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The Differential Influence of Culture Change Models on Long-Term Care Staff Empowerment and Provision of Individualized Care*

Published online by Cambridge University Press:  01 June 2009

Sienna Caspar ,
Norm O’Rourke  and
Gloria M. Gutman
Sienna Caspar
Affiliation:
University of British Columbia
Norm O’Rourke*
Affiliation:
Simon Fraser University—Vancouver Campus
Gloria M. Gutman
Affiliation:
Simon Fraser University—Vancouver Campus
*
†Correspondence to: / Correspondance à : Norm O’Rourke, Ph.D., R.Psych. Department of Gerontology Simon Fraser University—Vancouver Campus #2800– 515 West Hastings Street Vancouver, British Columbia V6B 5K3 Canada (ORourke@sfu.ca)
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Abstract

With this study we set out to determine if differences exist across culture change models (CCM) in relation to formal caregivers’ perceived access to empowerment structures and reported provision of individualized care. We recruited staff working in facilities that had implemented the Eden Alternative, GentleCare, Facility Specific Social Models of Care (FSSMOC), or no CCM. Multivariate analyses of variance (MANOVA) compared these constructs by CCM for each of three caregiver groups (Registered Nurses, Licensed Practical Nurses, and care aides). Results suggest that considerable differences exist between formal caregivers and by CCM. The greater caregivers’ day-to-day contact with residents, the more CCMs appear to affect perceived empowerment and reported provision of individualized care. Findings suggest the greatest benefits existed for staff working in facilities with a FSSMOC. Conversely, in only one instance did responses from staff in Eden Alternative facilities differ from those in facilities with no CCM.

Résumé

La présente étude vise à déterminer si des différences existent entre les divers modèles de changement de culture (MCC) relativement à la perception du personnel soignant agréé à l’égard de l’accès aux structures d’habilitation et des prestations connues de soins individualisés. Nous avons embauché des employés qui travaillent dans des établissements ayant mis en œuvre les modèles sociaux de soins Eden Alternative, GentleCare ou Facility Specific ou n’ayant pas implanté de MCC. Nous avons effectué des analyses de variance multidimensionnelles de chacun des trois groupes de personnel soignant (infirmières autorisées, infirmières auxiliaires autorisées et aides-soignants) en fonction de chaque CCM. Les résultats indiquent qu’il existe des différences considérables entre le personnel soignant agréé et entre chacun des MCC. Plus le personnel soignant côtoie quotidiennement les patients, plus l’influence des MCC semble affecter l’autonomisation perçue et les prestations connues de soins individualisés. Des recherches suggèrent que les employés travaillant dans des établissements ayant mis en œuvre un des modèles sociaux de soins mentionnés ci-dessus profitent des meilleures conditions de travail. Inversement, parmi les établissements ayant implanté un de ces modèles, seul le personnel d’un établissement a fourni des réponses différentes de celles des employés travaillant dans des établissements sans MCC.

Keywords

modèles de changement de culturede l’autonomisation des structuresdes soins individualisésde soins de longue duréecomportement organisationnell’amélioration de la qualitéculture change modelsempowerment structuresindividualized carelong-term careorganizational behaviourquality improvement
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 28 , Issue 2 , June 2009 , pp. 165 - 175
Copyright
Copyright © Canadian Association on Gerontology 2009

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Footnotes

*

Support for this study was received by Sienna Caspar from the Social Sciences and Humanities Research Council of Canada (SSHRC Masters Fellowship) and the Michael Smith Foundation for Health Research (MSFHR Trainee Award).

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