A Scoping Study of Health Promotion in the Nursing Home Setting
Bibliographic record
Abstract
Background Nursing homes (NHs) in many countries follow the medical model of care, which can compromise basic human rights and liberties. Moving away from a medical model of care to one in which the well-being of the NH resident is central and in which active aging is embraced, requires a health promotion (HP) framework. It was explored which HP approaches currently exist for the NH setting. Methods A scoping study was conducted to review the international scientific literature from 2003 to 2013. The Integrated Model of Population Health and Health Promotion was modified to analyze publications. Ottawa Charter strategies (OCS), population health levels, determinants of health/social determinants of health (DOH/SDOH), and key HP principles were assessed. Results 54 publications, categorized under the main approaches of ecological, person-centered care, relationship-centered care and workplace health promotion, applied HP in NH setting. Although most approaches had not labelled HP specifically, all approaches did apply HP through the OCS of creating supportive environments and of re-orienting health services and most recognized the importance of the DOH/SDOH of governance, physical and social environment. The OCS of developing personal skills for staff was less frequently targeted and strengthening community action, building healthy public policy were seldom targeted. Conclusions This study reveals that HP was applied in the approaches. However, it was often not recognized as HP and the HP framework was under-utilized. Therefore, the approaches maximal effectiveness and full potential were not reached. Recognition and implementation NHs as a viable new setting (Health Promoting Nursing Homes) under the settings approach, would assist in improving the well-being of residents and in ensuring a healthy workplace for the staff at local, national and global levels. Key messages Health promotion offers a systematic framework to improve the well-being of residents in nursing homes Promising approaches exist which apply HP to NH setting
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.068 | 0.139 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.025 | 0.030 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".