An investigation into resident satisfaction following the implementation of a quality assurance programme at a home for the elderly

Ellis, Susanna Louisa Hendrina Maria (2015-12)

Thesis (MCur)--Stellenbosch University, 2015.

Thesis

ENGLISH ABSTRACT: A growing number of elderly citizens are being cared for in residential facilities in South Africa. They are highly dependent on those caring for them to meet their basic needs, as well as maintaining their well-being and human dignity. The quality of care provided to them could thus have a distinctive influence on their wellness and experience of quality in their daily lives. The aim of the study was to investigate resident satisfaction following the implementation of a quality assurance programme at a home for the elderly. The objectives of the study included resident satisfaction about structure and process standards related to the programme, as well as residents’ opinion of areas for further improvement. The relationship between the demographic variables and study variables was also investigated. Ethics approval to conduct the study was obtained from the Health Research Ethics Committee of Stellenbosch University. Permission was further obtained from the Board of Directors of the facility. A descriptive research design with a quantitative approach was applied. The population consisted of all the residents of the home for the elderly. No sampling method was applied. After application of the inclusion and exclusion criteria, 103 (N=103) residents were invited to participate in the study. A self-administered questionnaire designed by the researcher was used to collect the data. It consisted mainly of closed-ended questions and a few open-ended questions. A return rate of was 50 (n=50) questionnaires was obtained. Reliability and validity were supported by an in-depth literature review, a pilot study and consultations with experts in geriatric nursing care, a nursing researcher and a statistician. The data was analysed with the assistance of a statistician and computer software. Cronbach’s alpha coefficient was used to test the internal reliability of the questionnaire. The results were 0.926, 0.919 and 0.879 respectively for the questions related to structure-, process – and outcome standards. Non-parametric statistical tests and correlations were applied to the variables. This included the Mann-Whitney U test and Spearman’s rank-order correlational coefficient. The narrative data generated from the open-ended questions were thematically analysed. The results showed that the participants (n=50) were satisfied with most aspects of the facility. They were highly satisfied with the environment, safety aspects and positive attitude of the staff. However, they were less satisfied with the food services, bathroom facilities and communication processes. Many participants (44%) were dissatisfied with the input they have into the management of the facility. Almost all the participants (98%) indicated that they would recommend the facility to their friends and family, while only two participants (4%) indicated they would prefer to live at another facility. The recommendations were aimed at improvements in the food services and communication processes. Other recommendations focused on the maintenance of the infrastructure, social interaction and nursing care. It was concluded that a quality assurance programme is needed in homes for the elderly to ensure their well-being. The level of resident satisfaction could furthermore be used as an indicator of excellence.

AFRIKAANSE OPSOMMING: Daar is ʼn toenemende aantal bejaarde burgers wat in Suid-Afrika in inrigtings woon en versorg word. Hulle is hoogs afhanklik van diegene wat hulle versorg om in hulle basiese behoeftes te voorsien, asook vir die handhawing van hulle welsyn en menswaardigheid. Die gehalte van die versorging wat aan hulle gebied word, het dus ʼn bepalende invloed op hulle welsyn en ervaring van gehalte in hulle daaglikse lewe. Die doel van hierdie studie was om inwoner-tevredenheid te bepaal nadat ʼn gehalte versekeringsprogram by ʼn tehuis vir bejaardes geïmplementeer is. Die doelwitte van die studie het inwoner-tevredenheid met die struktuur- en proses-standaarde, wat verband hou met die program, ingesluit, asook inwoners se opinie omtrent areas vir verdere verbetering. Die verhouding tussen demografiese veranderlikes en die studies veranderlikes is ook ondersoek. Etiese goedkeuring vir die uitvoer van die studie was verkry van die Gesondheidsnavorsings-etiekkomitee van die Universiteit van Stellenbosch. Toestemming was verder ook verkry van die Raad van Direkteure van die inrigting. ʼn Beskrywende navorsingsontwerp met ʼn kwantitatiewe benadering is toegepas. Die teikengroep het bestaan uit al die inwoners van die tehuis vir bejaardes. Geen steekproef metode was toegepas nie. Na toepassing van die insluitings- en uitsluitingskriteria was 103 (N=103) inwoners uitgenooi om aan die studie deel te nee. ʼn Self-voltooide vraelys wat deur die navorser ontwerp is, was gebruik om die data in te samel. Dit het hoofsaaklik uit geslote vrae, asook ʼn paar oop vrae bestaan. ʼn Terugbesorgingstempo van 50 (n=50) vraelyste is verkry. Geldigheid en betroubaarheid is ondersteun deur ʼn in-diepte literatuur-studie, ʼn loodsstudie en konsultasies met kenners in geriatriese verpleegsorg, ʼn navorser in verpleegkunde en ʼn statistikus. Die data was geanaliseer met behulp van ʼn statistikus en rekenaar-sagteware. Cronbach se alfa-koeffisiënt was gebruik om die interne betroubaarheid van die vraelys te toets. Die resultate was 0.926, 0.919 en 0.879 onderskeidelik vir die vrae in verband met struktuur-, proses- en uitkomsstandaarde. Nie-parametriese statistiese toetse en korrelasies was op die veranderlikes toegepas. Dit sluit in die Mann-Whitney U toets en Spearman’s rangorde korrelasie koeffisiënt. Die geskrewe data wat deur middel van die oop-einde vrae gegenereer is, was tematies geanaliseer. Die resultate het getoon dat die deelnemers (n=50) tevrede was met die meeste aspekte van die inrigting. Hulle was hoogs tevrede met die omgewing, veiligheidsaspekte en die positiewe gesindheid van die personeel. Daarenteen, was hulle minder tevrede met die voedselvoorsienings-dienste, badkamer-geriewe en kommunikasie-prosesse. Baie deelnemers (44%) was ontevrede met die insette wat hulle kon lewer in die bestuur van die inrigting. Byna al die deelnemers (98%) het aangedui dat hulle die inrigting sou aanbeveel by hulle vriende en familie, terwyl slegs twee deelnemers (4%) aangedui het dat hulle sou verkies om by ʼn ander inrigting te gaan woon. Die aanbevelings was gerig op verbeteringe in die voedselvoorsienings-dienste en kommunikasie prosesse. Ander aanbevelings het gefokus op die instandhouding van die infrastruktuur, sosiale interaksie en verpleegsorg. Die gevolgtrekking was dat ʼn gehalteversekeringsprogram benodig word in tehuise vir bejaardes om hulle welsyn te verseker. Die vlak van inwoner-tevredenheid kan verder gebruik word as ʼn aanwyser vir uitnemendheid.

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