The self-reported and observed competence of nursing staff in mobility care based on Kinaesthetics in nursing homes – A cross-sectional study
Abstract
Abstract.Background: The majority of care-dependent persons living in nursing homes have mobility impairment affecting the physical, psychological, and social aspects of the persons’ lives. Therefore, nursing staff needs competence to provide good mobility enhancing care. Aim: This study assesses the self-reported and observed competence of nursing home staff in mobility care based on Kinaesthetics in order to increase attention about nursing staff’s impact on nursing home residents’ mobility. Methods: A cross-sectional study design involving a survey and an observational study was employed. Survey data were collected using the Kinaesthetics Competence Self-Evaluation (KCSE) scale. For the observational study, data were collected with a video camera and rated using the Kinaesthetics Competence Observation (KCO) instrument. Data were analysed using descriptive statistics, correlation methods and a generalised linear model. Results: The majority of survey participants (n = 180) indicated their competence in mobility care based on Kinaesthetics as very good (mean score 13, SD 1.44, on a scale from 4 to 16). The observed competence of nursing staff (n = 40) was good (mean score 10.8, SD 2.44, out of a possible score from 4 to 16). Positive correlations were found between self-reported or observed competence in mobility care based on Kinaesthetics and employment rate, work experience in nursing home care and Kinaesthetics training. Conclusion: A combined assessment of self-evaluation and observation is recommended in order to get a comprehensive picture of knowledge, skills, attitude and dynamic state of nursing staffs’ competence in mobility care based on Kinaesthetics.
Zusammenfassung.Hintergrund: Die Mehrzahl pflegebedürftiger Menschen, die in Pflegeheimen leben, haben Mobilitätseinschränkungen, welche negative physische, psychische und soziale Folgen haben können. Es ist wichtig, dass Pflegepersonen eine gute bewegungsfördernde Pflege durchführen können. Ziel: In dieser Studie wurde die selbsteingeschätzte und beobachtete pflegerische Kompetenz in Kinästhetik evaluiert, mit dem Zweck, Bewusstsein hinsichtlich der pflegerischen Rolle bei der Bewegungsförderung von Pflegeheimbewohnenden zu stärken. Methode: Es wurde eine Querschnittsbeobachtungsstudie unter Verwendung des Kinaesthetics Competence Observation (KCO) Instruments und eine Fragebogenerhebung mittels der Kinaesthetics Competence Self-Evaluation (KCSE) Skala durchgeführt. Daten wurden mittels deskriptiver Statistik, Korrelationsmethoden und einem verallgemeinerten linearen Modell analysiert. Ergebnisse: Die Mehrheit der Pflegepersonen (n = 180) schätzte ihre Kompetenz in Kinästhetik als sehr gut ein (MW 13, SD 1,44, Score von 4 bis 16). Die beobachtete Kompetenz der Pflegenden (n = 40) war gut (MW 10,8; SD 2,44; Score von 4 bis 16). Höhere Kompetenzlevel waren positiv korreliert mit Anstellungsgrad, Erfahrung in der Langzeitpflege und Kinästhetik-Training. Schlussfolgerung: Ein kombiniertes Assessment von Selbsteinschätzung und Beobachtung ist empfohlen, um ein umfassendes Bild über Wissen, Skills, Einstellung und Weiterentwicklung von Pflegenden hinsichtlich der mobilitätsfördernden Pflege basierend auf Kinästhetik zu erhalten.
References
(2012). Factors associated with quality of life in older adults in the United States.
Quality of Life Research , 21 (3), 527 – 534.(2011). Trajectories of functional change among long stayers in nursing homes: does baseline impairment matter?
Journal of Aging and Health , 23 (5), 862 – 882.(2012). Function-focused care (FFC) interventions. In: Boltz,, M. Capezuti,, E. Fulmer,, T. Zwicher,, D. Ardis, O-’Meara, M. A. (Ed.),
Evidence-Based Geriatric Nursing Protocols for Best Practice . 4th ed. New York: Springer, pp. 104 – 121.(2002). The meaning of mobility for residents and staff in long-term care facilities.
Journal of Advanced Nursing , 37 (4), 338 – 345.(2011). Twenty-year trends in dependency in residential aged care in Auckland, New Zealand: a descriptive study.
