Journal of clinical nursing · 2026
Current Situation and Factors Influencing Person-Centered Dementia Care in Nursing Homes: A Cross-Sectional Survey.
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Guan Xin, Ren Jia-Bao, Duan A-Min, Xin Gong-Kai, Oyebode Jan, Liu Yu
Аннотация
BACKGROUND: Person-centered dementia care (PCDC) is considered the gold standard in nursing homes, but evidence on influencing factors remains limited by qualitative designs and lack of validated tools.
AIM: To describe the current level of PCDC in nursing homes in northeastern China and to analyse multi-level factors influencing its implementation.
DESIGN: A cross-sectional survey.
SETTINGS: Sixteen nursing homes across six cities in Liaoning Province, China.
PARTICIPANTS: One Hundred Eighty-Nine Participants, Including 170 Nursing and Care Staff and 19 Managers.
METHODS: The Person-Centered Care Assessment Tool (P-CAT) and a newly developed questionnaire, Influencing Factors on PCDC (IF-PCDC), were administered. Kruskal-Wallis tests, Spearman's rank correlations, and multiple linear regression were used for analysis.
RESULTS: The overall P-CAT score was 76% (individualized care and environmental accessibility 80%; organizational support 73%). Regression analysis showed that PCDC was associated with factors from all four IF-PCDC dimensions, including work-related stress (β = -0.242, p < 0.001), knowledge of people with dementia (β = 0.238, p < 0.001), and dementia care knowledge (β = 0.194, p < 0.001); nursing home type (β = 0.317, p < 0.001), teamwork (β = 0.187, p = 0.002), and star rating (β = 0.140, p = 0.004); family trust in staff (β = 0.123, p = 0.023); and workload and working hours (β = 0.121, p = 0.046).
CONCLUSIONS: PCDC levels in northeastern Chinese nursing homes are reasonably good. This study is the first to systematically identify multi-level influencing factors using a newly developed, preliminarily validated questionnaire. Findings highlight the importance of reducing staff stress, enhancing dementia care knowledge, strengthening teamwork, building family trust, and optimizing workloads to improve PCDC.
IMPACT: This study provides quantitative evidence on PCDC and its influencing factors in Chinese nursing homes. The findings may facilitate nursing home managers, policymakers, and nursing professionals to develop targeted strategies to strengthen PCDC and improve dementia care quality in long-term care settings.
CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY: This study contributes quantitative evidence on PCDC from a non-Western nursing home context, addressing a gap in the international literature. By examining multilevel factors influencing care implementation, the findings enhance global understanding of PCDC across diverse health system and cultural contexts.
REPORTING METHOD: This study was reported in accordance with the STROBE guidelines for cross-sectional studies.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
TRIAL REGISTRATION: We registered the study with the Chinese Clinical Trial Registrat-ion Center (ID: ChiCTR2400086418. Available from: https://www.chictr.org.cn/showproj.html?proj=234364).
AIM: To describe the current level of PCDC in nursing homes in northeastern China and to analyse multi-level factors influencing its implementation.
DESIGN: A cross-sectional survey.
SETTINGS: Sixteen nursing homes across six cities in Liaoning Province, China.
PARTICIPANTS: One Hundred Eighty-Nine Participants, Including 170 Nursing and Care Staff and 19 Managers.
METHODS: The Person-Centered Care Assessment Tool (P-CAT) and a newly developed questionnaire, Influencing Factors on PCDC (IF-PCDC), were administered. Kruskal-Wallis tests, Spearman's rank correlations, and multiple linear regression were used for analysis.
RESULTS: The overall P-CAT score was 76% (individualized care and environmental accessibility 80%; organizational support 73%). Regression analysis showed that PCDC was associated with factors from all four IF-PCDC dimensions, including work-related stress (β = -0.242, p < 0.001), knowledge of people with dementia (β = 0.238, p < 0.001), and dementia care knowledge (β = 0.194, p < 0.001); nursing home type (β = 0.317, p < 0.001), teamwork (β = 0.187, p = 0.002), and star rating (β = 0.140, p = 0.004); family trust in staff (β = 0.123, p = 0.023); and workload and working hours (β = 0.121, p = 0.046).
CONCLUSIONS: PCDC levels in northeastern Chinese nursing homes are reasonably good. This study is the first to systematically identify multi-level influencing factors using a newly developed, preliminarily validated questionnaire. Findings highlight the importance of reducing staff stress, enhancing dementia care knowledge, strengthening teamwork, building family trust, and optimizing workloads to improve PCDC.
IMPACT: This study provides quantitative evidence on PCDC and its influencing factors in Chinese nursing homes. The findings may facilitate nursing home managers, policymakers, and nursing professionals to develop targeted strategies to strengthen PCDC and improve dementia care quality in long-term care settings.
CONTRIBUTION TO THE WIDER GLOBAL CLINICAL COMMUNITY: This study contributes quantitative evidence on PCDC from a non-Western nursing home context, addressing a gap in the international literature. By examining multilevel factors influencing care implementation, the findings enhance global understanding of PCDC across diverse health system and cultural contexts.
REPORTING METHOD: This study was reported in accordance with the STROBE guidelines for cross-sectional studies.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
TRIAL REGISTRATION: We registered the study with the Chinese Clinical Trial Registrat-ion Center (ID: ChiCTR2400086418. Available from: https://www.chictr.org.cn/showproj.html?proj=234364).