Organizational Culture and Quality of Life in Nursing Homes: A Qualitative Study

疗养院的组织文化和生活质量：定性研究

• 批准号: 7083209
• 负责人: Miriam Ryvicker
• 金额: $ 3.18万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7083209
• 关键词: administrative personnel; behavioral /social science research tag; caregivers; clinical research; conflict; culture; emotional dependency; ethics; health care personnel performance; health care policy; human subject; nursing administration; nursing care evaluation; nursing care quality; nursing homes; nursing personnel; outcomes research; patient care personnel attitude; patient care personnel relations; predoctoral investigator; quality of life; racial /ethnic difference; social support network

DESCRIPTION (provided by the applicant): This dissertation examines the effects of organizational culture on quality of life in two nursing homes. Previous ethnographic studies of nursing homes suggest that the bureaucratic regulations meant to improve quality of care lead to an emphasis on organizational efficiency that conflicts with an ethic of caring. This dissertation re-examines this idea by analyzing how different organizational cultures surrounding bureaucratic regulation affect caregivers' abilities to customize care to residents' individual needs. I conduct ethnographic research in two well-regarded nursing homes that are similar in structural characteristics, but vary in organizational culture, particularly in their approaches to bureaucratic procedure. Therefore, this study asks: How do different organizational cultures shape the formation of a caring environment in nursing homes? Previous assessments of quality of life in nursing homes have used brief observation as a source of data, alongside patient surveys. The comparative ethnographic design of the proposed project deepens the analysis of quality of life by providing a detailed, long-term account of the organizational processes that produce different outcomes in quality of life surveys. Ethnography allows me to examine how caregiving relationships change over time in response to their surrounding circumstances. Out of this approach I develop analytic categories for assessing the degree to which caregivers attend to the emotional needs of residents. The long-term goal of this study is to develop tools for analyzing the effects of different organizational structures and cultures on quality of life in nursing homes and other long-term care facilities. As emphasized in the goals of the Agency for Healthcare Research and Quality, organizational efficiency is a necessary aim for improving overall quality of care in health care facilities such as nursing homes. This study seeks to improve our understanding of how health care organizations can maintain a certain level of efficiency, while promoting practices that respond to patients' social, emotional, and spiritual needs. Therefore, this dissertation advances AHRQ's interests in developing measures of health care quality, improving efficiency in health services, and promoting a patient-centered approach to care.

描述（由申请人提供）：本论文研究了组织文化对两个疗养院生活质量的影响。先前对疗养院的人种学研究表明，旨在提高护理质量的官僚法规导致了对组织效率的强调，这与护理道德相冲突。本论文通过分析围绕官僚监管的不同组织文化如何影响护理人员根据居民的个人需求定制护理的能力，重新审视了这一想法。我在两家备受推崇的疗养院进行了人种学研究，这两家疗养院在结构特征上相似，但在组织文化上有所不同，特别是在官僚程序方面。因此，本研究提出：不同的组织文化如何塑造养老院关爱环境的形成？以前对疗养院生活质量的评估使用了简短的观察作为数据来源， 同时进行患者调查。拟议项目的比较民族志设计加深了 通过提供详细的、长期的组织流程分析来分析生活质量 生活质量调查产生不同的结果。民族志让我能够研究护理如何 关系随着时间的推移而变化，以适应周围的环境。出于这种方法我 制定分析类别来评估护理人员关注居民情感需求的程度。这项研究的长期目标是开发工具来分析不同因素的影响 影响疗养院和其他长期护理机构生活质量的组织结构和文化。正如医疗保健研究和质量局的目标所强调的那样，组织效率是提高疗养院等医疗保健机构整体护理质量的必要目标。这项研究旨在提高我们对医疗保健组织如何保持一定水平的效率的理解，同时促进满足患者社交、情感和精神需求的实践。因此，本论文推动了 AHRQ 在制定医疗保健质量衡量标准、提高医疗服务效率以及推广以患者为中心的护理方法方面的兴趣。