Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada.
Health Expect. 2022 Oct;25(5):2155-2165. doi: 10.1111/hex.13381. Epub 2021 Nov 8.
This paper aims to explore the care processes that best exemplify person-centred care during physical activity (PA) for long-term care (LTC) residents with dementia from the perspectives of substitute decision-makers (SDMs) and LTC home staff. Little is known about how person-centred care is reflected during PA for residents with dementia, or the barriers and benefits to enacting person-centred care during PA.
Semistructured interviews were used to collect SDMs and LTC home staffs' perspectives on the importance of person-centred care during PA from two LTC homes in Canada. The McCormack and McCance person-centredness framework was used to guide thematic content analysis of responses.
SDM (n = 26) and staff (n = 21) identified actions categorized under the sympathetic presence or engagement care processes from the person-centredness framework as most reflecting person-centred care. Benefits of person-centred care during PA were categorized into three themes: functional and physical, behavioural and communication and psychosocial improvements. Barriers to person-centred care during PA identified were lack of time, opportunities for meaningful activity in LTC setting and staff experiences with resident aggression.
Understanding the care processes that are most recognized as person-centred care and valued by SDMs and LTC home staff has implications for education and training. Insights into SDMs' care expectations regarding person-centred care can inform staff about which actions should be prioritized to meet care expectations and can foster relationships to the benefit of residents with dementia.
Study participants were not involved in the development of research questions, research design or outcome measures of this study.
本研究旨在从替代决策人(SDM)和长期护理(LTC)院方工作人员的角度,探讨在身体活动(PA)中最能体现以患者为中心的护理过程,以了解痴呆症患者的 PA 中体现了哪些以人为中心的护理,以及在 PA 中实施以人为中心的护理的障碍和益处。
采用半结构式访谈,从加拿大的两家 LTC 院收集 SDM 和 LTC 院方工作人员对 PA 中以人为中心护理重要性的看法。采用 McCormack 和 McCance 以人为中心框架指导对回应的主题内容分析。
SDM(n=26)和工作人员(n=21)确定了以人为中心框架下的同情存在或参与护理过程的行为,这些行为最能体现以人为中心的护理。PA 中以人为中心护理的益处分为三个主题:功能和身体、行为和沟通以及心理社会改善。PA 中以人为中心护理的障碍包括缺乏时间、LTC 环境中进行有意义活动的机会以及工作人员对居民攻击性的体验。
了解最被 SDM 和 LTC 院方工作人员认可为以人为中心的护理过程和重视的护理过程,对教育和培训具有重要意义。了解 SDM 对以人为中心护理的护理期望,可以让工作人员了解哪些行动应优先考虑以满足护理期望,并可以促进与居民的关系,使痴呆症患者受益。
研究参与者未参与本研究的研究问题、研究设计或结果衡量标准的制定。