Hostname: page-component-5d59c44645-jb2ch Total loading time: 0 Render date: 2024-02-21T20:31:33.657Z Has data issue: false hasContentIssue false

Exploring evolving caring relationship experiences among nursing home residents and nurse aides in Shanghai: a dyadic perspective

Published online by Cambridge University Press:  09 December 2021

Lin Chen*
Affiliation:
Department of Social Work, LSE-Fudan Research Centre for Global Public Policy, Fudan University, Shanghai, China
Qiang Zhu
Affiliation:
Department of Social Work, Fudan University, Shanghai, China
Ling Xu
Affiliation:
School of Social Work, University of Texas at Arlington, Texas, USA
Yura Lee
Affiliation:
Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
Bum Jung Kim
Affiliation:
Department of Social Welfare, Chung-Ang University, Seoul, South Korea
*
*Corresponding author. Email: linc@fudan.edu.cn

Abstract

Although research has shown that older nursing home residents can benefit from caring relationships with nurse aides, few studies have explored their dyadic, evolving relationship dynamics. Using a dyadic perspective, this study simultaneously explores caring relationships among older residents and nurse aides in Shanghai. In a government-sponsored nursing home in Shanghai, 20 matched resident–nurse aide dyads participated in semi-structured, in-depth interviews (N = 40). We performed thematic analysis to interpret and conceptualise the evolving caring relationships within dyads. Four types emerged during the evolution of caring relationships across the 20 dyads: (a) sharing strong rapport, (b) respecting each other, (c) hesitant responding, and (d) keeping emotional distance. Upon placement, all the residents kept emotional distance from nurse aides, and their assigned nurse aides provided care-giving by following nursing home regulations. As time passed, nurse aides began to create a family environment and tried to interact with residents on an emotional level; however, residents’ attitudes varied. The caring relationships in some dyads evolved as rapport and respect emerged, while others remained hesitant and distant. This suggests that residents and nurse aides prioritised caring relationships differently in terms of autonomy preservation and safety protection, respectively. This study sheds light on nursing home practice to facilitate building caring relationships between residents and nurse aides.

Type
Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adra, MG, Hopton, J and Keady, J (2015) Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family. International Journal of Older People Nursing 10, 306318.CrossRefGoogle ScholarPubMed
Andersson, F and Hjelm, K (2017) Patient safety in nursing homes in Sweden: nurses’ views on safety and their role. Journal of Health Services Research & Policy 22, 204210.CrossRefGoogle ScholarPubMed
Anyan, F (2013) The influence of power shifts in data collection and analysis stages: a focus on qualitative research interview. Qualitative Report 18, 3645.Google Scholar
Bangerter, LR, Van Haitsma, K, Heid, AR and Abbott, K (2016) ‘Make me feel at ease and at home’: differential care preferences of nursing home residents. The Gerontologist 56, 702713.CrossRefGoogle ScholarPubMed
Bergland, A and Kirkevold, M (2005) Resident–caregiver relationships and thriving among nursing home residents. Research in Nursing and Health 28, 365375.CrossRefGoogle ScholarPubMed
Bowers, BJ, Esmond, S and Jacobson, N (2000) The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides. Journal of Nursing Care Quality 14, 5564.CrossRefGoogle ScholarPubMed
