The Implementation of a Model of Person-Centred Practice In Older ...

The implementation of a model of person-centred practice in older person settings
Site Time 1 Time 2 Time 3
1 6 (1.0) 36 (7.1) 74 (15.4)
2 12 (1.9) 17 (3.4) 9 (1.9)
3 57 (9.2) 67 (13.3) 63 (13.1)
4 11 (1.8) 4 (0.8) 2 (0.4)
5 29 (4.7) 15 (3.0) 17 (3.5)
6 11 (1.8) 23 (4.6) 18 (3.8)
7 16 (2.6) ---- 5 (1.0)
8 37 (6) 31 (6.2) 26 (5.4)
9 16 (2.6) 19 (3.8) 19 (4.0)
10 61 (9.8) 32 (6.3) 51 (10.6)
11 44 (7.1) 23 (4.6) 28 (5.8)
12 52 (8.4) 14 (2.8) 9 (1.9)
13 28 (4.5) 28 (5.6) 20 (4.2)
14 46 (7.4) 27 (5.4) 35 (7.3)
15 93 (15) 98 (19.4) 62 (12.9)
16 34 (5.5) 31 (6.2) 24 (5.0)
17 28 (4.5) 16 (3.2) ----
18 34 (5.5) 23 (4.6) 18 (3.8)
TOTAL 614 498 422
Table 4.2: PCCI response rate for each site
Nursing Context Index (NCI) and Caring Context Index (CCI)
The ‘care environment’ is a key consideration in the development of a person-centred
culture (McCormack and McCance 2006). The NCI and CCI determine the impact of
change on creating a person-centred care environment as that which achieves a
decrease in nursing and care worker stress; an increase in nursing/care worker
satisfaction and organizational commitment; and a decrease in intention to leave the
job in the next year. Using these criteria of change, the practice environment was
examined for each care setting.
Nine factors measure aspects related to nurse/care worker stress levels (see Table
4.3, factors 1-9). In the nurse sample, scoring ranged from 1-7 and a decrease in
scoring indicates a decrease in stress levels. The overall stress levels were low
among the sample of nurses’ at all three time points. A heavy workload was deemed
to be the main cause of stress among nurses on all three occasions and equally the
scores decreased over the three time points but not at a statistically significant level.
Conflict with other nurses was scored as causing the least amount of stress. Stress
levels decreased at a statistical level on five of the nine constructs (inadequate
preparation; lack of staff support; and uncertainty regarding treatment; lack of
communication and support and career development). All statistically significant
changes reflected a positive change in the practice environment.
130