Department of Tranzo Scientific Centre for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands.
Stichting Mijzo, Waalwijk, The Netherlands.
Gerontologist. 2023 Sep 2;63(8):1351-1364. doi: 10.1093/geront/gnac114.
To protect residents with dementia from harm, nursing homes (NHs) often have closed-door policies. However, current research suggests a positive influence of freedom of movement, that is, the right to (decide to) independently move from one place to another, on the health of NH residents with dementia. This systematic review aims to collate, summarize, and synthesize the scientific evidence published to date on the influence of freedom of movement on health among NH residents with dementia.
Multiple databases were searched up until March 2021. Peer-reviewed qualitative, quantitative, and mixed methods studies were included. Health was operationalized using the Positive Health framework, encompassing 6 dimensions: bodily functions, mental functions and perception, existential dimension, quality of life, social and societal participation, and daily functioning. The quality of included studies was assessed using the Mixed Methods Appraisal Tool.
Sixteen studies were included of good to excellent quality. Compared to closed NHs, freedom of movement in semiopen and open NHs may have a positive influence on bodily functions, mental functions and perception, quality of life, and social and societal participation. The influence on daily functioning and on the existential dimension remains unclear.
Freedom of movement of NH residents with dementia is often studied as part of a larger context in which other factors may contribute to health benefits. More research is therefore needed to unravel the underlying mechanisms of the positive influence of freedom of movement on health.
为了保护患有痴呆症的居民免受伤害，养老院（NH）通常采取闭门政策。然而，目前的研究表明，行动自由（即独立从一个地方移动到另一个地方的权利）对患有痴呆症的 NH 居民的健康有积极影响。本系统评价旨在整理、总结和综合迄今为止发表的关于行动自由对患有痴呆症的 NH 居民健康影响的科学证据。
截至 2021 年 3 月，对多个数据库进行了搜索。纳入了同行评审的定性、定量和混合方法研究。健康使用积极健康框架来操作，包括 6 个维度：身体功能、心理功能和感知、存在维度、生活质量、社会和社会参与以及日常功能。使用混合方法评估工具评估纳入研究的质量。
纳入了 16 项质量较好或优秀的研究。与封闭式 NH 相比，半开放式和开放式 NH 中的行动自由可能对身体功能、心理功能和感知、生活质量以及社会和社会参与有积极影响。对日常生活功能和存在维度的影响尚不清楚。
患有痴呆症的 NH 居民的行动自由通常作为其他因素可能对健康有益的更大背景的一部分进行研究。因此，需要进行更多的研究来揭示行动自由对健康的积极影响的潜在机制。
