a Department of General Practice and Elderly Care Medicine , Amsterdam Public Health Research Institute , VU University Medical Center , Amsterdam , The Netherlands.
b Department of Public and Occupational Health , Amsterdam Public Health Research Institute , Amsterdam , The Netherlands.
Aging Ment Health. 2019 Apr;23(4):498-506. doi: 10.1080/13607863.2018.1428934. Epub 2018 Feb 7.
To avoid restraints and involuntary care caregivers should be aware if and how a patient resists care. This article focuses on behavioural expressions of people with severe dementia in nursing homes that are interpreted by their formal and informal caregivers as possible expressions of their experience of involuntary care.
Concept mapping was used, following five steps: (1) brainstorming, (2) rating, (3) sorting, (4) statistical analysis & visual representation and (5) interpretation. Specialists (n = 12), nurses (n = 23) and relatives (n = 13) participated in separate groups .
The views generated are grouped into clusters of behaviour, presented in graphic charts for each of the respondent groups. The large variety of behavioural symptoms includes, in all groups, not only the more obvious and direct behavioural expressions like aggression, resistance and agitation, but also more subtle behaviour such as sorrow, general discomfort or discontent.
CONCLUSION(S): In the interpretation of behavioural symptoms of people with severe dementia it is important to take into account the possibility of that person experiencing involuntary care. Increased awareness and understanding of the meaning and consequences of the behavioural expressions is an important step in improving dementia care by avoiding restraints and involuntary care to its maximum.
为避免约束和非自愿护理，护理人员应了解患者是否以及如何抗拒护理。本文重点关注养老院中患有严重痴呆症的人表现出的行为表达，这些行为表达被他们的正式和非正式护理人员解释为他们经历非自愿护理的可能表达。
采用概念映射法，分为五个步骤：（1）头脑风暴，（2）评分，（3）分类，（4）统计分析和可视化表示，（5）解释。专家（n=12）、护士（n=23）和亲属（n=13）分别参加了不同的小组。
生成的观点分为行为群，为每个受访者群体以图表形式呈现。各种行为症状不仅包括更明显和直接的行为表达，如攻击、抵抗和激动，而且还包括更微妙的行为，如悲伤、一般不适或不满。
在解释严重痴呆症患者的行为症状时，必须考虑到该人可能经历非自愿护理的可能性。提高对行为表达的意义和后果的认识和理解，是通过最大限度地避免约束和非自愿护理来改善痴呆症护理的重要步骤。
