CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, Maastricht University, The Netherlands.
Int J Nurs Stud. 2012 Jan;49(1):21-9. doi: 10.1016/j.ijnurstu.2011.07.008. Epub 2011 Aug 5.
Current developments in institutional dementia care aim at the downsizing of facilities and increasing their homelike appearance. Small-scale living facilities are an example of this movement, in which a small group of residents (usually six to eight) live together in a homelike environment. Residents are encouraged to participate in normal daily activities and nursing staff is part of the household with integrated tasks. Despite the increase of these facilities, little is known about experiences of family caregivers of residents and nursing staff.
To gain an in-depth insight into the experiences of family caregivers and nursing staff with small-scale living facilities.
A process evaluation was conducted alongside the final measurement of an effectiveness study, using a cross-sectional, descriptive design.
Two types of institutional dementia care in the Netherlands: small-scale living facilities and regular wards in nursing homes.
In total, 130 family caregivers and 309 nursing staff workers in both care settings participated in a survey questionnaire. Additional in-depth interviews were conducted with a random selection of 24 participants in small-scale living facilities: 13 family caregivers and 11 nursing staff workers.
Survey questions for family caregivers focused on care service delivery; questions for nursing staff were related to skills. The interviews especially related to positive and negative aspects of small-scale living facilities and skills for nursing staff.
Both family caregivers and staff mainly reported positive experiences with small-scale living facilities, especially the personal attention that nursing staff provides to residents, their involvement with residents and the emphasis on autonomy in daily life. Barriers mainly related to nursing staff working alone during a large part of the day. Family caregivers in small-scale living facilities were more satisfied with the care facility and nursing staff than those in regular wards.
The findings of the study revealed several positive aspects of small-scale living facilities related to physical, social and organizational aspects that could be used as tools to implement changes in institutional dementia care settings.
目前机构性痴呆护理的发展旨在缩小设施规模并增加其家庭般的外观。小规模生活设施就是这种运动的一个例子，一小群居民（通常为六到八人）共同生活在家庭般的环境中。鼓励居民参与正常的日常活动，护理人员是家庭的一部分，承担着综合任务。尽管这些设施有所增加，但对居民的家庭照顾者和护理人员的经验却知之甚少。
深入了解小规模生活设施中家庭照顾者和护理人员的经验。
在一项有效性研究的最终测量的同时进行了过程评估，使用了横断面描述性设计。
荷兰的两种机构性痴呆护理：小规模生活设施和养老院的常规病房。
在这两种护理环境中，共有 130 名家庭照顾者和 309 名护理人员参与了问卷调查。还对小规模生活设施中的 24 名随机参与者进行了深入访谈：13 名家庭照顾者和 11 名护理人员。
家庭照顾者的调查问题集中在护理服务提供方面；护理人员的问题与技能有关。访谈特别涉及小规模生活设施的积极和消极方面以及护理人员的技能。
家庭照顾者和工作人员主要报告了小规模生活设施的积极体验，特别是护理人员对居民的个人关注、他们与居民的互动以及对日常生活自主性的重视。障碍主要与护理人员在一天中的大部分时间独自工作有关。小规模生活设施中的家庭照顾者比常规病房中的家庭照顾者对护理机构和护理人员更满意。
该研究的结果揭示了小规模生活设施与身体、社会和组织方面的几个积极方面，这些方面可以作为在机构性痴呆护理环境中实施变革的工具。
