title: Day-to-day care: the interplay of CNAs' views of residents & nursing home environments.
abstract: This qualitative study identified certified nursing assistants' (CNAs') perspectives of nursing home residents and how these perspectives translate into care practices. Data included observations of and interviews with 27 CNAs in three dissimilar nursing homes. All participants were people of color, and all but 3 were immigrants. CNAs constructed three views of residents: as fictive kin, as a commodity, and as an autonomous person. Although individual CNAs held one primary view of residents in general, select residents were viewed from an alternative perspective, resulting in variations in care practices. These findings suggest that such distinctions, in tandem with structural, organizational, and cultural differences in nursing homes, present opportunities for nursing leadership to affect the visible, everyday practice of nursing CNAs. To target interventions, further research is needed on how CNAs come to differentially view residents and how these differences influence CNAs' care relationships with residents.
authors.affiliation: Department of Family Health Nursing, University of California, San Francisco, CA 94143-0606, USA. lucy.fisher@ucsf.edu
authors.forename: Lucy Takesue
authors.initials: LT
authors.lastname: Fisher
authors.forename: Margaret I
authors.initials: MI
authors.lastname: Wallhagen
mesh_terms: D000328:Adult; D000368:Aged / Q000523:psychology; D001291:Attitude of Health Personnel / Q000208:ethnology; D002140:California; D032821:Commodification; D054242:Emigrants and Immigrants / Q000523:psychology; D004645:Empathy; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009723:Nurse-Patient Relations; D009728:Nursing Assistants / Q000458:organization & administration / Q000523:psychology; D009735:Nursing Homes / Q000458:organization & administration*; D015404:Nursing Methodology Research; D015279:Organizational Culture; D018802:Patient-Centered Care / Q000458:organization & administration; D026684:Personal Autonomy; D036301:Qualitative Research; D011795:Surveys and Questionnaires