将家庭照顾者纳入住院老年患者谵妄预防护理中：案例研究分析。

Integration of family caregivers in delirium prevention care for hospitalized older adults: A case study analysis.

机构信息

La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts, Western Switzerland, Lausanne, Switzerland.

School of Health Sciences, HES-SO Valais/Wallis, University of Applied Sciences and Arts, Western Switzerland, Sion, Switzerland.

出版信息

J Adv Nurs. 2021 Jan;77(1):318-330. doi: 10.1111/jan.14593. Epub 2020 Oct 20.

DOI:10.1111/jan.14593

PMID:33078872

Abstract

AIM

To understand how family caregivers of older adults hospitalized for orthopaedic surgery are integrated by nurses in delirium prevention care.

DESIGN

Multiple case study.

METHODS

The sample consisted of eight cases. Each case comprised an older adult, a family caregiver, and a nurse. Data were collected from September 2017 - April 2018 through various instruments, including semi-structured interviews and family caregiver logs. Within- and across-case analyses were conducted, based on the model of The Care Partner Engagement developed by Hill, Yevchak, Gilmore-Bykovskyi, & Kolanowski (Geriatric Nursing, 35, 2014, 272).

RESULTS

Two themes emerged: (a) family caregivers were engaged in caring for the older adults during their hospital stay, though they had differences in terms of views and needs; and (b) family caregivers communicated with nurses but nurses did not recognize their role and did not integrate them much in care.

CONCLUSION

The presence and availability of family caregivers, their sense of responsibility towards the hospitalized older adults, and their positive effects on them suggest that family caregivers could be integrated more systematically in a care partnership with nurses. Poor integration of family caregivers in delirium prevention care shows that nurse delirium prevention competencies and their relational skills for communicating effectively with family caregivers need to be developed further.

IMPACT

Integrating family caregivers in delirium prevention care for older adults is a challenge for nurses. Family caregivers are engaged during the hospitalization of older adults, though differences and problems exist between the two groups. While there is communication between patients, family caregivers, and nurses, nurses do not recognize the role of family caregivers and hardly integrated them in the delirium prevention care of hospitalized older adults. Nurses must adopt a patient- and family-centred approach. Care and training facilities must make resources available to implement this approach in nursing practice.

摘要

目的

了解护士如何将老年骨科手术住院患者的家庭照顾者纳入谵妄预防护理中。

设计

多案例研究。

方法

样本由 8 个案例组成。每个案例包括一位老年人、一位家庭照顾者和一位护士。数据于 2017 年 9 月至 2018 年 4 月通过半结构访谈和家庭照顾者日志等多种工具收集。采用 Hill、Yevchak、Gilmore-Bykovskyi 和 Kolanowski（老年护理学，35，2014，272）提出的“照顾伙伴参与模式”进行了案例内和跨案例分析。

结果

出现了两个主题：（a）家庭照顾者在老年人住院期间参与照顾，但他们的观点和需求存在差异；（b）家庭照顾者与护士进行了沟通，但护士没有认识到他们的角色，也没有在护理中充分整合他们。

结论

家庭照顾者的存在和可用性、他们对住院老年人的责任感以及他们对老年人的积极影响表明，可以更系统地将家庭照顾者纳入与护士的护理伙伴关系中。家庭照顾者在预防谵妄护理中整合不足表明，护士需要进一步发展预防谵妄的能力和与家庭照顾者有效沟通的关系技能。

影响

将家庭照顾者纳入老年预防谵妄护理对护士来说是一个挑战。家庭照顾者在老年人住院期间参与其中，但两组之间存在差异和问题。虽然患者、家庭照顾者和护士之间存在沟通，但护士没有认识到家庭照顾者的角色，几乎没有将他们纳入住院老年人的预防谵妄护理中。护士必须采取以患者和家庭为中心的方法。护理和培训设施必须提供资源，以便在护理实践中实施这种方法。