Chaudhury Habib, Hung Lillian, Rust Tiana, Wu Sarah
Simon Fraser University, Vancouver, BC, Canada.
Vancouver Coastal Health, Vancouver, BC, Canada.
Dementia (London). 2017 Oct;16(7):878-896. doi: 10.1177/1471301215622839. Epub 2016 Jan 12.
Purpose Drawing on therapeutic physical environmental design principles and Kitwood's theoretical view of person-centered care, this study examined the impact of environmental renovations in dining spaces of a long-term care facility on residents' mealtime experience and staff practice in two care units. Method The research design involved pre- and post-renovation ethnographic observations in the dining spaces of the care units and a post-renovation staff survey. The objective physical environmental features pre- and post-renovations were assessed with a newly developed tool titled Dining Environment Audit Protocol. We collected observational data from 10 residents and survey responses from 17 care aides and nurses. Findings Based on a systematic analysis of observational data and staff survey responses, five themes were identified: (a) autonomy and personal control, (b) comfort of homelike environment, (c) conducive to social interaction, (d) increased personal support, and (e) effective teamwork. Implications Although the physical environment can play an influential role in enhancing the dining experience of residents, the variability in staff practices reveals the complexity of mealtime environment and points to the necessity of a systemic approach to foster meaningful culture change.
目的 借鉴治疗性物理环境设计原则和基特伍德的以人为本的护理理论观点，本研究考察了长期护理机构就餐空间的环境改造对两个护理单元中居民用餐体验和工作人员实践的影响。方法 研究设计包括在护理单元就餐空间进行改造前和改造后的人种志观察，以及改造后的工作人员调查。使用一种名为“就餐环境审核协议”的新开发工具评估改造前后客观的物理环境特征。我们收集了10名居民的观察数据以及17名护理助理和护士的调查回复。结果 通过对观察数据和工作人员调查回复的系统分析，确定了五个主题：(a)自主性和个人控制，(b)家庭般环境的舒适度，(c)有利于社交互动，(d)个人支持增加，以及(e)有效的团队合作。启示 尽管物理环境在提升居民用餐体验方面可以发挥重要作用，但工作人员实践的差异揭示了用餐环境的复杂性，并指出需要采取系统方法来促进有意义的文化变革。
