卫生保健专业人员对痴呆症患者康复的看法。

Health Professional Perspectives on Rehabilitation for People With Dementia.

机构信息

College of Medicine and Public Health, Flinders University, South Australia.

NHMRC Cognitive Decline Partnership Centre, The University of Sydney, New South Wales.

出版信息

Gerontologist. 2020 Apr 2;60(3):503-512. doi: 10.1093/geront/gnz007.

Abstract

BACKGROUND AND OBJECTIVES

Multidisciplinary rehabilitation is not incorporated into the usual care pathway for dementia despite increasing demand from key advocates. Clinician views regarding the relevance of rehabilitation in dementia care are not well known. This qualitative study explored the perspectives of health professionals regarding barriers to provision of multidisciplinary rehabilitation programs for people with dementia.

RESEARCH DESIGN AND METHODS

Sixteen health professionals from a variety of settings and professional backgrounds were purposively sampled using maximum variation sampling. Semi-structured interviews were conducted to explore attitudes toward the care of people with dementia and beliefs about the feasibility and value of multidisciplinary rehabilitation in this population. Thematic analysis was used to identify themes.

RESULTS

Participating clinicians acknowledged problems with existing dementia care pathways in Australia but rarely conceptualized rehabilitation as relevant to this pathway. Analyses yielded two main and related themes: (i) difficulty defining worthwhile outcomes of a rehabilitation program for people with dementia and (ii) perceived barriers to participation in this population. Clinicians felt that achievable outcomes for people with dementia were not sufficiently worthwhile for investment.

DISCUSSION AND IMPLICATIONS

Broader acceptance of multidisciplinary rehabilitation as relevant to dementia care will require a reframing of practice that both educates emerging health professionals regarding the outcomes that may be achievable for people with dementia and persuades staff to appreciate that the investment is worthwhile.

摘要

背景与目的

尽管来自主要倡导者的需求不断增加,但多学科康复并未纳入痴呆症的常规护理途径。临床医生对康复在痴呆症护理中的相关性的看法尚不清楚。本定性研究探讨了卫生专业人员对为痴呆症患者提供多学科康复计划的障碍的看法。

研究设计和方法

使用最大变异抽样,从各种环境和专业背景中选择了 16 名卫生专业人员进行有目的抽样。进行半结构化访谈,以探讨对痴呆症患者护理的态度以及对该人群中多学科康复的可行性和价值的信念。使用主题分析来确定主题。

结果

参与的临床医生承认澳大利亚现有的痴呆症护理途径存在问题,但很少将康复视为与该途径相关。分析产生了两个主要且相关的主题:(i)难以定义针对痴呆症患者的康复计划的有价值的结果,以及(ii)认为参与该人群存在障碍。临床医生认为,痴呆症患者可实现的结果对于投资来说没有足够的价值。

讨论与启示

更广泛地接受多学科康复与痴呆症护理相关,将需要重新调整实践,既要教育新出现的卫生专业人员了解对痴呆症患者可能实现的结果,又要说服工作人员认识到投资是值得的。

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