A narrative approach to quality care in long-term care facilities

J Holist Nurs. 1997 Mar;15(1):68-81. doi: 10.1177/089801019701500107.


The negative effects of institutionalization caused partially by homogeneity and uniformity of care prompts the exploration of personal and common meanings of nursing home residents. This study is viewed as an initial step in providing quality care as defined by the resident. Personal and common meanings embedded in the lived lives of five older women residing in a long-term care facility are interpreted using a seven-stage Heideggerian hermeneutical phenomenological approach. An unstructured modified life review format is used to interview each participant on three separate occasions. Three constitutive patterns emerge: dwelling in remembering, living relatedly, and being after loss. These patterns endure across the life span of each woman and continue to endure after admission to the facility. The revelation of common and personal meanings provide new possibilities for the transformation of nursing practice to ensure quality care from the perspective of what is considered meaningful to each resident.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Frail Elderly / psychology*
  • Holistic Nursing
  • Humans
  • Life Change Events
  • Long-Term Care / psychology*
  • Memory
  • Nursing Methodology Research
  • Quality Assurance, Health Care / organization & administration*
  • Quality of Life*