Abstract
Social and professional relationships are an integral component of the daily care and work experience within residential care (long-term care), yet little is known about how these relationships influence residents’ perceptions of care and quality of life. The purpose of this two phased, mixed method study was to explore residents’ perspectives of workers’ peer interactions and identify if workers’ peer social interactions had an influence on residents’ experience of care and if so, how. Drawing upon workplace culture theory and using narrative reality methods, residents’ perspectives of workers’ peer relationships within four residential care facilities located in a large health authority in British Columbia, Canada were examined. In phase one, contextual data was gathered by administering a worker survey and collecting field observations focused on workers’ peer social interactions and residents’ behaviours in public areas (e.g., dining rooms, lounges). In phase two, lengthier field observations were conducted and interviews with residents who were asked about their observations of how workers interacted with peers and if, and how, this affected their care experiences. The final analysis resulted in producing three themes characterizing workers’ peer social interactions: shaming, blaming, and collegiality. Shaming and blaming peer interactions impacted negatively on residents’ quality of care by reducing workers’ team interactions, work capacity, and care coordination; and on residents’ quality of life by producing an oppressed environment, reduced resident social engagement, and emphasized resident vulnerability. Conversely, collegial workers’ peer social interactions impacted positively on residents’ quality of care through increased communication, seamless teamwork, and improved safety practices; and on quality of life by residents’ increased enjoyment and security, and creation of positive environments.
The results underscore the quality of workers’ peer relationships as influential to residents’ perceptions of quality of care and life, and add to the literature about the relational features of residential care. Recommendations arising from this study include promoting common collegial language and practices, fostering relational leadership, formalizing workplace relational processes and engaging in more research about residential care at a daily level, including residents with dementia and family perspectives of workers’ peer interactions on quality of care and the care environment.
