title: Nurse assistants' experience of an intervention focused on a palliative care approach for older people in residential care.
abstract: BACKGROUND
  Nurse assistants working in residential care facilities need support to ensure that they provide high-quality care for the residents and support for relatives, from admission to bereavement.
  
  
  OBJECTIVE
  The aim was to describe the nurse assistants' experience of how an intervention with a palliative care approach, had influenced them in their work in residential care for older people.
  
  
  METHODS
  Fourteen nurse assistants working in three different municipal residential care facilities.
  
  
  METHODS
  Data were collected by means of semi-structured individual interviews following an intervention consisting of study circles combined with workshops. The data were analysed using content analysis.
  
  
  RESULTS
  The nurse assistants felt that, through the intervention, they had gained insight into their understanding of the importance of quality of care. This included an increased awareness of, and respect for, residents' and relatives' needs, and an increased understanding of the importance of the outcome of encounters with residents and their relatives. After the intervention, they also felt there was increased openness and understanding between colleagues. However, the nurse assistants also expressed frustration over obstacles to implementing a palliative care approach, such as lack of resources and supportive leadership.
  
  
  CONCLUSIONS
  The nurse assistants felt that the intervention was positive and encouraged them to provide more person-centred care within the framework of a palliative care approach. Although the intervention was intended to involve and support the management, it was not sufficient. Nurse assistants described lack of resources and supportive leadership. There is, therefore, a need to place greater emphasis on leadership and their support of nurse assistants so that they can provide high-quality care.
  
  
  CONCLUSIONS
  To support nurse assistants in the provision of care, clear leadership and opportunities to discuss and reflect on issues associated with care, including systematic improvement work in practice, appear to be essential to ensure high-quality care.
authors.affiliation: PhD Student, The Swedish Institute for Health Sciences and the Department of Health Sciences, Lund University, Lund, Sweden Senior Lecturer, The Swedish Institute for Health Sciences, Lund University, Lund, Sweden and the Department of Social Work, Stockholm University, Stockholm, Sweden Professor, The Swedish Institute for Health Sciences, Lund University, Lund, Sweden and the Department of Health and Society, Kristianstad University, Kristianstad, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Beck
authors.forename: Agneta
authors.initials: A
authors.lastname: Törnquist
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Edberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D005851:Geriatric Nursing; D006801:Humans; D008297:Male; D009728:Nursing Assistants; D009735:Nursing Homes; D010166:Palliative Care; D058996:Quality Improvement; D013548:Sweden