Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
BMC Health Serv Res. 2022 Jun 25;22(1):825. doi: 10.1186/s12913-022-08229-2.
The progressive character of dementia usually leads to a continuously increasing need for support. There is some evidence of late use of professional support during the disease course. We aim to provide an overview of aspects influencing access and use of formal care in dementia from the perspective of health and social care professionals. Additionally, the perspectives of professionals and people with dementia/informal carers will be compared.
We conducted a scoping review with a systematic literature search in Medline via Ovid in January 2019 and updated this in April 2020 and in May 2021. Publications were considered eligible when focusing on influencing aspects of the use of formal care or support for people with dementia in an outpatient setting from the perspective of health professionals. Included publications were critically appraised using the Mixed Method Appraisal Tool. We identified aspects of access to and use of formal care and support services. A consultation exercise with three specialised trained dementia care nurses was conducted to validate our results.
We included 29 studies: n = 20 qualitative, n = 6 quantitative-descriptive, n = 3 mixed-methods. Various support services were identified, but a focus was on services for diagnostic and treatment of dementia. A wide range of influencing aspects (n = 15) describe the access to and use of formal care services. Aspects related to the complexity and structure of the healthcare system and the competence of professionals were frequently addressed. Second, attitudes and expectations of professionals, and experiences with people with dementia and their informal carers were identified. The dementia care nurses highlighted the importance of coordinated care to enhance dementia-specific competencies.
Health and social care professionals still describe barriers in accessing and using formal care due to various influences. Ways to improve access to and use of professional support in dementia should consider individual and system-level activities, as well as overarching aspects. Important topics are therefore education and training of professionals and coordinated dementia-specific care to provide adequate support for people with dementia and their relatives. Several professions may be involved in this increasingly important field, e.g., nurses with a dementia-specific training like dementia care nurses.
痴呆症的进行性特征通常导致对支持的需求不断增加。有证据表明，在疾病过程中晚期会使用专业支持。我们旨在从卫生和社会保健专业人员的角度提供有关痴呆症患者获得和使用正规护理的各个方面的概述。此外，还将比较专业人员和痴呆症患者/非正式照顾者的观点。
我们进行了范围综述，于 2019 年 1 月通过 Ovid 在 Medline 进行了系统的文献检索，并于 2020 年 4 月和 2021 年 5 月进行了更新。当出版物侧重于从卫生专业人员的角度关注门诊环境中痴呆症患者使用正规护理或支持的影响方面时，这些出版物被认为是合格的。使用混合方法评估工具对纳入的出版物进行了批判性评估。我们确定了获得和使用正规护理和支持服务的各个方面。与三名专门培训的痴呆症护理护士进行了咨询练习，以验证我们的结果。
我们共纳入了 29 项研究：n=20 项定性研究，n=6 项定量描述性研究，n=3 项混合方法研究。确定了各种支持服务，但重点是用于诊断和治疗痴呆症的服务。广泛的影响因素（n=15）描述了正规护理服务的获取和使用。经常涉及与医疗保健系统的复杂性和结构以及专业人员的能力相关的方面。其次，确定了专业人员的态度和期望，以及与痴呆症患者及其非正式照顾者的经验。痴呆症护理护士强调了协调护理以提高特定于痴呆症的能力的重要性。
卫生和社会保健专业人员仍然由于各种因素而描述了获得和使用正规护理的障碍。改善痴呆症患者获得和使用专业支持的方法应考虑个人和系统层面的活动以及总体方面。因此，重要的主题是专业人员的教育和培训以及协调的特定于痴呆症的护理，以为痴呆症患者及其亲属提供足够的支持。在这个日益重要的领域，可能涉及多个专业，例如具有痴呆症特定培训的护士，如痴呆症护理护士。