Journal of the American Medical Directors Association , 12 (7), 535 – 540.(2008). A guide for the design and conduct of self-administered surveys of clinicians.
CMAJ Canadian Medical Association Journal , 179 (3), 245 – 252.(2008). Measuring nursing competence: development of a self-assessment tool for general nurses across Europe.
International Journal of Nursing Studies , 45 (6), 902 – 913.(2013). Physical rehabilitation for older people in long-term care. The Cochrane database of systematic reviews 2, CD004294. DOI: 10.1002/14651858.CD004294.pub3.
DNQP (2014). Preserving and Promoting Mobility in nursing care: Guideline. Erhaltung und Förderung der Mobilität in der Pflege Expertenstandard nach § 113a SGB XI. www.gkv-spitzenverband.de/pflegeversicherung/qualitaet_in_der_pflege/expertenstandards/expertenstandards.jsp [21.7.2017].(2003). Effects of kinesthetic mobilization in comparison with standard mobilization on respiratory function after coronary artery bypass and other relevant factors.
Pflege , 16 (4), 205 – 215.(2007). Clinical research 3: Sample selection.
Accident and Emergency Nursing , 15 (4), 234 – 238.(2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses.
Behavior Research Methods , 41 (4), 1149 – 1160.European Kinaesthetics Association Kinaesthetics Education . www.kinaesthetics.net/bildungsweg.cfm [10.5.2018].(2008). Competency Assessment in Nursing: A summary of literature published since 2000. http://edcan.org.au/assets/edcan/files/docs/EdCancompetenciesliteraturereviewFINAL_0.pdf [21.7.2017].
Federal Office of Statistics [Bundesamt für Statistik] . (2014). Healthy Ageing – Data, Indicators for ability to walk and falls: Gesundheit im Alter – Daten, Indikatoren Gehvermögen und Stürze. www.bfs.admin.ch/bfs/portal/de/index/themen/14/02/01/key/07/05.html [21.7.2017].(2013). Discovering Statistics using IBM SPSS Statistics. 4th rev. London: Sage.
(2014). Nurses’ experiences with the implementation of the Kinaesthetics movement competence training into elderly nursing care: a qualitative focus group study.
Scandinavian Journal of Caring Sciences , 28 (4), 757 – 766.(2015). Nurses’ Learning Experiences with the Kinaesthetics Care Concept Training in a Nursing Home: A Qualitative Descriptive Study.
Educational Gerontology , 1 – 15.(2016a). Assessing nursing staff’s competences in mobility support in nursing-home care: development and psychometric testing of the Kinaesthetics Competence (KC) observation instrument.
BMC Nursing , 15, 65.(2016b). Nurses’ competence in kinaesthetics: a concept development.
Zeitschrift für Gerontologie und Geriatrie . DOI: 10.1007/s00391-016-1126-x.(2017). Mobility care in nursing homes: development and psychometric evaluation of the kinaesthetics competence self-evaluation (KCSE) scale.
BMC Nursing , 16, 67.(2012). Adverse risk: a ’dynamic interaction model of patient moving and handling’.
Journal of Nursing Management , 20 (6), 713 – 736.(2009). Auswirkungen eines präoperativen Bewegungsschulungsprogramms nach dem für kinästhetische Mobilisation aufgebauten Viv-Arte-Lernmodell auf Mobilität, Schmerzen und postoperative Verweildauer bei Patienten mit elektiver medianer Laparotomie.
Pflege , 22 (1), 19 – 28.(2003). Kinaesthetics: Health development and human activity. Kinästhtetik Gesundheitsentwicklung und menschliche Aktivitäten. 2nd ed. München: Urban & Fischer.
(2015). Effects of Mobility-Enhancing Nursing Intervention in Patients with MS and Stroke: Randomised Controlled Trial.
International Scholarly Research Notices , 2015 (2), 1 – 6.International Council of Nurses (2012). The ICN Code of Ethics for Nurses: Revised 2012. www.icn.ch [21.7.2017].(2007). Promoting self-awareness in nurses to improve nursing practice.
Nursing standard (Royal College of Nursing (Great Britain) 1987) 21 (32), 47 – 52; quiz 54.(2002). Evaluation of training in patient handling and moving skills among hospital and home care personnel.
