The relation between quality of co-ordination of nursing care and quality of life in Dutch nursing homes

Quality of life of nursing home residents is a critical consideration in international health care policies and health care decisions. Yet, there is little relevant research to support decisions about client-tailored and effective nursing care for this population. Because of the permanency of their stay, the care received affects the quality of daily life. This study investigated the quality of co-ordination of care and the way it is related to gaps between needs and care supply, the quality of life and health status of residents living in Dutch nursing homes. To assess the perceived quality of life and experienced discrepancies between needs and care supply, 337 residents of 10 different nursing homes were interviewed. The quality of co-ordination of nursing care was assessed by judgements of the residents and nurses and by analysing the care documents. The results showed a relation between the co-ordination of care and care discrepancies; the higher the quality of co-ordination of care, the fewer the gaps between residents' needs and the care they received. The psycho-social aspects in particular showed a gap between the needs and care supply. As regards the relation between co-ordination of care and quality of life, the strongest positive relations were found between taking case histories, patient allocation and dimensions of quality of life. No direct relations were found between the co-ordination of care and care discrepancies on the one hand and the health status of the residents on the other. In conclusion, this study showed that the quality of co-ordination of care can affect the perceived quality of life of nursing home residents. To meet the residents' needs it is important to assess their physical and psycho-social needs accurately. More research focusing on this assessment is needed in order to improve the quality of life of nursing home residents.