满足居家护理服务中痴呆症患者的心理社会需求——对医疗保健提供者不同认知与实践的定性研究
Meeting psychosocial needs for persons with dementia in home care services - a qualitative study of different perceptions and practices among health care providers.
作者信息
Hansen Anette, Hauge Solveig, Bergland Ådel
机构信息
University College of Southeast Norway, Faculty of Health and Social Sciences and Centre for Care Research, Postbox 235, 3603, Kongsberg, Norway.
Department of Nursing Science and Lovisenberg Diaconal University College, Institute of Health and Society, University of Oslo, Lovisenberggaten 15b, 0456, Oslo, Norway.
出版信息
BMC Geriatr. 2017 Sep 11;17(1):211. doi: 10.1186/s12877-017-0612-3.
BACKGROUND
The majority of persons with dementia are home-dwelling. To enable these persons to stay in their own homes as long as possible, a holistic, individual and flexible care is recommended. Despite a requirement for meeting psychological, social and physical needs, home care services seem to focus on patients' physical needs. Accordingly, the aim of this study was to explore how the psychosocial needs of home-dwelling, older persons with dementia were perceived, emphasized and met by home care services.
METHODS
A descriptive, qualitative approach was used. Data were collected through semi-structured focus group interviews with 24 health care providers in home care services from four municipalities. Data were analysed using systematic text condensation.
RESULTS
This study showed major differences in how health care providers perceived the psychosocial needs of older home-dwelling persons with dementia and how they perceived their responsibilities for meeting those psychosocial needs. The differences in the health care providers' perceptions seemed to significantly influence the provided care. Three co-existing logics of care were identified: the physical need-oriented logic, the renouncement logic and the integrated logic.
CONCLUSIONS
The differences in how health care providers perceived the psychosocial needs of persons with dementia and their responsibilities for meeting those needs, influenced how the psychosocial needs were met. These differences indicates a need for a clarification of how psychosocial needs should be conceptualized and who should be responsible for meeting these needs. Further, increased competence and increased consciousness of psychosocial needs and how those needs can be met, are essential for delivering high-quality holistic care that enables persons with dementia to live in their own home for as long as possible.
背景
大多数痴呆症患者居家生活。为使这些患者尽可能长时间地待在自己家中，建议提供全面、个性化且灵活的护理。尽管需要满足心理、社会和身体需求，但居家护理服务似乎侧重于患者的身体需求。因此，本研究的目的是探讨居家痴呆症老年患者的心理社会需求如何被居家护理服务所认识、重视和满足。
方法
采用描述性定性研究方法。通过对来自四个城市的24名居家护理服务医疗保健提供者进行半结构化焦点小组访谈收集数据。使用系统文本浓缩法对数据进行分析。
结果
本研究表明，医疗保健提供者对居家痴呆症老年患者心理社会需求的认识以及他们对满足这些心理社会需求的责任认知存在重大差异。医疗保健提供者认知上的差异似乎对所提供的护理有显著影响。确定了三种并存的护理逻辑：身体需求导向逻辑、放弃逻辑和综合逻辑。
结论
医疗保健提供者对痴呆症患者心理社会需求的认知及其满足这些需求的责任差异，影响了心理社会需求的满足方式。这些差异表明需要明确心理社会需求应如何概念化以及谁应负责满足这些需求。此外，提高能力以及增强对心理社会需求及其满足方式的认识，对于提供高质量的全面护理至关重要，这种护理能使痴呆症患者尽可能长时间地居家生活。
Zotero 插件