Department of Medicine, University of Udine, Viale Ungheria 20, 33010 Udine, Italy.
South Denmark European Office, Avenue Palmerston 3, B-1000 Brussels, Belgium.
Health Policy. 2021 Aug;125(8):1013-1022. doi: 10.1016/j.healthpol.2021.05.012. Epub 2021 May 27.
This qualitative descriptive study explored needs, issues, and expectations on dementia care at home as expressed by relatives of people living with dementia (PwD), health and social care professionals (HSCPs), and members of civil society organisations (CSOs) from four European countries. A focus group methodology integrated with individual semi-structured interviews was adopted to collect data by employing a purposeful sampling method. A total of 13 focus groups and 12 individual interviews were conducted in 2019, involving 65 relatives of PwD, 32 HSCPs, and 23 members of CSOs. Deductive content analysis and findings triangulation were performed to analyse data, and a subgroup of participants confirmed the findings. Relatives need to be (a) informed and trained to cope with changes in PwD, (b) recognised for their caregiving role, and (c) assisted by specialised HSCPs. Professionals who work in partnership with PwD and their relatives call for a reorganisation of available services. CSOs compensate for the lack of proper support, promoting networks, and cooperation with local communities. Several commonalities emerged across countries, highlighting the chance to inform and develop common policies to improve the quality of life of PwD and their relatives across Europe. Policies improving person- and family-centred care and spreading dementia-friendly community concepts and practices are suggested. Strong collaborations between formal and informal services and communities are also needed as well as information on educational strategies to improve the use of resources, promote PwD care, and support PwD relatives' needs.
本定性描述性研究探讨了来自四个欧洲国家的痴呆症患者亲属、卫生和社会保健专业人员以及民间社会组织成员对家庭中痴呆症护理的需求、问题和期望。采用焦点小组方法与个体半结构化访谈相结合,通过采用目的性抽样方法收集数据。2019 年共进行了 13 个焦点小组和 12 个个体访谈,涉及 65 名痴呆症患者亲属、32 名卫生和社会保健专业人员以及 23 名民间社会组织成员。采用演绎内容分析和研究结果三角验证法分析数据,一小部分参与者对研究结果进行了确认。亲属需要:(a) 接受信息和培训以应对痴呆症患者的变化;(b) 认可他们的照顾角色;(c) 得到专业卫生和社会保健专业人员的帮助。与痴呆症患者及其亲属合作的专业人员呼吁重新组织现有的服务。民间社会组织弥补了适当支持的不足,促进了网络建设,并与当地社区合作。各国之间出现了一些共同之处,突出了为改善欧洲各地痴呆症患者及其亲属的生活质量提供信息和制定共同政策的机会。建议制定以患者和家庭为中心的政策,并推广对痴呆症友好的社区概念和实践。还需要正式和非正式服务以及社区之间的紧密合作,以及有关教育策略的信息,以提高资源利用、促进痴呆症患者护理和支持痴呆症患者亲属的需求。