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“对你来说什么最重要?”-一项关于痴呆养老院居民对其接受的医疗保健看法的定性研究。

'What matters to you?'-a qualitative study on the views of nursing home residents with dementia regarding the health care they receive.

机构信息

Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.

Centre for Development of Institutional and Home Care Services, Lørenskog Municipality, Viken (Akershus), Norway.

出版信息

J Clin Nurs. 2022 Jan;31(1-2):262-274. doi: 10.1111/jocn.15904. Epub 2021 Jun 6.

Abstract

AIMS AND OBJECTIVE

This study's aim is to examine what matters to nursing home residents with dementia by exploring their perceptions of nursing home health care through the conceptual lens of person-centred care.

BACKGROUND

Dementia is a major contributor to nursing home placement. To understand the meaning of living with dementia, the inclusion of persons with dementia in research studies is essential.

METHODS

In total, 35 in-depth qualitative interviews were conducted with people who have dementia and live in nursing homes. A thematic analysis was applied to analyse the data. Checklist for qualitative studies: Consolidated Criteria for Reporting Qualitative Research (COREQ) https://www.equator-network.org/reporting-guidelines/coreq/ RESULTS: The analysis revealed one overarching theme with four sub-themes. Different matchings of person-centred care and routines in health care being the overarching theme. The four sub-themes were as follows: (a) understanding of the interplay between disabilities and ageing; (b) participating based on one's own preferences and needs; (c) incongruence between the person with dementia's preferences and needs and health-care support; and (d) working conditions: the relationship between residents and health-care providers. Despite the substantive focus of researchers on person-centred care and the positive impact on the nursing home health care of those who receive it, the results showed that nursing home residents still want more person-centred care.

CONCLUSIONS

The results indicate that the incongruence between general routines and individual preferences and needs, as well as the demand to operationalise the person-centred dimensions of health-care behaviour in nursing homes, must be resolved. Health care in nursing homes must focus on enabling residents to participate in daily activities and sustain their personhood and sense of self.

RELEVANCE TO CLINICAL PRACTICE

Based on the residents' statements, the results contribute to the fields of dementia education, health-care provision and policy-making and may be used to achieve person-centredness and governance.

摘要

目的和目标

本研究旨在通过探索认知症患者对护理院医疗保健的看法,从以患者为中心的护理概念视角来审视认知症患者关心的问题。

背景

痴呆症是导致入住护理院的主要原因之一。为了理解患有痴呆症的生活意义,将痴呆症患者纳入研究至关重要。

方法

共对 35 名居住在护理院的认知症患者进行了 35 次深入的定性访谈。应用主题分析法对数据进行分析。定性研究的清单:统一报告定性研究的标准(COREQ)https://www.equator-network.org/reporting-guidelines/coreq/

结果

分析揭示了一个总主题和四个子主题。以患者为中心的护理与医疗保健常规之间的不同匹配是总主题。四个子主题如下:(a)理解残疾和衰老之间的相互作用;(b)根据自己的喜好和需求参与;(c)认知症患者的喜好和需求与医疗保健支持之间的不匹配;以及(d)工作条件:居民与医疗保健提供者之间的关系。尽管研究人员对以患者为中心的护理的实质性关注以及它对接受者的护理院医疗保健的积极影响,但结果表明,护理院居民仍然希望获得更多的以患者为中心的护理。

结论

结果表明,必须解决一般常规与个人喜好和需求之间的不匹配问题,以及在护理院中实施以患者为中心的医疗保健行为的要求。护理院的医疗保健必须注重使居民能够参与日常活动,维持其人格和自我意识。

临床相关性

根据患者的陈述,结果有助于痴呆症教育、医疗保健提供和政策制定领域,并可用于实现以患者为中心和治理。

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