St John Kimberley, Koffman Jonathan
Cicely Saunders Institute, King's College London, London, UK.
Ann Palliat Med. 2017 Oct;6(4):354-364. doi: 10.21037/apm.2017.06.27.
The rising prevalence of dementia is impacting on acute hospitals and placing increased expectations on health and social care professionals to improve the support and services they are delivering. It has been recommended that good practice in dementia care relies on adopting a palliative approach to care and meeting people's physical, psychological, social and spiritual needs. Increased dementia training for staff that includes initiatives that promote dignity; enhancing communication skills and recognizing that a person with dementia may be approaching the end of their lives are needed. Our study aim was to explore whether Namaste Care is an acceptable and effective service for people with advanced dementia being cared for on an acute hospital ward.
This was an exploratory qualitative interview, pilot study. Individual, semi-structured, face-to-face interviews were conducted with hospital healthcare staff working in an area of the hospital where Namaste Care had been implemented. Data were analysed using the framework approach.
Eight interviews were completed with members of the multidisciplinary ward team. Two themes were identified: (I) difficulties establishing relationships with people with dementia in hospital (subthemes: lack of time and resources, lack of confidence leading to fear and anxiety); (II) the benefits of a Namaste Care service in an acute hospital setting (subthemes: a reduction in agitated behavior; connecting and communicating with patients with dementia using the senses; a way of showing people with dementia they are cared for and valued).
This small-scale study indicates that Namaste Case has the potential to improve the quality of life of people with advanced dementia being cared for in an acute hospital setting. However, further research is required to explore more specifically its benefits in terms of improved symptom management and wellbeing of people with dementia on acute hospitals wards.
痴呆症患病率的上升正在影响急症医院，并对健康和社会护理专业人员提出了更高期望，要求他们改善所提供的支持和服务。有人建议，痴呆症护理的良好实践依赖于采用姑息治疗方法，并满足人们的身体、心理、社会和精神需求。需要为工作人员增加痴呆症培训，包括促进尊严的举措；提高沟通技巧，并认识到痴呆症患者可能已接近生命终点。我们的研究目的是探讨“合十礼护理”对于在急症医院病房接受护理的晚期痴呆症患者而言是否是一项可接受且有效的服务。
这是一项探索性定性访谈试点研究。对在医院实施了“合十礼护理”的区域工作的医院医护人员进行了个体、半结构化、面对面访谈。使用框架方法对数据进行了分析。
与多学科病房团队成员完成了8次访谈。确定了两个主题：（I）在医院与痴呆症患者建立关系存在困难（子主题：缺乏时间和资源、缺乏信心导致恐惧和焦虑）；（II）急症医院环境中“合十礼护理”服务的益处（子主题：激越行为减少；通过感官与痴呆症患者建立联系和沟通；向痴呆症患者表明他们得到关爱和重视的一种方式）。
这项小规模研究表明，“合十礼护理”有潜力改善在急症医院环境中接受护理的晚期痴呆症患者的生活质量。然而，需要进一步研究以更具体地探讨其在改善急症医院病房中痴呆症患者的症状管理和幸福感方面的益处。
