Description

A systematic scoping review of research into the effect that physical environment in nursing homes has on residents' health. The health care system has increasingly emphasized consumers' satisfaction in developing models of health care quality. Among health professionals, nurses spend more time with patients, hence, the measure of consumers' perception of quality nursing care is crucial. Children are vulnerable and unable to effectively express their views; hence, their caregivers often serve as their decision makers. This study aimed to assess caregivers' perception of the quality of nursing care in child health care services.

A descriptive cross-sectional survey was conducted using a stratified sampling technique to recruit 308 caregivers attending Immunization and Child welfare clinics of University College Hospital, Nigeria. Participants were surveyed using an adapted version of the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) which was analyzed using descriptive and inferential statistics at a 0.05 level of significance.

Scoping Review and Policy Brief

A large percentage of the caregivers were female (86.9%).“Concern and caring by the nurses”, “recognition of carers' needs”, “coordination of care” and “privacy” were perceived to be fair (50.2%, 54.9%, 56.3%, 57%) while “clarity about instructions given”, “helpfulness”, “skill and competence” were perceived to be good (61.7%, 56.3%, 63.8%).The age, occupation, and marital status of the caregivers had a significant association with their perception of nursing care (p < 0.05). The attitudes of nurses regarding concern, caring and privacy were perceived to be fair as compared with the skill and competence of nurses which were perceived to be good.

Although caregivers had an overall average perception of quality of nursing care, more efforts should be geared towards improving on areas that were fair, like care and concern, courtesy, friendliness, and kindness, which are central to nursing as a caring profession.

Good interpersonal relationships and acknowledgment of caregivers as decision-makers in health care which were perceived to be inadequate in this study are key factors that drive a good perception of quality nursing care. Nurses must continue to provide inclusive quality care where caregivers are seen as significant contributors to health care. Large-scale population research initiatives are continuing to rapidly advance precision health interests. United States (U.S.) examples include the All of Us initiative at the National Institutes of Health (NIH) and the Veteran's Administration (VA) Million Veteran Program (MVP; Bick et al, 2019; The All of Us Research Program Investigators, 2019; U.S. Department of Veteran's Affairs, 2020). A recently published review (Fu et al., 2020) presents nursing perspectives on precision health and encourages nurse scientists and clinical leaders to contribute fully to the precision health effort by conducting novel genomic research on social determinants of health, environmental and lifestyle choices, and biological contributors for a wide variety of health conditions with All of Us data.

Setting and Participants

Search for relevant English-language articles in PubMed and the Cochrane database before April 15, 2022. Article selection and data extraction were performed by 2 researchers. Studies were included if conducted on nursing home residents and if they examined associations between components of the physical environment and health outcomes. The review was performed in accordance with the PRISMA statement.

Of 1347 articles retrieved, 59 met the inclusion criteria—40 observational, 1 survey, and 18 interventional studies, of which 5 were randomized controlled trials. Certain environmental features repeatedly show significant positive effect on resident's health, such as noise reduction, tuning of lighting, natural light, easy access to garden, dining environment, and resident-centered interior renovation. Nursing home size was not found to have a direct relationship to resident health and well-being, although it is related to more than only the physical environment (eg, social environment).

This review provides guidance in selective areas of the physical environment for the design of nursing homes, with potential benefits for the health and well-being of residents Precision health—tailored patient care based on an individual's genomic or other omics, clinical, physiologic, lifestyle, behavioral and environmental characteristics—is moving closer to clinical utility validation and clinical care implementation (Collins & Varmus, 2015; National Institutes of Health, 2020a). Although geographical disparities exist, there are a number of examples of what can become part of routine care. These include incorporation of three generation family history into electronic health records (EHRs; Davis, 2019, Hickey et al. 2017) and screening for at-risk individuals for common hereditary cancer syndromes including BRCA1/2 (breast and ovarian cancer) and Lynch Syndrome (gastrointestinal, ovarian, endometrial, brain, urinary tract and sebaceous skin tumors; Buchanan Other applications include noninvasive prenatal screening of cell-free DNA for genetic mutations during maternal health care visits and diagnosis of solid organ transplant rejection. Oncology uses targeted diagnosis and therapeutics for cancers based on cancer cell molecular signatures (Madhavan et al., 2018; Rehm, 2017). And there are a number of prescription drug selections and dosing that incorporates a patient's genetic variation. These advances are derived from foundational scientific investments in large-scale genomic research programs, computational science methodologies, and government-academic collaborations, leading to a paradigm shift in clinical practice.