Effects of a person-centred and health-promoting intervention in home care services- a non-randomized controlled trial

Kristina Lämås, Karin Bölenius, Per-Olof Sandman, Marie Lindkvist, David Edvardsson, Kristina Lämås, Karin Bölenius, Per-Olof Sandman, Marie Lindkvist, David Edvardsson

Abstract

Background: Home care recipients have reported little self-determination and opportunity to influence their own care. Person-centred care focusing on involvement has improved the quality of life of older adults in health care and nursing homes; however, knowledge about the effects of person-centred interventions in aged care at home is sparse. The aim of this study was to study the effects of a person-centred and health-promoting intervention, compared with usual care, on health-related quality of life, thriving and self-determination among older adults, and on job satisfaction, stress of conscience and level of person-centred care among care staff.

Methods: This is a non-randomized controlled trial with a before/after design. Participants from five home care districts in one municipality in northern Sweden were recruited to an intervention or control group. We evaluated health-related quality of life, thriving and self-determination among older home care recipients, and job satisfaction, person-centred care and stress of conscience among care staff. Evaluation was performed by questionnaires and responses were analysed using parametric and non-parametric statistical analyses.

Results: Eighty-one older adults and 48 staff were included in the study. A clinically moderate and statistically significant difference between the intervention and control groups was found in thriving and negative emotions among older adults. The intervention contributed to maintaining high thriving levels, in contrast to decreased thriving in the control group (intervention: + 1, control: - 4, p 0.026, CI: - 10. 766, - 0.717). However, the intervention group rated an increase in negative emotions, while the control group was unchanged (intervention: - 7 control: + - 0, p 0.048, CI: - 17.435, - 0.098). No significant effects were found among staff.

Conclusions: The intervention contributed to maintaining high levels of thriving in contrast to low levels found in the control group, and it seems reasonable to consider the intervention focus on staff as more person-centred and health-promoting. The finding that the intervention group had increase in negative emotions is difficult to interpret, and warrants further exploration. Even though the results are sparse, the challenges discussed may be of importance for future studies in the context of HCS.

Trial registration: NCT02846246. Date of registration: 27 July 2016.

Keywords: Home care service; Intervention; Older adults; Person-centred care.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart of home care service (HCS) recipients participating in the study
Fig. 2
Fig. 2
Flow chart of home care service (HCS) staff participating in the study

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