Bowers, BJ, Fibich, B and Jacobson, N (2001) Care-as-service, care-as-relating, care-as-comfort: understanding nursing home residents’ definitions of quality. The Gerontologist 41, 539545.CrossRefGoogle ScholarPubMed
Braun, M, Scholz, U, Bailey, B, Perren, S, Hornung, R and Martin, M (2009) Dementia caregiving in spousal relationships: a dyadic perspective. Aging and Mental Health 13, 426436.CrossRefGoogle ScholarPubMed
Brown-Wilson, CB and Davies, S (2009) Developing relationships in long term care environments: the contribution of staff. Journal of Clinical Nursing 18, 17461755.CrossRefGoogle Scholar
Brown-Wilson, CB and Davies, S (2009) Developing relationships in long term care environments: The contribution of staff. Journal of Clinical Nursing 18, 17461755.CrossRefGoogle Scholar
Chao, S-Y, Lan, Y-H, Tso, H-C, Chung, C-M, Neim, Y-M and Clark, MJ (2008) Predictors of psychosocial adaptation among elderly residents in long-term care settings. Journal of Nursing Research 16, 149159.CrossRefGoogle ScholarPubMed
Chen, L (2017) Power and ambivalence in intergenerational communication: Deciding to institutionalize in Shanghai. Journal of Aging Studies 41, 4451.CrossRefGoogle ScholarPubMed
Chen, L and Han, W-J (2016) Shanghai: Front-runner in community-based elder care in China. Journal of Aging and Social Policy 28, 292307.CrossRefGoogle Scholar
Cheng, ST (2009) The social networks of nursing-home residents in Hong Kong. Ageing & Society 29, 163178.CrossRefGoogle Scholar
Chung, G (2012) Nursing assistant views on nursing home regulatory inspection: knowledge and attitudes regarding the state nursing home survey. Journal of Applied Gerontology 31, 336353.CrossRefGoogle Scholar
Cook, G and Brown-Wilson, C (2010) Care home residents’ experiences of social relationships with staff. Nursing Older People 22, 2429.CrossRefGoogle ScholarPubMed
Creswell, JW and Poth, CN (2017) Qualitative Inquiry and Research Design: Choosing Among Five Approaches, 4th Edn. Thousand Oaks, CA: Sage.Google Scholar
Custers, AF, Westerfhof, GJ, Kuin, Y and Riksen-Walraven, M (2010) Need fulfilment in caring relationships: its relation with well-being of residents in somatic nursing homes. Aging and Mental Health 14, 731739.CrossRefGoogle ScholarPubMed
Custers, AF, Westerhof, GJ, Kuin, Y, Gerritsen, DL and Riksen-Walraven, JM (2012) Relatedness, autonomy, and competence in the caring relationship: the perspective of nursing home residents. Journal of Aging Studies 26, 319326.CrossRefGoogle Scholar
Feng, Z, Liu, C, Guan, X and Mor, V (2012) China's rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Affairs 31, 27642773.CrossRefGoogle ScholarPubMed
Feng, Z, Li, Q, Glinskaya, E, Zheng, NT and Wiener, JM (2018) Building a long-term care delivery system with a balanced mix of services. In Glinskaya, E and Feng, Z (eds), Options for Aged Care in China: Building an Efficient and Sustainable Aged Care System. Washington, DC: World Bank, pp. 129154.CrossRefGoogle Scholar
Feng, Z, Glinskaya, E, Chen, H, Gong, S, Qiu, Y, Xu, J and Yip, W (2020) Long-term care system for older adults in China: policy landscape, challenges, and future prospects. The Lancet 396, 13621372.CrossRefGoogle Scholar
Forsgren, E, Skott, C, Hartelius, L and Saldert, C (2016) Communicative barriers and resources in nursing homes from the enrolled nurses’ perspective: a qualitative interview study. International Journal of Nursing Studies 54, 112121.CrossRefGoogle ScholarPubMed
Funk, LM and Outcalt, L (2020) Maintaining the ‘caring self’ and working relationships: a critically informed analysis of meaning-construction among paid companions in long-term residential care. Ageing & Society 40, 15111528.CrossRefGoogle Scholar
