Betsi Cadwaladr University Health Board & Senior Honorary Lecturer in dementia studies, School of Health Sciences, Bangor University, Bangor, UK.
Lecturer in Mental Health Nursing, School of Health Sciences, Bangor University, Bangor, UK.
J Psychiatr Ment Health Nurs. 2021 Dec;28(6):961-969. doi: 10.1111/jpm.12763. Epub 2021 Apr 28.
WHAT IS KNOWN ON THE SUBJECT?: Coronavirus disease 2019 (COVID-19) is a new infectious disease that has spread across the world and infected a large number of people many of whom have died. People with moderate to severe dementia are at very high risk of becoming infected as the disease mainly impacts on older people with other health problems and once infected the person with dementia is more likely to become seriously ill than other people. To prevent infection, people are required to wear masks and isolate from contact with others. It is believed that these measures can reduce the quality of life and general well-being of people with moderate to severe dementia in hospital or social care. This belief has not yet been demonstrated by research. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: We show that people with moderate to severe dementia receiving care on mental health hospital wards and subject to strict infection prevention measures can still achieve high levels of well-being. We show that mental health nurses alter the focus of their care to deliberately overcome the challenges and particularly the restrictions on visiting by families. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We believe that the changes in practice we observed can occur in other healthcare and social care settings and that whilst restrictions remain in place care staff can protect and possibly enhance well-being for people with moderate to severe dementia. ABSTRACT: Introduction The effect of coronavirus (COVID-19) on people living with dementia is potentially severe in its clinical impacts. More widely, for this vulnerable group, the social restrictions to limit the spread of infection may be emotionally and psychologically damaging. Aim To explore the impact of restrictions on well-being for people with moderate to severe dementia in acute mental health hospital care. Method "Dementia Care Mapping" was the observational tool used to determine well- or ill-being. Observations were undertaken in two mental health hospital wards during a time of restrictions and the use of personal protective equipment. Results We report levels of well-being that are higher than might be expected alongside a change in the focus of psychological care delivered through mental health nursing interventions aimed at enhancing well-being. Discussion-We postulate that mental health nurses faced with an unprecedented challenge respond by changing practice to mitigate for infection prevention measures and to compensate for family absence. Implications for practice We suggest that the desirable enhancing actions by nursing staff which raise well-being in these hospital settings are readily transferable to other settings that are aiming to maintain well-being but also practising under COVID-19 restrictions.
2019 年冠状病毒病（COVID-19）是一种新的传染病，已在全球范围内传播，感染了大量人群，其中许多人死亡。患有中度至重度痴呆症的人感染的风险非常高，因为这种疾病主要影响老年人和其他有健康问题的人，一旦感染，痴呆症患者比其他人更容易病重。为了预防感染，人们需要戴口罩并与他人隔离。据信，这些措施可以降低医院或社会护理中患有中度至重度痴呆症的人的生活质量和整体幸福感。这一信念尚未得到研究的证明。本文增加了哪些新知识：我们表明，在精神科医院病房接受护理并受到严格感染预防措施的中度至重度痴呆症患者仍能获得高度幸福感。我们表明，精神科护士改变了护理重点，有意克服家庭探视的挑战和限制。这对实践有何影响：我们相信，我们观察到的实践变化可能会在其他医疗保健和社会护理环境中发生，并且在限制仍然存在的情况下，护理人员可以保护和可能增强中度至重度痴呆症患者的幸福感。摘要：介绍 冠状病毒（COVID-19）对痴呆症患者的影响在其临床影响方面可能是严重的。更广泛地说，对于这个弱势群体，限制社会传播感染的措施可能会在情感和心理上造成伤害。目的 探讨限制措施对急性精神卫生医院中度至重度痴呆症患者幸福感的影响。方法 使用“痴呆症护理映射”作为观察工具来确定幸福感或不适。在限制使用个人防护设备的情况下，在两个精神科病房进行了观察。结果 我们报告的幸福感水平高于预期，同时护理心理的重点发生了变化，通过精神科护理干预来增强幸福感。讨论 我们假设，面对前所未有的挑战，精神科护士通过改变实践来减轻感染预防措施的影响，并弥补家庭的缺失。对实践的影响 我们认为，护士人员采取的有益的增强措施可以提高这些医院环境的幸福感，并且易于转移到其他旨在维持幸福感但也在 COVID-19 限制下实践的环境中。
