Institute of Symbiotic Life-TECH, 26721Yonsei University, Seoul, Korea.
School of Nursing, University of British Columbia, British Columbia, Canada.
Dementia (London). 2021 Oct;20(7):2558-2572. doi: 10.1177/14713012211003994. Epub 2021 Mar 29.
This study aimed to explore staff perspectives of the physical environment in supporting their care practices for residents living with dementia in Canadian and Swedish long-term care facilities.
An exploratory, descriptive, qualitative research design based on focus groups was used.
A total of 24 staff members who worked closely with the residents such as nurses or care aides participated in the focus group interviews from four facilities, two in Sweden and two in Canada.
Focus group interview was held at each selected care facility once and a total of four times were conducted. Broad questions were asked about the effect of physical environment on care practice, job satisfaction, and interaction with residents. Data were analyzed by thematic analysis.
This study identified three environmental themes that have substantial effect on the social interaction and care practice: (i) design ambience enables and limits social and care interaction, (ii) space arrangements facilitate and hinder the effectiveness of care delivery, and (iii) sensory stimuli have direct impact on residents. The findings demonstrate that well-designed environment qualities such as homelike ambience, an open layout, and stimulating courtyard positively stimulate the emotion of staff as well as residents, which also leads to build trust and relationship and to increase job satisfaction. The study found that the appropriate level of sound or familiar music for residents with dementia is a positive stimulus. When the staff felt comfortable and supported by good care unit's ambience, they can be motivated to care for their residents, leading to better care practices. The study also found that the closed floor plan in an institutional setting could increase staff fatigue by obstructing the view of residents' behaviors and movement and by increasing walking loads.
This study highlights the complexities of how care was organized and influenced by the physical environment of the setting. The variations in the physical environmental characteristics and quality of care suggest the value of comparative research in identifying and exploring the possible causes and consequences. Future development in long-term care facilities requires a better understanding of staff experiences and staff involvement in the physical design of care settings.
本研究旨在探讨员工对加拿大和瑞典长期护理机构中痴呆症居民护理实践的物理环境的看法。
采用基于焦点小组的探索性、描述性、定性研究设计。
共有 24 名与居民密切合作的工作人员（如护士或护理助理）参加了来自四个设施（两个在瑞典，两个在加拿大）的焦点小组访谈。
在每个选定的护理设施进行一次焦点小组访谈，共进行了四次。广泛询问物理环境对护理实践、工作满意度和与居民互动的影响。数据通过主题分析进行分析。
本研究确定了对社会互动和护理实践有重大影响的三个环境主题：（i）设计氛围可以促进和限制社会和护理互动，（ii）空间布置有利于或阻碍护理服务的有效性，以及（iii）感官刺激直接影响居民。研究结果表明，精心设计的环境质量，如家庭般的氛围、开放式布局和刺激的庭院，积极激发员工和居民的情绪，也有助于建立信任和关系，提高工作满意度。研究还发现，为痴呆症患者提供适当水平的声音或熟悉的音乐是一种积极的刺激。当员工感到舒适并得到良好护理单元氛围的支持时，他们会有动力照顾居民，从而提供更好的护理实践。研究还发现，机构环境中的封闭式平面布局会通过阻碍居民行为和运动的视线以及增加步行负荷，增加员工疲劳感。
本研究强调了护理是如何组织起来并受到环境物理环境特征的影响的复杂性。环境物理特征和护理质量的差异表明，进行比较研究以确定和探索可能的原因和后果具有价值。未来长期护理设施的发展需要更好地了解员工的经验，并让员工参与护理环境的物理设计。