Gubrium, JF and Holstein, JA (1999) The nursing home as a discursive anchor for the ageing body. Ageing & Society 19, 519538.CrossRefGoogle Scholar
Guest, G, MacQueen, KM and Namey, EE (2011) Applied Thematic Analysis. Thousand Oaks, CA: Sage.Google Scholar
Haugan, G (2014) The relationship between nurse–patient interaction and meaning-in-life in cognitively intact nursing home patients. Journal of Advanced Nursing 70, 107120.CrossRefGoogle ScholarPubMed
Heliker, D and Nguyen, HT (2010) Story sharing: enhancing nurse aide–resident relationships in long-term care. Research in Gerontological Nursing 3, 240252.CrossRefGoogle ScholarPubMed
Huang, X (2013) Continual education for nurse aides in the community nursing homes in Shanghai. Journal of Chinese Nursing Management 13, supplement, 124126. (In Chinese)Google Scholar
Hunt, SR, Corazzini, K and Anderson, RA (2014) Top nurse-management staffing collapse and care quality in nursing homes. Journal of Applied Gerontology 33, 5174.CrossRefGoogle ScholarPubMed
Husserl, E ([1911] 1965) Philosophy as rigorous science. In Laurer, Q (ed. and trans.), Phenomenology and the Crisis of Philosophy. New York, NY: Harper, pp. 71147.Google Scholar
Kahana, E (1982) A congruence model of person–environment interaction. In Lawton, MP, Windley, PG and Byerts, TO (eds), Aging and the Environment. Theoretical Approaches. New York, NY: Springer, pp. 97121.Google Scholar
Lawton, MP (1989) Environmental proactivity in older people. In Bengtson, VL and Schaie, KW (eds), The Course of Later Life. New York, NY: Springer, pp. 1523.Google Scholar
Lung, CC and Liu, JYW (2016) How the perspectives of nursing assistants and frail older residents on their daily interaction in nursing homes affect their interaction: a qualitative study. BMC Geriatrics 16, 13.CrossRefGoogle Scholar
Lung, CC and Liu, JYW (2016) How the perspectives of nursing assistants and frail older residents on their daily interaction in nursing homes affect their interaction: a qualitative study. BMC Geriatrics 16, 114.CrossRefGoogle Scholar
Manchha, AV, Walker, N, Way, KA, Dawson, D, Tann, K and Thai, M (2021) Deeply discrediting: a systematic review examining the conceptualizations and consequences of the stigma of working in aged care. The Gerontologist 61, e129e146.CrossRefGoogle ScholarPubMed
McGilton, KS, O'Brien-Pallas, LL, Darlington, G, Evans, M, Wynn, F and Pringle, DM (2003) Effects of a relationship-enhancing program of care on outcomes. Journal of Nursing Scholarship 35, 151156.CrossRefGoogle ScholarPubMed
Ministry of Civil Affairs (2019) The National Professional Standards for Long-term Care Nursing Staff. Available at http://www.gov.cn/xinwen/2019–10/16/content_5440676.html.Google Scholar
Moustakas, CE (1994) Phenomenological Research Methods. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Nakrem, S, Vinsnes, AG and Seim, A (2011) Residents’ experiences of interpersonal factors in nursing home care: a qualitative study. International Journal of Nursing Studies 48, 13571366.CrossRefGoogle ScholarPubMed
National Bureau of Statistics of China (2016) 2015 National Economic and Social Development Communication. Available at http://www.stats.gov.cn/tjsj/zxfb/201602/t20160229_1323991.html.Google Scholar
Nolan, MR, Davies, S, Brown, J, Keady, J and Nolan, J (2004) Beyond ‘person-centred’ care: a new vision for gerontological nursing. Journal of Clinical Nursing 13, 4553.CrossRefGoogle Scholar
Nolan, MR, Brown, J, Davies, S, Nolan, J and Keady, J (2006) The Senses Framework: Improving Care for Older People Through a Relationship-centred Approach (Getting Research into Practice (GRiP) Report No. 2) Sheffield Hallam University, United Kingdom.Google Scholar
