de Boer B, Hamers J P H, Beerens H C, Zwakhalen S M G, Tan F E S, Verbeek H
Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Department of Methodology and Statistics, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
BMC Geriatr. 2015 Nov 2;15:144. doi: 10.1186/s12877-015-0141-x.
In nursing home care, new care environments directed towards small-scale and homelike environments are developing. The green care farm, which provides 24-h nursing home care for people with dementia, is one such new care environment. Knowledge is needed on the relation between environmental features of green care farms such as nature, domesticity and offering care in small groups and the influence on the daily lives of residents. The aim of this study is to explore (1) the daily lives of residents, (2) the quality of care and (3) the experiences of caregivers on green care farms compared with other nursing home care environments.
METHODS/DESIGN: An observational longitudinal study including a baseline and a six-month follow-up measurement is carried out. Four types of nursing home care environments are included: (1) large scale nursing home ward, (2) small scale living facility on the terrain of a larger nursing home (3) stand-alone small scale living facility and (4) green care farm. Quality of care is examined through structure, process and outcome indicators. The primary outcome measure is the daily life of residents, assessed by ecological momentary assessments. Aspects of daily life include (1) activity (activity performed by the resident, the engagement in this activity and the degree of physical effort); (2) physical environment (the location of the resident and the interaction with the physical environment); (3) social environment (the level and type of social interaction, and with whom this social interaction took place) and (4) psychological well-being (mood and agitation). In addition, social engagement, quality of life, behavioral symptoms and agitation are evaluated through questionnaires. Furthermore, demographics, cognitive impairment, functional dependence and the severity of dementia are assessed. Semi-structured interviews are performed with caregivers regarding their experiences with the different nursing home care environments.
This is the first study investigating green care farms providing 24-h nursing home care for people with dementia. The study provides valuable insight into the daily lives of residents, the quality of care, and the experiences of caregivers at green care farms in comparison with other nursing home care environments including small-scale care environments and large scale nursing home wards.
在养老院护理中，正朝着小规模且类似家庭环境的新型护理环境发展。绿色护理农场就是这样一种新型护理环境，它为痴呆症患者提供24小时养老院护理服务。我们需要了解绿色护理农场的环境特征（如自然环境、家庭氛围以及小组护理）与对居民日常生活的影响之间的关系。本研究的目的是探索：（1）居民的日常生活；（2）护理质量；（3）与其他养老院护理环境相比，绿色护理农场中护理人员的体验。
方法/设计：开展一项观察性纵向研究，包括基线测量和为期六个月的随访测量。纳入四种类型的养老院护理环境：（1）大型养老院病房；（2）位于大型养老院场地内的小型生活设施；（3）独立的小型生活设施；（4）绿色护理农场。通过结构、过程和结果指标来检验护理质量。主要结局指标是居民的日常生活，通过生态瞬时评估进行评估。日常生活的方面包括：（1）活动（居民进行的活动、参与该活动的程度以及体力消耗程度）；（2）物理环境（居民的位置以及与物理环境的互动）；（3）社会环境（社会互动的水平和类型以及发生这种社会互动的对象）；（4）心理健康（情绪和激动程度）。此外，通过问卷评估社会参与度、生活质量、行为症状和激动程度。此外，评估人口统计学特征、认知障碍、功能依赖和痴呆症的严重程度。对护理人员进行半结构化访谈，了解他们在不同养老院护理环境中的体验。
这是第一项调查为痴呆症患者提供24小时养老院护理服务的绿色护理农场的研究。该研究提供了宝贵的见解，有助于了解绿色护理农场中居民的日常生活、护理质量以及护理人员的体验，并与包括小型护理环境和大型养老院病房在内的其他养老院护理环境进行比较。
