School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
J Clin Nurs. 2013 Oct;22(19-20):2768-77. doi: 10.1111/j.1365-2702.2012.04292.x. Epub 2012 Sep 24.
To provide evidence for the development of a physical domain attached to the well-known bio-psycho-social model of dementia. The objectives were to develop a set of international case studies that followed a trajectory approach, from prevention to end-of-life care.
In the UK the bio-psycho-social model has informed the shape of the National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence 'dementia' guideline. However, limited attention has been paid to outlining and describing a physical domain of dementia, a discrepancy that informed the rationale for this study.
A collective case study design was used to address the research aim and objectives.
Case studies from along the trajectory of dementia were provided by an international team of contributors from an inter-disciplinary background comprising nursing (general and mental health), social work and social science.
The team's synthesis and analysis of the six case studies generated five repeating themes with each theme becoming components of a 'physical' domain of dementia. The five identified physical components were: (1) physical well-being, (2) physical health and examination, (3) physical care, (4) physical treatment and (5) physical environment.
The development of a bio-psycho-social-physical model of dementia presents a holistic and culturally sensitive approach to understanding the experience of living with dementia, and to providing care and support in a variety of situations and contexts.
The physical domain of dementia has particular relevance to nursing and nursing practice, such as providing physical care at the end-of-life. The interplay between the biological-psychological-social-physical domains of dementia and the trajectory of dementia could form the basis of clinical decision-making and practice.
为开发与著名的痴呆生物心理社会模型相关的物理领域提供证据。目标是开发一组国际案例研究，这些研究遵循从预防到临终关怀的轨迹方法。
在英国，生物心理社会模型为国家健康与临床卓越研究所和社会护理卓越研究所的“痴呆”指南的形成提供了信息。然而，对于概述和描述痴呆的物理领域，关注有限，这为这项研究的基本原理提供了信息。
使用集体案例研究设计来解决研究目的和目标。
来自不同学科背景的国际团队成员提供了痴呆轨迹沿线的案例研究，包括护理（普通和精神健康）、社会工作和社会科学。
团队对六个案例研究的综合分析和分析产生了五个重复主题，每个主题都成为痴呆“物理”领域的组成部分。确定的五个物理组件是：（1）身体健康，（2）身体健康检查，（3）身体护理，（4）身体治疗和（5）物理环境。
开发痴呆的生物心理社会物理模型为理解痴呆患者的生活体验提供了一种整体的、文化敏感的方法，并为各种情况和环境提供了护理和支持。
痴呆的物理领域与护理和护理实践特别相关，例如在生命末期提供身体护理。痴呆的生物心理社会物理领域之间的相互作用和痴呆的轨迹可以为临床决策和实践提供基础。
