Health and Quality of Life in Nursing Homes: A Repeated Cross-Sectional Study on the Impact of Leadership and Person-Centred Care.

The study was repeated cross-sectional, not randomised or intervention-based, so it cannot show that person-centred care, leadership or social interactions caused better or worse resident outcomes. Resident outcomes were rated by staff rather than by residents, which may bias quality of life, behaviour, ADL and cognition ratings. The two measurement rounds did not follow the same residents, so individual change over five years could not be assessed. Leadership and person-centred care were self-rated by staff and assigned to residents at care-unit level, not measured independently. Social interaction items were simple yes/no reports about the last week, and associations may reflect reverse causation or differences between residents. The EQ-5D utility scores were calculated using a Danish tariff because Swedish values were unavailable. The study was conducted in Swedish nursing homes, so results may not transfer to other settings.

The authors declared no conflicts of interest. The study was funded by Vetenskapsrådet and Forskningsrådet om Hälsa, Arbetsliv och Välfärd.

Do not read the person-centred care association as evidence that a person-centred care programme will improve resident outcomes. This was a repeated cross-sectional survey with proxy-rated resident outcomes and staff-reported predictors, so it can only show associations at the same time points.