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深入了解护理人员对痴呆症患者生命故事工作的理解:一项定性研究的结果

Insights Into Care Providers' Understandings of Life Story Work With Persons With Dementia: Findings From a Qualitative Study.

作者信息

Berendonk Charlotte, Caine Vera

出版信息

Res Theory Nurs Pract. 2017 Aug 1;31(3):272-294. doi: 10.1891/1541-6577.31.3.272.

Abstract

BACKGROUND AND PURPOSE

In Germany, life story work, an approach which acknowledges humans as narrative beings and honors biographies, is required by health authorities to be integrated in care provided in nursing homes. Insufficient attention to life story work could place residents at risk of dehumanization, particularly residents with dementia, who depend on support of others to tell and make meaning of their life experiences.

METHODS

We conducted a qualitative study to gain insights into care providers' perceptions and practices of life story work with persons with dementia. Thirty-six care providers in 7 nursing homes participated in semistructured interviews or group discussions. We derived subjective theories (individual understandings) of care providers and higher-order concept patterns following the principles and processes of grounded theory.

RESULTS

We found a great variation in participants' understandings of life story work. Some participants were unsure if and how life story work impacts persons with dementia. Starting points for improving the integration of life story work into practice are discussed.

IMPLICATIONS FOR PRACTICE

We conclude that care providers need a better understanding of life story work as a nursing intervention. The importance of the notion of humans as narrative beings and the multiple ways in which we story our lives as well as embody life stories needs to be further developed. Knowledge is required about the practical and systemic challenges of integrating life story work in the care of persons with dementia.

摘要

背景与目的

在德国,生活故事工作作为一种承认人类为叙事性存在并尊重个人经历的方法,被卫生当局要求纳入养老院的护理服务中。对生活故事工作关注不足可能会使居民面临被剥夺人性的风险,尤其是痴呆症患者,他们需要他人的支持来讲述自己的生活经历并赋予其意义。

方法

我们进行了一项定性研究,以深入了解护理人员对痴呆症患者生活故事工作的看法和实践。7家养老院的36名护理人员参与了半结构化访谈或小组讨论。我们依据扎根理论的原则和流程,得出了护理人员的主观理论(个人理解)和高阶概念模式。

结果

我们发现参与者对生活故事工作的理解存在很大差异。一些参与者不确定生活故事工作是否以及如何对痴呆症患者产生影响。文中讨论了将生活故事工作更好地融入实践的切入点。

对实践的启示

我们得出结论,护理人员需要更好地理解生活故事工作作为一种护理干预措施的意义。需要进一步探讨将人类视为叙事性存在这一概念的重要性,以及我们讲述自己生活故事并体现这些故事的多种方式。还需要了解将生活故事工作融入痴呆症患者护理中的实际和系统性挑战。

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