Clifford C, Doody O
Health Service Executive, Kilkenny, Ireland.
Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
J Psychiatr Ment Health Nurs. 2018 Feb;25(1):26-36. doi: 10.1111/jpm.12436. Epub 2017 Oct 26.
WHAT IS KNOWN ON THE SUBJECT?: Caring for people with dementia and responsive behaviours is challenging; however, little is known of nurses' experiences of responsive behaviours. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: To demonstrate understanding nurses need to be aware of their own actions, thoughts, attitudes and reactions. Time, education and management support are essential in enabling a person-centred approach. A decision regarding the place of care is difficult to come to, and given the drive to a person-centred approach, there is a need to consider the views of people with dementia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing staff supporting people with dementia should engage more frequently in reflective practice, ongoing education and decision-making. Service providers/managers need to have an understanding of the complexities of caring for a person with dementia and responsive behaviours and provide their staff with relevant supports and education that is accessible to all staff.
Introduction Caring for people with dementia and responsive behaviours can challenge nurses, and little is known of their experiences. Aims To explore nurses' views of supporting people with dementia and responsive behaviours in long-stay facilities. Methods A qualitative descriptive study utilizing in-depth audio-recorded interviews of nine nurses, recruited from private and public care facilities. Qualitative content analyses conducted involving iterative comparisons of transcripts, summaries and memos, where coding, key quotes and tables were developed to determine themes. Results Four themes emerged: recognizing and understanding responsive behaviour, resources and interventions to support people with dementia and responsive behaviour, the impact of education on nursing practice and the care environment. Discussion Availability of staff, adequate time and financial restraints hinder nurses' ability to provide care. Access to ongoing education and being able to provide one-to-one care was valued as dementia-specific education changed nursing practice. Implications for practice Place of care was seen as dependent on the type of responsive behaviour in question, the duration of the behaviour and the impact of the behaviour on the person, other residents and staff. Dementia education needs to be accessible to all staff, and a collaborative approach is necessary in order to develop management guidelines and support strategies.
关于该主题已知的信息：照顾患有痴呆症且有反应性行为的人具有挑战性；然而，对于护士在应对反应性行为方面的经历知之甚少。本文对现有知识有何补充？：为了证明理解，护士需要意识到自己的行为、想法、态度和反应。时间、教育和管理支持对于采用以人为本的方法至关重要。关于护理场所的决策很难做出，并且鉴于对以人为本方法的推动，有必要考虑痴呆症患者的观点。对实践有何影响？：支持痴呆症患者的护理人员应更频繁地参与反思性实践、持续教育和决策。服务提供者/管理者需要了解照顾患有痴呆症且有反应性行为的人的复杂性，并为其员工提供所有员工都能获得的相关支持和教育。
引言 照顾患有痴呆症且有反应性行为的人可能会给护士带来挑战，而对他们的经历了解甚少。目的 探讨护士对在长期护理机构中支持患有痴呆症且有反应性行为的人的看法。方法 一项定性描述性研究，对从私立和公立护理机构招募的九名护士进行深入的录音访谈。进行定性内容分析，包括对转录本、摘要和备忘录的反复比较，在此过程中制定编码、关键引语和表格以确定主题。结果 出现了四个主题：识别和理解反应性行为、支持患有痴呆症且有反应性行为的人的资源和干预措施、教育对护理实践的影响以及护理环境。讨论 员工可用性、充足的时间和经济限制阻碍了护士提供护理的能力。获得持续教育并能够提供一对一护理受到重视，因为针对痴呆症的教育改变了护理实践。对实践的影响 护理场所被视为取决于所讨论的反应性行为类型、行为持续时间以及行为对患者、其他居民和工作人员的影响。所有员工都需要能够获得痴呆症教育，并且需要采用协作方法来制定管理指南和支持策略。
