Relatedness, autonomy, and competence in the caring relationship: The perspective of nursing home residents

Based on self-determination theory and person-environment congruence models, this study investigated the importance and experiences of relatedness, autonomy, and competence in the caring relationship from the perspective of residents of somatic nursing homes. Furthermore, discrepancies between the attached importance and the fulfillment of these three needs, as well as the role of resident age, health and cognition were explored.Structured questionnaires and semi-structured interview questions were used with 75 recently admitted somatic nursing home residents. The results show that relatedness was considered as more important than autonomy and competence, on average, but there also was large variation between residents in the importance attached to these three needs (n = 75). A subgroup that was asked about relatedness, autonomy, and competence in the caring relationship (n = 35) experienced rather high fulfillment of these needs, although the semi-structured interview questions revealed more nuances. In addition, discrepancies existed between the importance and the fulfillment of the needs for a considerable group of residents in this subgroup. Subjective health and cognitive functioning were correlated with the evaluation of relatedness, autonomy, and competence in the caring relationship.It is concluded that, in nursing homes, the focus should be on the match between individual preferences and actual support of relatedness, autonomy, and competence.This involves asking residents for personal preferences and facilitating caregivers in taking these into account during daily caregiving.

► We investigate aspects of the caring relationship from the perspective of residents.
► We base our study on self-determination and person-environment theories.
► Relatedness is found to be the most important aspect of the caring relationship.
► Lack of person-environment fit is found in a considerable group of residents.
► Nursing homes should focus on the match between individual preferences and care.