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; 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。先前对疗养院的民族志研究表明，旨在提高护理质量的官僚法规会导致强调与关怀伦理冲突的组织效率。该论文通过分析围绕官僚主义监管的不同组织文化如何影响护理人员对居民的个人需求定制护理的能力来重新审查这一想法。我在两个备受赞誉的疗养院中进行人种志研究，这些疗养院在结构特征上相似，但在组织文化中有所不同，尤其是在其官僚程序的方法中。因此，这项研究问：不同的组织文化如何塑造疗养院关怀环境的形成？先前对疗养院生活质量的评估已使用简短的观察作为数据来源， 与患者调查一起。拟议项目的比较人种学设计加深了 通过提供对组织过程的详细长期说明来分析生活质量 在生活质量调查中产生不同的结果。人种学使我能够检查如何照顾 关系随着时间的流逝而变化，以应对周围的环境。我从这种方法中 开发分析类别，以评估照顾者满足居民情感需求的程度。这项研究的长期目标是开发用于分析不同影响的工具 关于疗养院和其他长期护理设施生活质量的组织结构和文化。正如医疗研究和质量署目标中强调的那样，组织效率是改善疗养院（例如疗养院）的总体护理质量的必要目的。这项研究旨在提高我们对卫生保健组织如何保持一定程度的效率的理解，同时促进对患者的社会，情感和精神需求做出反应的实践。因此，本文提出了AHRQ在制定卫生保健质量措施，提高卫生服务效率以及促进以患者为中心的护理方法的措施方面的利益。