NIHR ARC South West Peninsula, University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK.
Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK.
Age Ageing. 2021 Jun 28;50(4):1077-1080. doi: 10.1093/ageing/afab065.
The need to improve care for people living with dementia in the hospital setting has long been recognised. Person-centred care has the potential to improve the experience of care for persons living with dementia and their carers, and has been shown to improve the experiences of hospital staff caring for the persons living with dementia, however it remains challenging to deliver in a time- and task-focussed acute care setting. This commentary suggests that to embed person-centred care across the hospital environment, cultural changes are needed at organisational and ward levels. In particular there needs to be: leadership that supports and advocates for workforce capacity to recognise and meet both psychological and physical needs of people living with dementia, promotion of physical environments that support familiarisation and social interactions, an inclusive approach to carers and the development of a culture of sharing knowledge and information across hierarchies and roles. An evidence-based set of pointers for service change are described which highlight institutional and environmental practices and processes that need to be addressed in order for person-centred care to become part of routine care.
长期以来,人们一直认识到需要改善医院环境中痴呆症患者的护理。以患者为中心的护理有可能改善痴呆症患者及其照顾者的护理体验,并且已被证明可以改善照顾痴呆症患者的医院工作人员的体验,然而,在注重时间和任务的急性护理环境中提供这种护理仍然具有挑战性。本评论认为,要将以患者为中心的护理嵌入整个医院环境中,需要在组织和病房层面进行文化变革。特别是需要:领导层支持和倡导工作人员的能力,以识别和满足痴呆症患者的心理和身体需求,促进支持熟悉和社交互动的物理环境,对照顾者采取包容的态度,并培养一种在层次和角色之间分享知识和信息的文化。描述了一组基于证据的服务变革要点,强调了需要解决的机构和环境实践和流程,以便将以患者为中心的护理成为常规护理的一部分。