1. Person-Centred Care in Rural and Urban regions in Sweden
Karin Sjögren, RN, MSc, PhD-student
David Edvardsson RN, Associate professor
Marie Lindkvist PhD, Lecturer in Statistics
Per-Olof Sandman RN, Professor
Karin Zingmark RN, PhD

2. Sweden

3. Person-Centred Care Focus on the person and not the disease
Create a positive psychosocial environment
Life story work
Individualization
Include the family in care
Shared decision making

4. Research Well-being, sence of pride and confidence (McKeown, 2010)
Decreased agitation (Chenoweth et al,2009)
Improved bowel elimination pattern and lower prevalence of constipation (Palese et al., 2010)

5. The aim
Investigate degree of person-centred care in age care facilities in urban and rural Sweden and the relationship to degree of quality of life, pain, depression, agitation and activity of daily living

6. Design and sample Cross-sectional descriptive study National sample
Questionnaires
Staff
Resident proxy
Rural
Urban
Total
Care facilities 41
112
153
Residents
325
1141
1466
Staff
322
899
1221

7. Instruments Person-centredness
Person-Centred Care Assessment Tool (P-CAT, Edvardsson et al., 2010)
Resident health
Quality of Life in Late Stage Dementia (QUALID, Weiner et al., 2000)
Pain Assessment in Advanced Dementia (PAINAD, Warden et al., 2003)
Cornell Scale for Depression in Dementia (Alexopoulos et al., 1988)
Cohen-Mansfield Agitation Inventory (CMAI, Cohen-Mansfield et al., 1989)
Multi-Dimensional Dementia Assessment Scale (MDDAS, Sandman et al., 1988)

8. (Independent samples t-test)
Resident health
Urban
Rural
P-value
Men
340
121
Women
787 (79%)
199 (62%)
Mean age 85 84
0,01
QoL (1-5)
1,93
1,90
0,5
Pain (0-2)
0,40
0,39
0,7
Depression (0-3)
1,24
1,20
0,33
Agitation (1-7)
1,62
1,60
0,72
ADL (1-5)
2,51
2,66
0,02
(Independent samples t-test)

9. Differences in Person-centredness
Urban
Rural
P-value
Total P-CAT (1-5)
3.83
3.68
0.032
Subscale 1
Personalizing care
4.12
3.90
0.001
Subscale 2
Organizational and environmental support
3.37
3.36
0.850
(Independent samples t-test)

10. Person-centredness and activity of daily living
Proportion of residents with high performance in ADL
High PCC
Low PCC
P-value
Rural
61 %
53%
0.25
Urban
55 %
46 %
0.008
(Chi square test)

11. Person-centredness and prevalence of depression
Proportion of residents with depression
High PCC
Low PCC
P-value
Rural
72 %
60 %
0.06
Urban
66 %
0.08
(Chi square test)

12. Person-centredness and quality of life
Proportion of residents with high QoL
High PCC
Low PCC
P-value
Rural
77,4 %
63,1 %
0.03
Urban
63,5 %
62,1 %
0.68
(Chi square test)

13. Factors associated with high degree of Person-centred care
Age
1.00
ADL
1.01
Pain
0,98
Depression
1.04*
Agitation
1,01
Urban/rural
2,06 **
Sex
0,92
QoL high/low
1,47 *
(* p< 0,05, **p<0,001)

14. Conclusions
There are differences in person-centredness between rural and urban aged care facilities in Sweden. Urban facilities have a higher degree of person-centredness than rural facilities
Person-centredness is associated with higher levels of quality of life, higher proportion of depressive symptoms and high performance in activities of daily living
Person-centredness has an impact on resident health/well-being

15. Thank you for listening
Rural regions
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Datum
Sidfot

16. Conflict of Interest Disclosure Karin Sjögren, RN PhD student
Has no real or apparent conflicts of interest to report.