Kuiper D, Dijkstra G J, Tuinstra J, Groothoff J W
Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen.
Tijdschr Gerontol Geriatr. 2009 Jun;40(3):102-12. doi: 10.1007/BF03079572.
The prevalence of behavioural problems in nursing home residents with dementia is high. Knowledge based on practical experiences suggests that problems diminish when caregivers are better able to recognize and acknowledge the individual psychosocial needs of residents. Dementia Care Mapping (DCM) is a method designed to support caregivers in providing person centered care. After implementing two DCM-cycli in a Dutch care facility changes in behaviour and level of agitation of clients with dementia and changes in job satisfaction of caregivers were evaluated in a One-Group Pretest-Posttest design. The GIP-28 (Dutch Behavioral Rating Scale for Psychogeriatric Inpatients) and the CMAI (Cohen Mansfield Agitation Inventory) were used to measure potential changes in behaviour and level of agitation of the clients. The MAS-GZ (Maastricht Scale of Satisfaction with Labour in Health Care) was used to measure potential changes in job satisfaction of caregivers. The data of 45 clients with dementia and 27 caregivers were analyzed. They stayed and worked in seven different wards of the care facility including day-care for clients who were still living at home, group care and small-scale-living care for residential clients. The results of this pilot study show that problems related to affective behaviour (subscale GIP-28: emotions of anxiety, mistrust and melancholy) as well as verbal agitation (subscale CMAI: excessively asking for attention, complaining and negativism) decreased in the group clients with dementia. No changes occurred in the other subscales and in the total score of the GIP-28 and CMAI. The overall job satisfaction of caregivers did not change, but their contentment with the extent to which they feel connected with clients improved. In conclusion, the results of this pilot study indicate that implementing DCM in care facilities for persons with dementia could have some positive consequences for both clients and caregivers. A large-scale controlled trial including diagnosis and stage of dementia as baseline measures, is recommended.
患有痴呆症的养老院居民中行为问题的患病率很高。基于实践经验的知识表明，当护理人员能够更好地识别和认识居民的个体心理社会需求时，问题就会减少。痴呆症护理图谱（DCM）是一种旨在支持护理人员提供以患者为中心护理的方法。在荷兰一家护理机构实施两个DCM周期后，采用单组前测-后测设计对患有痴呆症患者的行为和激动程度变化以及护理人员的工作满意度变化进行了评估。使用GIP-28（荷兰老年精神病住院患者行为评定量表）和CMAI（科恩·曼斯菲尔德激动量表）来测量患者行为和激动程度的潜在变化。使用MAS-GZ（马斯特里赫特医疗保健劳动满意度量表）来测量护理人员工作满意度的潜在变化。对45名患有痴呆症的患者和27名护理人员的数据进行了分析。他们在护理机构的七个不同病房工作和居住，包括为仍在家居住的患者提供日托服务、为住院患者提供集体护理和小规模生活护理。这项试点研究的结果表明，患有痴呆症的患者组中与情感行为相关的问题（GIP-28子量表：焦虑、不信任和忧郁情绪）以及言语激动（CMAI子量表：过度寻求关注、抱怨和消极情绪）有所减少。GIP-28和CMAI的其他子量表及总分没有变化。护理人员的总体工作满意度没有改变，但他们对与患者联系程度的满意度有所提高。总之，这项试点研究的结果表明，在痴呆症患者护理机构实施DCM可能对患者和护理人员都有一些积极影响。建议进行一项大规模对照试验，将痴呆症的诊断和阶段作为基线测量指标。
