title: Experiences and Effects of Structurally Involving Residents in the Nursing Home by Means of Participatory Action Research: A Mixed Method Study.
abstract: OBJECTIVE
  This study aimed to examine the effects of introducing participatory action research (PAR) within the nursing home (NH) on residents' quality of life (QoL) and NH experience and participation, and to explore their experiences with PAR.
  
  
  METHODS
  A mixed methods design was chosen, including a clustered randomized controlled trial (RCT) and qualitative interviews.
  
  
  METHODS
  For the RCT, 3 NHs were randomly allocated to 3 conditions: an intervention (weekly PAR activity), an active control (weekly reminiscence-activity), or passive control (care as usual). The qualitative study took place in the intervention NH.
  
  
  METHODS
  Within the RCT, about 30 residents were recruited for assessments per NH, including 9 PAR participants and 10 reminiscence participants. Qualitative interviews were held with all PAR participants (residents and internal moderator).
  
  
  METHODS
  PAR is a method to structurally involve residents in the NH operation. Weekly PAR sessions were held with 9 residents and 2 moderators. Here, residents critically analyzed and discussed the NH operation, identified possible problems, suggested improvements, which were further implemented by the NH and monitored by the PAR group.
  
  
  METHODS
  Residents' NH experience (NH Active Aging Survey), QoL (Anamnestic Comparison Self-Assessment), and experienced participation (Impact on Participation and Autonomy) were measured in the RCT at pre-test, post-test (6 months), and follow-up (12 months). The qualitative study took into account interviews with the PAR stakeholders after 6 months.
  
  
  RESULTS
  The RCT showed residents' QoL improving more between pre-test and follow-up in the intervention and active control NH compared with the passive control NH. No other effects were observed. The qualitative data revealed a positive PAR experience. Participants enjoyed the activity and indicated various positive influences. Still, there was room for improvement, including communication toward other residents and between staff.
  
  
  CONCLUSIONS
  Notwithstanding the modest quantitative effects, PAR led to positive experiences and can have a future in the NH when solving some limitations.
authors.affiliation: Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation Flanders, Brussels, Belgium. Electronic address: Lien.van.malderen@vub.ac.be.
authors.forename: Lien
authors.initials: L
authors.lastname: Van Malderen
authors.affiliation: Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Artevelde University College, Ghent, Belgium.
authors.forename: Patricia
authors.initials: P
authors.lastname: De Vriendt
authors.affiliation: Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Tony
authors.initials: T
authors.lastname: Mets
authors.affiliation: Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Verté
authors.affiliation: Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium; Geriatric Department, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: Gorus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D055812:Community-Based Participatory Research; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009735:Nursing Homes / Q000592:standards*; D010358:Patient Participation; D036301:Qualitative Research; D058996:Quality Improvement
keywords: Quality improvement; active aging; culture change; empowerment; participation; quality of life