Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, the Netherlands.
Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Geriatr Gerontol Int. 2017 Dec;17(12):2466-2471. doi: 10.1111/ggi.13107. Epub 2017 Jul 20.
In a context of increasing emphasis on shared decision-making and palliative care in dementia, research on family caregivers' trust in health professionals in advanced dementia is surprisingly scant. The aim of the present study was to assess trust in nursing home health professionals of family caregivers of nursing home residents with advanced dementia, and possible correlates, such as family caregivers' satisfaction, involvement in care, care burden and patients' symptom burden.
A cross-sectional study was carried out using structured questionnaires administered through the telephone. Generalized estimating equation analyses with adjustment for nursing home clustering were applied to assess the most important associations with family caregivers' trust.
A total of 214 family caregivers of persons with dementia residing in 25 nursing homes participated in the study. The majority of the participants (67%) were women and adult children (75%). The majority of the family caregivers trusted physicians, nurses and nurses' aides at a moderate-to-high level. Approximately half to one-third reported moderate-to-low levels of trust. Higher levels of trust were associated with more positive care outcomes, such as higher family satisfaction with care and more positive evaluations of physician-family communication.
The present study showed the importance of family caregivers trusting nursing home health professionals for their experiences as caregivers. Although causation cannot be established, increased family caregivers' trust in nursing home health professionals by improving communication and exchange of information might provide a good basis for providing optimal palliative care in advanced dementia. Geriatr Gerontol Int 2017; 17: 2466-2471.
在痴呆症中越来越强调共同决策和姑息治疗的背景下,对高级痴呆症患者家庭照顾者对卫生专业人员信任的研究却少之又少。本研究旨在评估养老院中患有晚期痴呆症的居民的家庭照顾者对养老院卫生专业人员的信任程度,以及可能的相关因素,如家庭照顾者的满意度、参与护理程度、护理负担和患者的症状负担。
采用横断面研究方法,通过电话使用结构化问卷进行调查。应用广义估计方程分析,对养老院聚类进行调整,以评估与家庭照顾者信任最相关的因素。
共有 214 名居住在 25 家养老院的痴呆症患者的家庭照顾者参与了本研究。大多数参与者(67%)为女性和成年子女(75%)。大多数家庭照顾者对医生、护士和护士助理的信任程度处于中等至高度水平。约有一半至三分之一的人报告信任程度处于中等至低度水平。较高的信任程度与更好的护理结果相关,如家庭对护理的满意度更高,对医生与家庭之间沟通的评价更积极。
本研究表明家庭照顾者对养老院卫生专业人员的信任对他们作为照顾者的体验很重要。虽然不能确定因果关系,但通过改善沟通和信息交流,增加家庭照顾者对养老院卫生专业人员的信任,可能为晚期痴呆症提供最佳姑息治疗提供良好的基础。老年医学与老年病学国际 2017; 17: 2466-2471.