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为医院中的痴呆症患者提供关怀的新视野:服务变革的痴呆症护理要点。

New horizons for caring for people with dementia in hospital: the DEMENTIA CARE pointers for service change.

机构信息

Evidence Synthesis Team, NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, College of Medicine and Health, St Luke's Campus, University of Exeter, Exeter EX1 2LU, UK.

Mental Health Research Group, University of Exeter Medical School, St Luke's Campus, University of Exeter, Exeter EX1 2LU, UK.

出版信息

Age Ageing. 2022 Sep 2;51(9). doi: 10.1093/ageing/afac190.

Abstract

Approximately two-thirds of hospital admissions are older adults and almost half of these are likely to have some form of dementia. People with dementia are not only at an increased risk of adverse outcomes once admitted, but the unfamiliar environment and routinised practices of the wards and acute care can be particularly challenging for them, heightening their confusion, agitation and distress further impacting the ability to optimise their care. It is well established that a person-centred care approach helps alleviate some of the unfamiliar stress but how to embed this in the acute-care setting remains a challenge. In this article, we highlight the challenges that have been recognised in this area and put forward a set of evidence-based 'pointers for service change' to help organisations in the delivery of person-centred care. The DEMENTIA CARE pointers cover areas of: dementia awareness and understanding, education and training, modelling of person-centred care by clinical leaders, adapting the environment, teamwork (not being alone), taking the time to 'get to know', information sharing, access to necessary resources, communication, involving family (ask family), raising the profile of dementia care, and engaging volunteers. The pointers extend previous guidance, by recognising the importance of ward cultures that prioritise dementia care and institutional support that actively seeks to raise the profile of dementia care. The pointers provide a range of simple to more complex actions or areas for hospitals to help implement person-centred care approaches; however, embedding them within the organisational cultures of hospitals is the next challenge.

摘要

大约三分之二的住院患者是老年人,其中近一半可能患有某种形式的痴呆症。患有痴呆症的人不仅在入院后出现不良后果的风险增加,而且病房和急性护理的陌生环境和例行程序对他们来说特别具有挑战性,进一步加剧了他们的困惑、激动和痛苦,从而进一步影响了优化他们的护理的能力。众所周知,以人为本的护理方法有助于减轻一些陌生的压力,但如何将其融入急性护理环境仍然是一个挑战。在本文中,我们强调了在这一领域已经认识到的挑战,并提出了一系列基于证据的“服务变革要点”,以帮助组织提供以人为本的护理。痴呆症护理要点涵盖以下领域:痴呆症意识和理解、教育和培训、临床领导者的以人为本护理模式、环境适应、团队合作(不孤单)、花时间“了解”、信息共享、获得必要资源、沟通、让家人参与(询问家人)、提高痴呆症护理的知名度以及让志愿者参与。这些要点扩展了之前的指导,认识到优先考虑痴呆症护理的病房文化和积极寻求提高痴呆症护理知名度的机构支持的重要性。这些要点为医院提供了一系列简单到更复杂的行动或领域,以帮助实施以人为本的护理方法;然而,将它们嵌入医院的组织文化中是下一个挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a15/9441201/92a418d72753/afac190f1.jpg

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