Poey, JL, Hermer, L, Cornelison, L, Kaup, ML, Drake, P, Stone, RI and Doll, G (2017) Does person-centered care improve residents’ satisfaction with nursing home quality? Journal of the American Medical Directors Association 18, 974979.CrossRefGoogle ScholarPubMed
Putnam, M, Tang, F, Brooks-Danso, A, Pickard, J and Morrow-Howell, N (2007) Professionals’ beliefs about nursing home regulations in Missouri. Journal of Applied Gerontology 26, 290304.CrossRefGoogle Scholar
Reker, GT and Woo, LC (2011) Personal meaning orientations and psychosocial adaptation in older adults. SAGE Open 1, 110. https://doi.org/10.1177/2158244011405217.CrossRefGoogle Scholar
Roberts, T and Bowers, B (2015) How nursing home residents develop relationships with peers and staff: a grounded theory study. International Journal of Nursing Studies 52, 5767.CrossRefGoogle Scholar
Ryvicker, M (2011) Staff–resident interaction in the nursing home: an ethnographic study of socio-economic disparities and community contexts. Journal of Aging Studies 25, 295–04.CrossRefGoogle Scholar
Shanghai Civil Affairs Bureau (2013) Notice on publishing Shanghai municipal standard of ‘Nursing Home Care Level Assessment.’ Available online at http://www.shweilao.cn/cms/cmsDetail?uuid=c4f2e59d-29f6-4060-b0d1-0726d4c0eec0 [2021-01-20].Google Scholar
Shanghai Civil Affairs Bureau (2019) Notice on the Issuance of the ‘2019 Implementation Plan on National Nursing Home Service Quality Special Action’. Available at http://www.shweilao.cn/cms/cmsDetail?uuid=4ce05022-24ee-4fd4-9e23-545d1edce8ef.Google Scholar
Shanghai Civil Affairs Bureau (2020) Information on Ageing Population in Shanghai 2019. Available at http://www.shweilao.cn/cms/cmsDetail?uuid=6e177166-42e8-49d2-8621-a8ad22a2a2a9.Google Scholar
Shenton, AK (2004) Strategies for ensuring trustworthiness in qualitative research projects. Education for Information 22, 6375.CrossRefGoogle Scholar
Strauss, A and Corbin, J (1998) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: Sage.Google Scholar
Street, D, Burge, S, Quadagno, J and Barrett, A (2007) The salience of social relationships for resident well-being in assisted living. Journals of Gerontology: Psychological Sciences and Social Sciences 62B, 129134.CrossRefGoogle Scholar
United Nations (2019) World Population Prospects. Available at https://population.un.org/wpp.Google Scholar
Wahl, H-W (2015) Theories of environmental influences on aging and behavior. In Pachana, N (ed). Encyclopedia of Geropsychology. Singapore: Springer. https://doi.org/10.1007/978-981-287-080-3_132-1.Google Scholar
Wahl, H-W and Weisman, GD (2003) Environmental gerontology at the beginning of the new millennium: reflections on its historical, empirical, and theoretical development. The Gerontologist 43, 616627.CrossRefGoogle ScholarPubMed
Wahl, H-W, Iwarsson, S and Oswald, F (2012) Aging well and the environment: toward an integrative model and research agenda for the future. The Gerontologist 52, 306316.CrossRefGoogle ScholarPubMed
Wong, JS and Hsieh, N (2019) Functional status, cognition, and social relationships in dyadic perspective. Journals of Gerontology: Psychological Sciences and Social Sciences 74B, 703714.CrossRefGoogle Scholar
workercn.cn (2016) How to Make Up for the Gap of 40 Million Care Work Force? Available at http://media.workercn.cn/sites/media/jlgrb/2016_07/25/GR0503.htm.Google Scholar
Zhang, J, Glinskaya, E, Gong, S and Zhang, S (2018) Long-term care workforce issues. In Glinskaya, E and Feng, Z (eds), Options for Aged Care in China: Building an Efficient and Sustainable Aged Care System. Washington, DC: World Bank, pp. 285298.CrossRefGoogle Scholar