quartile. CONCLUSION: NH-reported adoption of EOL-CC practices varies, and the presence of palliative care consults in NHs explains only some of this variation. Findings support the importance of evaluating EOL-CC practices separately from other culture change practices.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30578935&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/j.jpainsymman.2018.12.330
dc.subjectNursing homes
dc.subjectculture change
dc.subjectend-of-life
dc.subjectpalliative care
dc.subjectperson-centered care
dc.subjectGeriatrics
dc.subjectHealth Psychology
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectPalliative Care
dc.titleEnd-of-Life Culture Change Practices in U.S. Nursing Homes in 2016/2017
dc.typeArticle
dc.source.journaltitleJournal of pain and symptom management
dc.source.volume57
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1238
dc.identifier.contextkey13667586
html.description.abstract<p>CONTEXT: The nursing home (NH) culture change (CC) movement, which emphasizes person-centered care, is particularly relevant to meeting the unique needs of residents near the end of life.</p> <p>OBJECTIVES: We aimed to evaluate the NH-reported adoption of person-centered end-of-life culture change (EOL-CC) practices and identify NH characteristics associated with greater adoption.</p> <p>METHODS: We used NH and state policy data for 1358 NHs completing a nationally representative 2016/17 NH Culture Change Survey. An 18-point EOL-CC score was created by summarizing responses from six survey items related to practices for residents who were dying/had died. NHs were divided into quartiles reflecting their EOL-CC score, and multivariable ordered logistic regression was used to identify NH characteristics associated with having higher (quartile) scores.</p> <p>RESULTS: The mean EOL-CC score was 13.7 (SD = 3.0). Correlates of higher scores differed from those previously found for non-EOL-CC practices. Higher NH leadership scores and nonprofit status were consistently associated with higher EOL-CC scores. For example, a three-point leadership score increase was associated with higher odds of an NH performing in the top EOL-CC quartile (odds ratio [OR] = 2.0, 95% CI: 1.82-2.30), whereas for-profit status was associated with lower odds (OR = 0.7, 95% CI: 0.49-0.90). The availability of palliative care consults was associated with a greater likelihood of EOL-CC scores above the median (OR = 1.5, 95% CI: 1.10-1.93), but not in the top or bottom quartile.</p> <p>CONCLUSION: NH-reported adoption of EOL-CC practices varies, and the presence of palliative care consults in NHs explains only some of this variation. Findings support the importance of evaluating EOL-CC practices separately from other culture change practices.</p>
dc.identifier.submissionpathqhs_pp/1238
dc.contributor.departmentDepartment of Population and Quantitative Health Sciences
dc.source.pages525-534


Files in this item

Thumbnail
Name:
Publisher version

This item appears in the following Collection(s)

Show simple item record