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老年痴呆症患者的精神关怀的意义和实践:护士和护理人员的经验。

Meaning and practices of spiritual care for older people with dementia: experiences of nurses and care workers.

机构信息

Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Nagoya University School of Medicine, Nagoya, Japan.

出版信息

Psychogeriatrics. 2020 Jan;20(1):44-49. doi: 10.1111/psyg.12454. Epub 2019 Apr 15.

DOI:10.1111/psyg.12454
PMID:30983086
Abstract

BACKGROUND

The aim of the present study was to comprehensively investigate the meaning and practices of spiritual care for older people with dementia based on the perspective and experiences of nurses and care workers.

METHODS

The study was designed according to qualitative research strategies and used face-to-face interview data, with a focus on the experiences of nurses and care workers who care for elderly persons with dementia. Five nurses and 13 care workers from nine care facilities participated. We conducted 10 interviews, each with one to three participants, from April to August 2017. An open-ended questionnaire concerning the meaning and practices of spiritual care for older people with severe dementia was used to comprehensively capture the participants' experiences of caring for older people with dementia. Qualitative content analysis was used to systematically identify ideas and patterns emerging from the qualitative data.

RESULTS

Three main themes emerged from the qualitative analysis of what constituted spiritual care for older people with dementia: (i) self-esteem; (ii) communication; and (iii) individual difference.

CONCLUSIONS

Nurses and care workers perceived self-esteem as a core domain of spiritual care for older people with severe dementia. Reminiscing about important achievements and enjoying small pleasures in daily life enhance older people's self-esteem. Communication strategies involving active listening and therapeutic lying can help maintain older people's self-esteem and cognitive abilities. Older people with dementia respond in different ways to standardized care procedures, so care providers must employ of a variety of skilful approaches.

摘要

背景

本研究旨在全面调查护士和护理人员从自身视角和经验出发,对老年痴呆症患者进行精神关怀的意义和实践。

方法

该研究根据定性研究策略进行设计,使用面对面访谈数据,重点关注照顾老年痴呆症患者的护士和护理人员的经验。来自 9 家护理机构的 5 名护士和 13 名护理人员参与了此次研究。我们在 2017 年 4 月至 8 月期间进行了 10 次访谈,每次访谈有 1 至 3 名参与者。采用开放式问卷,内容涉及对严重痴呆症老年人进行精神关怀的意义和实践,以全面了解参与者对老年痴呆症患者的关怀体验。采用定性内容分析法,系统地识别定性数据中出现的观点和模式。

结果

从对构成老年痴呆症患者精神关怀的定性分析中得出了三个主题:(i)自尊;(ii)沟通;(iii)个体差异。

结论

护士和护理人员认为自尊是严重痴呆症老年患者精神关怀的核心领域。回忆重要成就和享受日常生活中的小乐趣可以增强老年人的自尊。包括积极倾听和善意谎言在内的沟通策略可以帮助维持老年人的自尊和认知能力。患有痴呆症的老年人对标准化护理程序的反应不同,因此护理人员必须采用多种熟练的方法。

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