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适应养老院的生活:痴呆症患者、家庭成员和养老院工作人员的观点。

Adjusting to life in a residential aged care facility: Perspectives of people with dementia, family members and facility care staff.

机构信息

Health and Ageing Research Group, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.

Department of Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.

出版信息

J Clin Nurs. 2019 Nov;28(21-22):3901-3913. doi: 10.1111/jocn.14978. Epub 2019 Jul 21.

Abstract

AIMS AND OBJECTIVES

To determine factors that facilitate or impede adjustment to residential aged care (RAC) from the perspectives of residents with dementia, families of residents with dementia and facility staff.

BACKGROUND

The transition to a RAC facility can be highly stressful for people with dementia and their families, but we lack an understanding of how people with dementia experience this transition. Knowledge on adjustment to the new environment is essential in order to develop procedures and interventions that better support residents.

DESIGN AND METHODS

This study consisted of interviews with 12 residents with dementia who had resided at a RAC facility for six months or less; 14 family members of RAC residents with dementia; and 12 RAC facility staff members. Parallel interview schedules were constructed, with questions on the experience of relocating to RAC for a person with dementia and views on enablers and barriers to successful adjustment. Thematic analysis guided the analysis of data. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) guidelines (see Supplementary File S1).

RESULTS

Adjustment to RAC appeared variable, with several residents reporting poor acceptance of their circumstances several months after the relocation. The three groups were largely congruent regarding the importance of support from families and staff, and the development of new relationships with other residents, but not all residents had succeeded in forming friendships. The provision of meaningful activities and opportunities to exert autonomy day-to-day were seen as critical, but staff experienced challenges in providing individualised care due to lack of dedicated time to engage with residents.

CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE

There is a need for evaluated interventions to help people with dementia to successfully transition to RAC. Attention should be paid to the way in which care is coordinated within the RAC sector, to enable staff to provide individualised approaches to facilitate adjustment.

摘要

目的和目标

从痴呆症患者、痴呆症患者家属和设施工作人员的角度确定促进或阻碍适应住宅养老院(RAC)的因素。

背景

对于痴呆症患者及其家属来说,过渡到养老院设施可能是高度紧张的,但我们缺乏对痴呆症患者如何体验这一过渡的理解。了解如何适应新环境对于制定更好地支持居民的程序和干预措施至关重要。

设计和方法

这项研究包括对 12 名在养老院居住不到 6 个月的痴呆症患者、14 名痴呆症患者的家属和 12 名养老院工作人员进行的访谈。构建了平行的访谈时间表,问题涉及痴呆症患者搬迁到养老院的经历以及对成功适应的促进因素和障碍的看法。主题分析指导了数据分析。该研究遵循了定性研究报告的统一标准(COREQ)指南(见补充文件 S1)。

结果

适应养老院的情况似乎各不相同,一些患者在搬迁几个月后报告对自己的情况难以接受。这三个群体在家庭和工作人员的支持以及与其他居民建立新关系的重要性方面基本一致,但并非所有患者都成功建立了友谊。提供有意义的活动和日常行使自主权的机会被视为关键,但由于缺乏专门的时间与居民互动,工作人员在提供个性化护理方面面临挑战。

结论和对临床实践的意义

需要评估干预措施,以帮助痴呆症患者成功过渡到养老院。应注意协调养老院内部的护理方式,使工作人员能够采用个性化的方法促进适应。

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