Pneumonia Care and the Nursing Home: A qualitative Research Study of resident and family member perspective. Jaya George
Introduction to Nursing Research
NRS-433 V
Bazydlo, Nora
June 06, 2011

Pneumonia Care and the Nursing Home: A qualitative Research Study of resident and family member perspective.
Introduction.
Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives. Soo Chan Carusone,1 Mark Loeb,1,2 and Lynne Lohfeld1,3 1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada2Department of Pathology and Molecular Medicine, McMaster University, Canada
3Program for Educational Research and Development, McMaster University, Canada Corresponding author. Soo Chan Carusone: chansy@mcmaster.ca; Mark Loeb: loebm@mcmaster.ca; Lynne Lohfeld: lohfeld@mcmaster.ca Received September 19, 2005; Accepted January 23, 2006. Pneumonia is the inflammation of the lung parenchyma, build up fluid in the tissue of the lungs and then this infection spread in to whole body. The causes are mainly by Viruses, Bacteria, often caused by parasites or fungi. Pneumonia is the 5th leading cause of death in elderly. It may be unrecognized due to many factors such as it may be asymptomatic, or may be confused with other medical issues, or the typical age related changes occurred in the lungs structure of the elderly. Background. The use of long-term care facilities are increased among the Americans due to changes in social values and demographic. Not only this reasons but due to the functional dependency and clinical complexity of health issues. Most of the elderly nursing homes residents need help in daily activities and some of them had difficulties with bowel and bladder continence.
Although many long term care facilities ( LTCF) residents are currently transferred to hospital for diagnostic tests or to receive acute medical services, fiscal pressures, improved technology, and complications associated with hospitalization suggest that more medical care should be provided in nursing homes. (Soo Chan Carusone, 2006 ). Purpose.
Purpose of this study is to find out residents with pneumonia at a low to medium level mortality risk may be managed safely in Nursing homes for low cost. (Soo Chan Carusone, 2006).
Objectives.
Objectives of this study is to learn if LTCF care for pneumonia is consistent with residents and their family preferences using a qualitative descriptive study design ( (Soo Chan Carusone, 2006 ). Methods.
The methods of the study was a qualitative descriptive study design. This study was part of randomized controlled, multi-centered clinical trial that tested the effectiveness and utility of using a protocol for treating nursing home acquired pneumonia. (Soo Chan Carusone, 2006 ). The study was conducted by the Interdisciplinary health research team grant and funded by the Canadian Institute of health research . twenty nursing homes in southern Ontario were matched size and one member in each pair was randomly allocated to use the clinical pathway. The other facility continued to follow normal care practices to diagnose and treat the pneumonia from November 2003 to June 2004.including and excluding criteria for the clinical trial prepared for the study. Procedure.
Participants were selected from the residents of nursing homes who treated for pneumonia and their families.( sampling and recruitment) . all of the participants were between the ages of 76 and 93 years. ( mean age of 84 years ) and their functional status varied greatly as measured by the modified –Barthel Index. This will rate the status on ten daily functions for a summery score that ranges from 0 to 20 points. In this 0 is considered as full dependences for their daily living activities and 20 is for full independences. Because the nature of research, they conducted a fourteen in-depth interviews.( Data Collection). Interviews to the families and the participant’s lasted about twenty minutes and according to the ability of the participant’s to answer the questions or express themselves. Numerous steps were taken to ensure the findings were truthful according to the participant’s descriptions and interpretations. ( Credible) and then the process of the research could be followed by another researcher ( rigorous). Inclusion and exclusion criteria of the clinical trial were made to ease the interview process. This aimed to enroll information rich participants or the people who can best describe their experience under the study. It is known as purposeful sampling. To ensure the continuity of the research, all interviews were conducted by the same researcher. And the informed consent was secured from all the participant’s before the interview and assured them that, their care would not be affected in any way by participating this project. ( Ethical Considerations). Then the interviewed data were analyzed to identify key themes using the editing style, described by Miller and Crabtree.
Result.
Participants included from both residents ( six) and family members ( eight) with mean age group of 84 years with a modified – Barthel Index of 0 to 20 points. Participants readily spoke about the topic where given in the interview. They had different views on about decision making about their preferred care.
Although the residents in the study had been diagnosed with pneumonia they largely preferred pneumonia can be treated in nursing homes when possible. Because they considered LTCF as a ‘home’ due to its benefits of being in a familiar surroundings and more comfort and personal attention in a LTCF than in hospital. One disadvantages they expressed that, though the staffs in LTCF were very friendly but they are too busy and hurry, in some cases, personal care is inadequate.
Implications to the HealthCare.
The study has given the expression of nursing homes residents and their families concerns regarding their care and satisfaction with treatment in pneumonia cases. The role of nursing homes should be taken in to account when developing programs to ensure patient’s or resident- centered care. The facilities will serve as both ‘ homes’ for their residents as well as a place where they can be treated their serious health care needs. The findings of this study have the implications for both future practice and research on pneumonia care for nursing homes residents. The provision of acute care services in nursing homes may become a more widely accepted option and may need to increase the public awareness of clinical skills and resources available in situ care. Conclusion.
Building on this research, we would hope that future studies on important topic explore the view of the public using variety of methods of research such as observation, surveys and interviews in order to fully investigate the treatment satisfaction and comfort of the senior citizens consistently identified with good quality care.
A greater understanding of residents and the family member’s preference and satisfaction with the treatment is important to develop viable models of resident- centered care in long term care facilities. Moreover, nursing homes may benefits from highlighting their ability to meet both disease- illness related care and the satisfaction of their residents and families. This study may be a good example of how qualitative studies can identify the underlying reasons for preferences of care for older adults.

References.
Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives. Soo Chan Carusone,1 Mark Loeb,1,2 and Lynne Lohfeld1,3 1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada2Department of Pathology and Molecular Medicine, McMaster University, Canadahttp://www.pubmedec central.nih.g