Borbasi Sally, Jones Jacqueline, Lockwood Craig, Emden Carolyn
Griffith University, School of Nursing and Midwifery, Queensland, Autralia.
Geriatr Nurs. 2006 Sep-Oct;27(5):300-8. doi: 10.1016/j.gerinurse.2006.08.013.
This article reports an interpretative research project about the care of patients with dementia admitted to the acute setting with a non-dementia-related illness. Open-ended interviews were conducted with 25 medical, nursing, and other health care professionals drawn from 3 metropolitan teaching hospitals in Australia. Qualitative data analysis generated 5 major themes relating to the built environment and organizational "system" as determinants of practice, the influence of key players, current dementia care management, and ideal dementia care management. Results showed acute care hospitals are not the best place for people with dementia and can negatively influence health outcomes such as functional independence and quality of life. Participants reported attempts to provide best practice but experienced major constraints stemming largely from environmental, sociocultural, and economic issues. Recommendations include the delivery of acute services in tandem with dementia services and a whole organization shift in thinking away from what conveniently suits the institution to thinking that is person-centered and dementia-friendly. With support from executive-level management, nurses can play a leading role in the implementation of practice change.
本文报道了一项关于对因非痴呆相关疾病入住急症科的痴呆患者护理的诠释性研究项目。对来自澳大利亚3家大都市教学医院的25名医学、护理及其他医疗保健专业人员进行了开放式访谈。定性数据分析产生了5个主要主题，涉及作为实践决定因素的建筑环境和组织“系统”、关键参与者的影响、当前的痴呆护理管理以及理想的痴呆护理管理。结果表明，急症医院并非痴呆患者的最佳去处，可能会对诸如功能独立性和生活质量等健康结果产生负面影响。参与者报告称，他们试图提供最佳实践，但遇到了主要源于环境、社会文化和经济问题的重大限制。建议包括与痴呆服务同步提供急症服务，以及整个组织从以机构便利为导向的思维方式转变为以患者为中心、对痴呆患者友好的思维方式。在高层管理的支持下，护士可以在实践变革的实施中发挥主导作用。
