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Abstract：
BACKGROUND: In the future, elderly care workers need to have competence of various different conditions due to greater amount of multimorbid elderly. Further, knowledge of national level guidelines is important since they are closely linked to improving quality of care and implementing better practices at work places. The impact of national level guidelines on quality of care at care units is, however, not widely examined in the Finnish context. In this study, the aim was to find out if worker\'s experience of his/her own competence is associated with quality of care. Secondly, we aimed to see how common is addressing national guidelines and policies at workplaces, and if they are associated with quality of care. Thirdly, we aimed to see whether there are differences between different occupational statuses in competence and addressing national guidelines and policies.
METHODS: Total number of respondents was 1997 from 273 different units. Xtreg procedure was used for examining the associations of age, occupational status, unit type, professional competence and addressing the guidelines and policies with quality of care.
RESULTS: Higher grade for QoC was associated with age, supervisor position, working in institutionalized care, better competence in supporting the self-determination of a person with memory disorders and falls prevention and addressing the act for elderly care and memory policy.
CONCLUSIONS: This study demonstrated that national policies and guidelines are not widely addressed among Finnish elderly care workers. The study also showed that experienced competence of workers and discussion of policies and guidelines are related to quality of care. Especially competence related to memory disorders was associated with higher QoC. However, the relationship between quality of care and things influencing it seems complex and a major part of the variation in QoC remained unexplained. Although the relationships between guidelines, competences and quality of care are weak, national policies and competences seem to have impact on actual care provided. Therefore, sufficient time to address the guidelines should be provided at workplace and competences developed, which can be seen as a supervisor\'s task. With knowledge about the guidelines, workers are able to change their practices at work places.
METHODS: Total number of respondents was 1997 from 273 different units. Xtreg procedure was used for examining the associations of age, occupational status, unit type, professional competence and addressing the guidelines and policies with quality of care.
RESULTS: Higher grade for QoC was associated with age, supervisor position, working in institutionalized care, better competence in supporting the self-determination of a person with memory disorders and falls prevention and addressing the act for elderly care and memory policy.
CONCLUSIONS: This study demonstrated that national policies and guidelines are not widely addressed among Finnish elderly care workers. The study also showed that experienced competence of workers and discussion of policies and guidelines are related to quality of care. Especially competence related to memory disorders was associated with higher QoC. However, the relationship between quality of care and things influencing it seems complex and a major part of the variation in QoC remained unexplained. Although the relationships between guidelines, competences and quality of care are weak, national policies and competences seem to have impact on actual care provided. Therefore, sufficient time to address the guidelines should be provided at workplace and competences developed, which can be seen as a supervisor\'s task. With knowledge about the guidelines, workers are able to change their practices at work places.
摘要：
背景：在未来，老年护理工作者需要具备各种不同条件的能力，因为有更多的多老年人。Further,了解国家一级的准则很重要，因为它们与提高护理质量和在工作场所实施更好的做法密切相关。国家一级准则对护理单位护理质量的影响是，然而,在芬兰的背景下没有得到广泛的审查。在这项研究中,目的是找出工人的经验，他/她自己的能力与护理质量有关。其次,我们的目标是看看在工作场所解决国家指导方针和政策有多普遍，以及它们是否与护理质量有关。第三，我们的目标是看看不同的职业地位在能力和解决国家指导方针和政策方面是否存在差异。
方法：1997年来自273个不同单位的受访者总数。Xtreg程序用于检查年龄的关联，职业状况,单元类型,专业能力和解决指导方针和政策与护理质量。
结果：QoC的高年级与年龄有关，主管职位,在制度化护理中工作，更好的能力，支持记忆障碍和跌倒预防的人的自决，并解决老年人护理和记忆政策的行为。
结论：这项研究表明，国家政策和指导方针在芬兰老年护理工作者中并未得到广泛关注。研究还表明，经验丰富的工人能力以及对政策和准则的讨论与护理质量有关。尤其是与记忆障碍相关的能力与较高的QoC相关。然而,护理质量与影响护理质量的事物之间的关系似乎很复杂，QoC变化的主要部分仍无法解释。虽然准则之间的关系，护理能力和质量薄弱，国家政策和能力似乎对所提供的实际护理有影响。因此,应在工作场所提供足够的时间来解决准则，并发展能力，这可以看作是主管的任务。有了关于准则的知识，工人能够改变他们在工作场所的做法。
方法：1997年来自273个不同单位的受访者总数。Xtreg程序用于检查年龄的关联，职业状况,单元类型,专业能力和解决指导方针和政策与护理质量。
结果：QoC的高年级与年龄有关，主管职位,在制度化护理中工作，更好的能力，支持记忆障碍和跌倒预防的人的自决，并解决老年人护理和记忆政策的行为。
结论：这项研究表明，国家政策和指导方针在芬兰老年护理工作者中并未得到广泛关注。研究还表明，经验丰富的工人能力以及对政策和准则的讨论与护理质量有关。尤其是与记忆障碍相关的能力与较高的QoC相关。然而,护理质量与影响护理质量的事物之间的关系似乎很复杂，QoC变化的主要部分仍无法解释。虽然准则之间的关系，护理能力和质量薄弱，国家政策和能力似乎对所提供的实际护理有影响。因此,应在工作场所提供足够的时间来解决准则，并发展能力，这可以看作是主管的任务。有了关于准则的知识，工人能够改变他们在工作场所的做法。