Ergonomics , 45 (12), 850 – 865.(2011). Nursing staff’s movement awareness, attitudes and reported behaviour in patient transfer before and after an educational intervention.
Applied Ergonomics , 42 (3), 455 – 463.(2014). Mobility of users of long-term care institutions: An analysis of research results and health-care data.
Pflege und Gesellschaft , 19 (2), 101 – 112.(2015). Mobility is the key! Trends and associations of common care problems in German long-term care facilities from 2008 to 2012.
International Journal of Nursing Studies , 52 (1), 167 – 174.(2008). Ergebnis der Pilotstudie Kinästhetik – Weniger Schmerzen beim Bewegen „Schwerstkranker“.
intensiv – Fachzeitschrift für Intensivpflege und Anästhesie , 16 (2), 95 – 101.(1982). Validity of self-evaluation of ability: A review and meta-analysis.
Journal of Applied Psychology , 67 (3), 280 – 296.(2006). Accuracy of physician self-assessment compared with observed measures of competence: a systematic review.
JAMA , 296 (9), 1094 – 1102.(2014). Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects.
Journal of Clinical Epidemiology , 67 (3), 267 – 277.(2017). Perceptions of Nursing and Physical Therapy Students Toward Peer-Led Interprofessional Education in Manual Handling.
Nurse Educator , 42 (1), E1–E6.OdA (2016). Joint courses for licensed practical nurses. Überbetriebliche Kurse Fachfrau / Fachmann Gesundheit EFZ. www.oda-gesundheit.ch/fileadmin/Media/docs/Bildungszentrum_UeK/FaGe/%C3%9CK-Konzept_FaGe_2015_original_01.pdf [21.7.2017].(2012). Nursing research: Generating and assessing evidence for nursing practice. 9th ed. Philadelphia: Wolters Kluwer Health.
(2010). Quality of life and barriers in the urban outdoor environment in old age.
Journal of the American Geriatrics Society , 58 (11), 2154 – 2159.(2013). Promoting mobility in older people.
Journal of Preventive Medicine and Public Health , 46 Suppl 1, S50 – 4.(2002). Bundeseinheitliche Altenpflegeausbildung: Materialien für die Umsetzung der Stundentafeln. www.kda.de/tl_files/kda/Jubilaeum1962%20-%202012/PDFs/bundeseinheitliche_altenpflegeausbildung_materialien.pdf [21.7.2017].
(2010). Kinaesthetics Concepts.
Kinaesthetics Konzepbuch . Linz: European Kinaesthetics Association.(2015). Improving person-centered mobility care in nursing homes: a feasibility study.
Geriatric Nursing , 36 (2), 98 – 105.(2016). An integrated practice approach to mobility care for older people.
Nursing Standard , 30 (29), 51 – 9; quiz 60.University of Applied Sciences FH Campus Wien (2016). General healthcare and nursing bachelor’s programme. Gesundheits- und Krankenpflege Bachelorstudium. www.fh-campuswien.ac.at/studium/studien-und-weiterbildungsangebot/detail/gesundheits-und-krankenpflege.html [21.7.2017].(2016). Older Adults with Dementia Are Sedentary for Most of the Day.
PloS one 11 (3), e0152457. DOI: 10.1371/journal.pone.0152457(2010). Measurement in nursing and health research.
4th ed . New York: Springer.(2009). The effects of resident and nursing home characteristics on activities of daily living.
The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences , 64 (4), 473 – 480.(2009). Experiences of physical strain during person transfer situations in dementia care units.
Scandinavian Journal of Caring Sciences , 23 (4), 644 – 650.(2013). Competency assessment tools for registered nurses: an integrative review.
Journal of Continuing Education in Nursing , 44 (1), 31 – 37.(2013). Work-relatedness of low back pain in nursing personnel: a systematic review.
International Journal of Occupational and Environmental Health , 19 (3), 223 – 244.(2014). Functional decline and mortality in long-term care settings: Static and dynamic approach.
Journal of Clinical Gerontology and Geriatrics , 5 (1), 13 – 17.(2013). Schlussbericht zur Befragung des Pflege- und Betreuungspersonals in Alters- und Pflegeinstitutionen der Schweiz. https://nursing.unibas.ch/shurp [21.7.2017].
