Oncology Department, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, People's Republic of China.
Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.
Clin Interv Aging. 2020 Sep 14;15:1637-1647. doi: 10.2147/CIA.S255454. eCollection 2020.
Good interactions are essential in caring for people with dementia. There is a lack of knowledge about interaction approaches used by caregivers in person-centered dementia care. This study aimed to understand interactions in person-centered dementia care.
A search for relevant publications was undertaken in 2020 on two electronic databases, MEDLINE with full text and CINAHL Plus with full text. This was supplemented by manual searching of the reference lists of relevant articles. Inclusion and exclusion criteria were applied to determine the relevance of the articles. Data extraction included publication year, country, study setting, aim, design, definition of person-centered dementia care, elements of person-centered dementia care and interaction approaches used by caregivers. A Donabedian quality framework was used to group the elements of person-centered dementia care into three categories: structure, process and outcome.
A total of 25 articles were included in the review, all from developed countries. A conceptual framework was developed for the delivery of person-centered dementia care. It includes the organizational structure, ie, management and resources, a competent workforce and physical environment; the dementia care process, ie, respectful interaction underpinned by good knowledge about the care recipients in a calm, peaceful environment; and care outcome, ie, the social, psychological, and physical well-being of the care recipients. Interaction approaches used by caregivers in providing person-centered dementia care were classified according to the six purposes of interaction: to know and understand the care recipient, to keep the person happy and satisfied, to make the person feel safe and secure, to calm the person, to support self-identity, and to guide the person in conducting daily activities.
The delivery of person-centered dementia care needs to consider organizational structure, the dementia care process, and care outcome which together foster a positive environment for meaningful interactions between caregivers and care recipients. The identified interaction approaches could be used by dementia care trainers to develop training materials.
良好的互动对于照顾痴呆症患者至关重要。目前,人们对以患者为中心的痴呆症护理中护理人员使用的互动方法知之甚少。本研究旨在了解以患者为中心的痴呆症护理中的互动。
2020 年,我们在两个电子数据库(全文 MEDLINE 和全文 CINAHL Plus)中进行了相关文献的检索,并补充了对相关文章参考文献列表的手动搜索。应用纳入和排除标准来确定文章的相关性。数据提取包括出版年份、国家、研究地点、目的、设计、以患者为中心的痴呆症护理的定义、以患者为中心的痴呆症护理的要素以及护理人员使用的互动方法。采用 Donabedian 质量框架将以患者为中心的痴呆症护理要素分为结构、过程和结果三个类别。
共纳入 25 篇综述文章,均来自发达国家。提出了以患者为中心的痴呆症护理实施的概念框架。它包括组织结构,即管理和资源、有能力的劳动力和物理环境;痴呆症护理过程,即尊重的互动,以对护理对象的良好了解为基础,在平静、平和的环境中进行;以及护理结果,即护理对象的社会、心理和身体福祉。根据互动的六个目的对护理人员在提供以患者为中心的痴呆症护理中使用的互动方法进行了分类:了解和理解护理对象、让护理对象感到快乐和满足、让护理对象感到安全和有保障、使护理对象平静、支持自我认同和指导护理对象进行日常活动。
提供以患者为中心的痴呆症护理需要考虑组织结构、痴呆症护理过程和护理结果,这三者共同为护理人员和护理对象之间有意义的互动营造积极的环境。确定的互动方法可由痴呆症护理培训师用于开发培训材料。