Smit Dieneke, de Lange Jacomine, Willemse Bernadette, Pot Anne Margriet
Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
Program on Aging, Netherlands Institute of Mental Health and Addiction, PO box 725, 3500 AS, Utrecht, the Netherlands.
BMC Geriatr. 2017 Aug 4;17(1):175. doi: 10.1186/s12877-017-0564-7.
Despite the finding that involvement in activities is one of the most important needs of residents with dementia living in care homes, care facilities struggle to fulfill this need. Over the years, various factors are suggested which may contribute to or disable activity provision in dementia care homes. These include limited financial resources, task oriented staff and disease-related characteristics of residents. This study aims to further clarify which of these factors predict higher activity involvement.
Data were derived from the second measurement (2011) of the Living Arrangements for people with Dementia study. One thousand two hundred eighteen people residing in 139 dementia care homes were involved. Forty predictors of higher involvement were studied. Multilevel backward regression analyses were performed.
The most important predictors of higher involvement were: absence of agitation, less ADL dependency, and a higher cognitive status of the residents, higher staff educational level, lower experienced job demands by care staff and a smaller number of residents living in the dementia care wards of a facility. More social supervisor support as perceived by staff was found to predict less activity involvement.
To increase the activity involvement of care home residents with dementia it seems vital to: 1) reduce staff's experienced job demands; 2) elevate their overall educational level; 3) train staff to provide suitable activities, taking account of the behavior and preserved capabilities of residents; and 4) foster transition towards small-scale care. In order to achieve these aims, care organizations might need to evaluate the use of their financial means.
尽管有研究发现参与活动是养老院痴呆症患者最重要的需求之一，但护理机构在满足这一需求方面仍面临困难。多年来，人们提出了各种可能有助于或阻碍痴呆症护理院提供活动的因素。这些因素包括财政资源有限、以任务为导向的工作人员以及患者的疾病相关特征。本研究旨在进一步明确这些因素中哪些能够预测更高的活动参与度。
数据来源于痴呆症患者生活安排研究的第二次测量（2011年）。共有139家痴呆症护理院的1218名患者参与了研究。研究了40个与更高参与度相关的预测因素。进行了多水平向后回归分析。
更高参与度的最重要预测因素包括：无激越症状、较少的日常生活活动依赖、患者较高的认知状态、工作人员较高的教育水平、护理人员感受到的较低工作需求以及痴呆症护理病房中居住的患者数量较少。工作人员感知到更多的社会监督支持被发现与较少的活动参与度相关。
为了提高养老院痴呆症患者的活动参与度，似乎至关重要的是：1）减少工作人员感受到的工作需求；2）提高他们的整体教育水平；3）培训工作人员根据患者的行为和保留的能力提供合适的活动；4）促进向小规模护理的转变。为了实现这些目标，护理组织可能需要评估其财政资源的使用情况。
