Kaasalainen Sharon, Hunter Paulette V, Dal Bello-Haas Vanina, Dolovich Lisa, Froggatt Katherine, Hadjistavropoulos Thomas, Markle-Reid Maureen, Ploeg Jenny, Simard Joyce, Thabane Lehana, van der Steen Jenny T, Volicer Ladislav
1School of Nursing, McMaster University, 1280 Main Street West, HSC 3H48C, Hamilton, ON L8S 3Z1 Canada.
2Department of Family Medicine, McMaster University, 1280 Main Street West, 3H48C, Hamilton, ON L8N 3Z5 Canada.
Pilot Feasibility Stud. 2020 Mar 2;6:34. doi: 10.1186/s40814-020-00575-4. eCollection 2020.
Residents living and dying in long-term care (LTC) homes represent one of society's most frail and marginalized populations of older adults, particularly those residents with advanced dementia who are often excluded from activities that promote quality of life in their last months of life. The purpose of this study is to evaluate the feasibility, acceptability, and effects of Namaste Care: an innovative program to improve end-of-life care for people with advanced dementia.
This study used a mixed-method survey design to evaluate the Namaste Care program in two LTC homes in Canada. Pain, quality of life, and medication costs were assessed for 31 residents before and 6 months after they participated in Namaste Care. The program consisted of two 2-h sessions per day for 5 days per week. Namaste Care staff provided high sensory care to residents in a calm, therapeutic environment in a small group setting. Feasibility was assessed in terms of recruitment rate, number of sessions attended, retention rate, and any adverse events. Acceptability was assessed using qualitative interviews with staff and family.
The feasibility of Namaste Care was acceptable with a participation rate of 89%. However, participants received only 72% of the sessions delivered and only 78% stayed in the program for at least 3 months due to mortality. After attending Namaste Care, participants' pain and quality of life improved and medication costs decreased. Family members and staff perceived the program to be beneficial, noting positive changes in residents. The majority of participants were very satisfied with the program, providing suggestions for ongoing engagement throughout the implementation process.
These study findings support the implementation of the Namaste Care program in Canadian LTC homes to improve the quality of life for residents. However, further testing is needed on a larger scale.
在长期护理（LTC）机构中生活和离世的居民是社会上最脆弱、最边缘化的老年人群体之一，尤其是那些患有晚期痴呆症的居民，他们在生命的最后几个月往往被排除在促进生活质量的活动之外。本研究的目的是评估“合十礼关爱”（Namaste Care）的可行性、可接受性和效果：这是一项旨在改善晚期痴呆症患者临终护理的创新项目。
本研究采用混合方法调查设计，对加拿大两家长期护理机构中的“合十礼关爱”项目进行评估。在31名居民参与“合十礼关爱”项目之前和之后6个月，对他们的疼痛、生活质量和药物费用进行了评估。该项目每周5天，每天进行两节时长为2小时的课程。“合十礼关爱”项目的工作人员在一个安静、具有治疗作用的环境中，以小组形式为居民提供高度感官护理。从招募率、参与课程数量、留存率和任何不良事件方面评估可行性。通过对工作人员和家属进行定性访谈来评估可接受性。
“合十礼关爱”项目的可行性是可以接受的，参与率为89%。然而，参与者只参加了72%的课程，并且由于死亡率，只有78%的人在该项目中停留了至少3个月。参与“合十礼关爱”项目后，参与者的疼痛和生活质量得到改善，药物费用降低。家庭成员和工作人员认为该项目有益，指出居民有积极变化。大多数参与者对该项目非常满意，并在整个实施过程中提出了持续参与的建议。
这些研究结果支持在加拿大长期护理机构中实施“合十礼关爱”项目，以提高居民的生活质量。然而，需要进行更大规模的进一步测试。
