Understanding the staff behaviours that promote quality for older people living in long term care facilities: a realist review

Haunch, Kirsty, Thompson, Carl, Arthur, Antony, Edwards, Paul, Goodman, Claire, Hanratty, Barbara, Meyer, Julienne, Charlwood, Andy, Valizade, Danat, Backhaus, Ramona, Verbeek, Hilde, Hamers, Jan and Spilsbury, Karen (2021) Understanding the staff behaviours that promote quality for older people living in long term care facilities: a realist review. International Journal of Nursing Studies, 117. ISSN 0020-7489

[thumbnail of Accepted_Manuscript]
PDF (Accepted_Manuscript) - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (937kB) | Preview


Background: Little is known about how the workforce influences quality in long term care facilities for older people. Staff numbers are important but do not fully explain this relationship. Objectives: To develop theoretical explanations for the relationship between long-term care facility staffing and quality of care as experienced by residents. Design: A realist evidence synthesis to understand staff behaviours that promote quality of care for older people living in long-term care facilities. Setting: Long-term residential care facilities Participants: Long-term care facility staff, residents, and relatives Methods: The realist review, (i) was co-developed with stakeholders to determine initial programme theories, (ii) systematically searched the evidence to test and develop theoretical propositions, and (iii) validated and refined emergent theory with stakeholder groups. Results: 66 research papers were included in the review. Three key findings explain the relationship between staffing and quality: (i) quality is influenced by staff behaviours; (ii) behaviours are contingent on relationships nurtured by long-term care facility environment and culture; and (iii) leadership has an important influence on how organisational resources (sufficient staff effectively deployed, with the knowledge, expertise and skills required to meet residents’ needs) are used to generate and sustain quality-promoting relationships. Six theoretical propositions explain these findings. Conclusion: Leaders (at all levels) through their role-modelling behaviours can use organisational resources to endorse and encourage relationships (at all levels) between staff, residents, co-workers and family (relationship centred care) that constitute learning opportunities for staff, and encourage quality as experienced by residents and families.

Item Type: Article
Uncontrolled Keywords: care homes,leadership,long term care facilities,nursing homes,quality,realist review,relationships,staff behaviours,nursing(all) ,/dk/atira/pure/subjectarea/asjc/2900
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 24 Feb 2021 00:59
Last Modified: 21 Apr 2023 00:59
URI: https://ueaeprints.uea.ac.uk/id/eprint/79315
DOI: 10.1016/j.ijnurstu.2021.103905


Downloads per month over past year

Actions (login required)

View Item View Item