Brooke Joanne, Ojo Omorogieva
Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, The Colonnade, Gipsy Lane Campus, Oxford, UK.
Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London, UK.
Int J Health Plann Manage. 2018 Jan;33(1):e10-e25. doi: 10.1002/hpm.2448. Epub 2017 Aug 24.
Internationally, there has been a focus on the development of acute hospital workforces to support and care for people with dementia. Recommendations and initiatives to improve person-centred care in acute hospitals have included: education and training, dementia-specific roles, clinical leads, and environment changes. The aim of this literature review is to understand the elements of a sustainable, competent, and empathetic acute hospital workforce providing person-centred care for patients with dementia. The following databases were searched for literature published in English from January 1, 2006, to August 1, 2016: CINHAL, MEDLINE, PsychINFO, PubMed, and Science Direct. A thematic analysis was applied to develop a meta-synthesis of the data. A total of 12 papers with a range of methodological approaches from various countries were included. Emergent themes were as follows: understanding the current workforce, implementation and evaluation of training, and exploration of new and existing roles. An important element was the sustainability of acute hospital workforces competent in dementia care, as studies highlighted an ageing nursing population and a high turnover of staff. Dementia awareness training was sustainable, although there was a lack of consistency in the length, content, and delivery, which had a viable impact on the provision of empathetic and person-centred care. The lack of consistency of training and specialist dementia roles restricts recommendations from a robust evidence base.
在国际上，人们一直关注急性医院工作人员队伍的发展，以支持和照顾痴呆症患者。改善急性医院以患者为中心护理的建议和举措包括：教育与培训、特定痴呆症角色、临床负责人以及环境改变。本综述的目的是了解一支可持续、有能力且富有同理心的急性医院工作人员队伍为痴呆症患者提供以患者为中心护理的要素。我们检索了以下数据库，以查找2006年1月1日至2016年8月1日期间以英文发表的文献：护理学与健康领域数据库（CINHAL）、医学索引数据库（MEDLINE）、心理学文摘数据库（PsychINFO）、医学期刊数据库（PubMed）和科学网数据库（Science Direct）。我们采用主题分析法对数据进行综合分析。总共纳入了12篇来自不同国家、采用一系列方法学途径的论文。浮现出的主题如下：了解当前工作人员队伍、培训的实施与评估以及对新角色和现有角色的探索。一个重要因素是胜任痴呆症护理的急性医院工作人员队伍的可持续性，因为研究强调了护理人员老龄化和员工高流动率。痴呆症认知培训具有可持续性，尽管在时长、内容和授课方式上缺乏一致性，这对提供富有同理心和以患者为中心的护理产生了切实影响。培训和痴呆症专科角色的不一致性限制了基于有力证据的建议。
