Centre for Nutrition,Prevention and Health Services,National Institute for Public Health and the Environment,BA Bilthoven,the Netherlands.
Department of Health Services Research,CAPHRI Care and Public Health Research Institute,Faculty of Health,Medicine and Life Sciences,Maastricht University,MD Maastricht,the Netherlands.
Int Psychogeriatr. 2018 Jul;30(7):1057-1068. doi: 10.1017/S1041610217002848. Epub 2018 Jan 16.
ABSTRACTBackground:People with dementia at green care farms (GCFs) are physically more active, have more social interactions, are involved in a larger variety of activities, and come outdoors more often than those in other long-term dementia care settings. These aspects may positively affect health and well-being. This study explored which and how characteristics of GCFs could be implemented in other long-term dementia care settings, taking into account possible facilitators and barriers.
Semi-structured interviews were conducted with 23 professionals from GCFs, independent small-scale long-term care facilities, and larger scale long-term care facilities in the Netherlands. The framework method was used to analyze the data.
Several characteristics of GCFs (e.g. homelike aspects, domestic activities, and access to outdoor environments) have already been applied in other types of long-term dementia care settings. However, how and the extent to which these characteristics are being applied differ between GCFs and other types of long-term dementia care settings. Facilitators and barriers for the implementation of characteristics of GCFs were related to the physical environment in which the care facility is situated (e.g. the degree of urbanization), characteristics and competences of staff members (e.g. flexibility, creativity), characteristics and competences of managers (e.g. leadership, vision), and the political context (e.g. application of risk and safety protocols).
Several characteristics can be implemented in other dementia care settings. However, to realize innovation in dementia care it is important that not only the physical environment but also the social and organizational environments are supporting the process of change.
摘要背景：与其他长期痴呆症护理环境相比，在绿色关怀农场（GCF）中的痴呆症患者身体活动更多，社交互动更多，参与的活动种类更多，户外活动更多。这些方面可能对健康和福祉产生积极影响。本研究探讨了如何将 GCF 的特征在其他长期痴呆症护理环境中实施，同时考虑到可能的促进因素和障碍。方法：对来自 GCF、独立的小型长期护理机构和荷兰较大规模长期护理机构的 23 名专业人员进行了半结构化访谈。使用框架方法对数据进行分析。结果：GCF 的一些特征（例如家庭般的方面、家庭活动和接触户外环境）已经在其他类型的长期痴呆症护理环境中得到应用。然而，这些特征在 GCF 和其他类型的长期痴呆症护理环境中的应用方式和程度有所不同。GCF 特征实施的促进因素和障碍与护理机构所在的物理环境有关（例如城市化程度）、员工的特征和能力（例如灵活性、创造力）、管理人员的特征和能力（例如领导力、愿景）以及政治背景（例如风险和安全协议的应用）。结论：一些特征可以在其他痴呆症护理环境中实施。然而，为了实现痴呆症护理的创新，不仅物理环境而且社会和组织环境都必须支持变革过程。
