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从痴呆症思维模式到情感与行为:预测护理专业人员以患者为中心的护理

From dementia mindsets to emotions and behaviors: Predicting person-centered care in care professionals.

作者信息

Kunz Lena K, Scheibe Susanne, Wisse Barbara, Boerner Kathrin, Zemlin Claudia

机构信息

Department of Psychology, 403520University of Groningen, Groningen, The Netherlands.

Department of Gerontology, 14708University of Massachusetts Boston, Boston, MA, USA.

出版信息

Dementia (London). 2022 Jul;21(5):1618-1635. doi: 10.1177/14713012221083392. Epub 2022 May 5.

Abstract

BACKGROUND AND OBJECTIVE

High-quality care standards for dementia care are increasingly based on person-centered care principles. To better understand facilitating factors of person-centered care this research focuses on individual characteristics of care professionals. Applying mindset theory to dementia care, we examined dementia mindsets (viewing dementia symptoms as either malleable or fixed) in care professionals. We tested whether there is a positive relationship between a malleable dementia mindset and person-centered care as well as a negative relationship between a fixed dementia mindset and person-centered care. Moreover, we examined whether care professionals' emotional responses in care situations help explain associations between dementia mindsets and person-centered care.

RESEARCH DESIGN AND METHOD

In two cross-sectional studies, care professionals of long-term care facilities (total = 370) completed a measure of dementia mindsets and reported their emotional and behavioral responses to five care scenarios. Regression and mediation analyses were performed.

FINDINGS

The tested hypotheses were partially supported. A fixed dementia mindset predicted reported person-centered care negatively, while a malleable dementia mindset did not. Mediation analyses suggest that reduced negative emotions may underlie the association between a malleable mindset and reported person-centered care, while reduced positive emotions in care situations may underlie the association of a fixed mindset and reported person-centered care. Study 2 partially replicated these findings. A fixed mindset and positive emotional responses were the most robust predictors of reported person-centered care.

DISCUSSION AND IMPLICATIONS

This study extends knowledge on facilitators (positive emotional responses to care situations) and barriers (fixed dementia mindset) to person-centered care in care professionals working with persons with dementia. We discuss how dementia mindsets and emotional responses to care situations may be a fruitful target for trainings for care professionals.

摘要

背景与目的

痴呆症护理的高质量标准越来越多地基于以患者为中心的护理原则。为了更好地理解以患者为中心的护理的促进因素,本研究聚焦于护理专业人员的个体特征。将思维模式理论应用于痴呆症护理,我们考察了护理专业人员的痴呆症思维模式(将痴呆症症状视为可改变的或固定不变的)。我们测试了可改变的痴呆症思维模式与以患者为中心的护理之间是否存在正相关,以及固定不变的痴呆症思维模式与以患者为中心的护理之间是否存在负相关。此外,我们考察了护理专业人员在护理情境中的情绪反应是否有助于解释痴呆症思维模式与以患者为中心的护理之间的关联。

研究设计与方法

在两项横断面研究中,长期护理机构的护理专业人员(共370名)完成了一项痴呆症思维模式测量,并报告了他们对五种护理场景的情绪和行为反应。进行了回归分析和中介分析。

研究结果

所检验的假设得到了部分支持。固定不变的痴呆症思维模式对报告的以患者为中心的护理有负向预测作用,而可改变的痴呆症思维模式则没有。中介分析表明,负面情绪的减少可能是可改变的思维模式与报告的以患者为中心的护理之间关联的基础,而护理情境中积极情绪的减少可能是固定不变的思维模式与报告的以患者为中心的护理之间关联的基础。研究2部分重复了这些发现。固定不变的思维模式和积极的情绪反应是报告的以患者为中心的护理最有力的预测因素。

讨论与启示

本研究扩展了关于痴呆症护理专业人员以患者为中心的护理的促进因素(对护理情境的积极情绪反应)和障碍(固定不变的痴呆症思维模式)的知识。我们讨论了痴呆症思维模式和对护理情境的情绪反应如何可能成为护理专业人员培训的一个富有成效的目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a49/9234781/a9246e9d9644/10.1177_14713012221083392-fig1.jpg

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