title: Staff-resident interactions in long-term care for people with dementia: the role of meeting psychological needs in achieving residents' well-being.
abstract: OBJECTIVE
  The aim of this study is to explore the extent to which staff-resident interactions address or undermine residents' psychological needs and how such interactions are associated with residents' well-being.
  
  
  METHODS
  Data on staff-resident interactions and residents' well-being were collected for 51 residents from nine long-term care settings using dementia care mapping (DCM). DCM yields a count and detailed description of staff-resident interactions that either address (personal enhancers - PEs) or undermine (personal detractions - PDs) residents' psychological needs, and every 5-minute scores for each resident's mood and engagement (ME-value). The relationship between PEs and PDs and well-being was analysed by studying residents' ME-values before and three time frames after a PE or PD occurred.
  
  
  RESULTS
  A total of 76 PEs and 33 PDs were observed. The most common PEs were those addressing psychological needs for comfort and occupation. However residents' well-being increased most often after PEs that addressed residents' need for identity, attachment and inclusion. The most common PDs were those which undermined the need for comfort, inclusion and occupation. Residents' well-being decreased most often after PDs that undermined the need for comfort.
  
  
  CONCLUSIONS
  Increasing interactions which address residents' need for attachment, identity and inclusion and eliminating interactions which undermine residents' need for comfort may be particularly important in achieving residents' well-being. In the long run, residents' well-being could be achieved by staff availing of the opportunities to empower and facilitate residents, thus meeting their needs for occupation. These findings provide directions for training in person-centred care.
authors.affiliation: a Program on Aging, Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.
authors.forename: Bernadette M
authors.initials: BM
authors.lastname: Willemse
authors.forename: Murna
authors.initials: M
authors.lastname: Downs
authors.forename: Lonneke
authors.initials: L
authors.lastname: Arnold
authors.forename: Dieneke
authors.initials: D
authors.lastname: Smit
authors.forename: Jacomine
authors.initials: J
authors.lastname: de Lange
authors.forename: Anne Margriet
authors.initials: AM
authors.lastname: Pot
mesh_terms: D001291:Attitude of Health Personnel; D003704:Dementia / Q000523:psychology*; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D009426:Netherlands; D018802:Patient-Centered Care; D010549:Personal Satisfaction; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D011788:Quality of Life / Q000523:psychology*; D012112:Residential Facilities / Q000458:organization & administration
keywords: dementia care mapping; nursing home care; person-centred care; quality of care; quality of life