School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
J Clin Nurs. 2013 Feb;22(3-4):501-12. doi: 10.1111/jocn.12003. Epub 2012 Nov 21.
This paper presents a theory explaining the processes used by informal carers of people with dementia to mange alterations to their, and people with dementias' relationships with and places within their social worlds.
Informal carers provide the majority of care to people with dementia. A great deal of international informal dementia care research is available, much of which elucidates the content, impacts and consequences of the informal caring role and the coping mechanisms that carers use. However, the socially situated experiences and processes integral to informal caring in dementia have not yet been robustly accounted for.
A classic grounded theory approach was used as it is designed for research enquiries that aim to generate theory illustrating social patterns of action used to address an identified problem.
Thirty interviews were conducted with 31 participants between 2006-2008. The theory was conceptualised from the data using the concurrent methods of theoretical sampling, constant comparative analysis, memo writing and theoretical sensitivity.
Informal carers' main concern was identified as 'Living on the fringes', which was stimulated by dementia-related stigma and living a different life. The theory of 'Sustaining Place' explains the social pattern of actions employed by informal carers to manage this problem on behalf of themselves and the person with dementia.
The theory of 'Sustaining Place' identifies an imperative for nurses, other formal carers and society to engage in actions to support and enable social connectedness, social inclusion and citizenship for informal carers and people with dementia.
'Sustaining Place' facilitates enhanced understanding of the complex and socially situated nature of informal dementia care through its portrayal of informal carers as social agents and can be used to guide nurses to better support those who live with dementia.
本文提出了一个理论，解释了痴呆症患者的非专业护理人员管理他们和痴呆症患者与他们的社会世界的关系和位置的变化的过程。
非专业护理人员为痴呆症患者提供了大部分护理。有大量的国际非正规痴呆症护理研究，其中许多阐明了非正规护理角色的内容、影响和后果，以及护理人员使用的应对机制。然而，在痴呆症中与非正规护理相关的社会情境经验和过程尚未得到充分解释。
经典扎根理论方法被使用，因为它是为旨在生成理论的研究查询而设计的，该理论说明用于解决已确定问题的社会行动模式。
2006 年至 2008 年间，对 31 名参与者进行了 30 次访谈。使用理论抽样、恒比分析、备忘录写作和理论敏感性等并发方法，从数据中概念化理论。
非专业护理人员的主要关注点被确定为“处于边缘”，这是由痴呆症相关的耻辱感和不同的生活方式所引发的。“维持地方”理论解释了非专业护理人员为自己和痴呆症患者管理这一问题而采用的社会行动模式。
“维持地方”理论表明，护士、其他正式护理人员和社会必须采取行动，支持和使非正式护理人员和痴呆症患者能够保持社会联系、包容和公民身份。
“维持地方”通过将非专业护理人员描绘为社会代理人，促进了对非正规痴呆症护理的复杂和社会情境性质的更深入理解，并可用于指导护士更好地支持那些与痴呆症生活在一起的人。
