Rory Meyers College of Nursing, New York University, New York, NY, USA.
Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA.
J Am Med Dir Assoc. 2022 Dec;23(12):2030.e1-2030.e8. doi: 10.1016/j.jamda.2022.07.025. Epub 2022 Sep 2.
To understand dementia care providers' perspectives on high-quality care for persons living with dementia (PLWD) in long-term care (LTC).
A qualitative study using a directed content analysis approach.
Nine national LTC dementia care providers.
We facilitated 5 listening sessions centered around dementia care philosophies, models, and practices. Two researchers first mapped qualitative data to the Holistic Approach to Transformational Change (HATCh) model for dementia care using a directed content analysis approach. They then identified themes and subthemes emerging from the data using a conventional analysis approach. They coded data iteratively and solicited input from 3 additional researchers to reach consensus where needed. Member checks were performed to ensure the trustworthiness of the data during 2 follow-up listening sessions.
The 9 participants described the importance of understanding the experiences of PLWDs in order to provide high-quality dementia care and to deliver such care with the residents and their preferences as the focus. They emphasized experiential education as essential for families and all staff, regardless of role. They noted the need to balance safety with resident choice, as well as the corresponding need for facility leadership and regulators to support such choices. The listening sessions revealed areas to foster person-centered care for PLWD, but also highlighted barriers to implementing this philosophy in LTC settings.
Emergent themes included care practices that center on resident preferences and are supported by staff with the experiential education and communication skills necessary to relate to and support PLWD. These findings provide contextual information for researchers seeking to identify and test interventions that reflect LTC providers' priorities for PLWD and emphasize the need to align research priorities with provider priorities.
了解长期护理（LTC）中痴呆症照护者对痴呆症患者（PLWD）高质量照护的看法。
采用有导向内容分析方法的定性研究。
9 名全国 LTC 痴呆症照护提供者。
我们围绕痴呆症照护理念、模式和实践，组织了 5 次聆听会议。两名研究人员首先使用有导向内容分析方法，将定性数据映射到痴呆症照护的整体方法转化变革（HATCh）模型。然后，他们使用常规分析方法，从数据中确定主题和子主题。他们迭代地对数据进行编码，并在需要时征求 3 名额外研究人员的意见以达成共识。在 2 次后续聆听会议中，进行了成员检查以确保数据的可信度。
9 名参与者描述了理解 PLWD 体验的重要性，以便提供高质量的痴呆症照护，并将这种照护以居民及其偏好为中心。他们强调体验式教育对家庭和所有员工的重要性，无论其角色如何。他们指出需要在安全性和居民选择之间取得平衡，同时也需要设施领导和监管机构支持这些选择。聆听会议揭示了促进 PLWD 以人为主的照护的领域，但也突出了在 LTC 环境中实施这一理念的障碍。
出现的主题包括以居民偏好为中心的照护实践，并得到具有相关体验式教育和沟通技能的员工的支持，这些技能对于与 PLWD 建立联系和提供支持是必要的。这些发现为研究人员提供了背景信息，他们希望确定和测试反映 LTC 提供者对 PLWD 优先事项的干预措施，并强调需要使研究重点与提供者的优先事项保持一致。
