Physicians' perceptions of care in the nursing home and of strategies for improvement in a survey on treatment of behavior problems.

摘要

OBJECTIVES: This paper reports on a survey documenting physicians' assessment of current levels of care in the nursing home and of the importance and feasibility of strategies to improve care. DESIGN: This is a descriptive study presenting responses to a Web-based questionnaire that asked about treatment of behavior problems in nursing homes as well as about perceptions of quality of care. SETTING: Nursing home. PARTICIPANTS: Participants were 110 physicians who provide services in a nursing home environment. MEASUREMENTS: Likert-type ratings of perceived levels of care in the facility and of the importance and feasibility of strategies to improve care. RESULTS: These physicians perceived current levels of care in the nursing home to be acceptable, but not good or outstanding. Overall care in the facility and the level of staff care for residents were seen as better than the level of administration care for nursing assistants or for physicians. The importance of specific strategies to improve care was rated higher than the feasibility of these strategies actually being employed. The item rated the most important for improving care was having the administration show respect, support, and caring for front line staff; this item was also rated the most feasible. Other items rated as highly important concerned either front line staff or families. The feasibility of improving care, but not the importance of improvement, was associated with the perception of current levels of care. CONCLUSION: These findings can be used as guidelines for improving the culture of care in nursing home facilities.