School of Nursing and Midwifery & Centre for Evidence and Social Innovation, Queen's University, Belfast, Northern Ireland.
Institute of Nursing and Health Research, Ulster University, Shore Road, Newtownabbey, Northern Ireland.
Palliat Med. 2022 Oct;36(9):1351-1363. doi: 10.1177/02692163221116763. Epub 2022 Sep 5.
People with dementia and their caregivers often lack equitable access to hospice care which is a concern internationally. Domains of best practice in palliative care for this population exist and hospices are urged to become dementia friendly.
This study aimed to evaluate the model of 'Hospice Enabled Dementia Partnership' mapped to international domains of best practice.
Three-phased monitoring, group interview and individual interview study using a formative evaluation framework.
The partnership model was a collaboration between a large specialist palliative care hospice, a dementia charity and a Health Care Trust in the United Kingdom. Service documents were subjected to documentary review of monitoring activity and key indicators of service success. Group interviews and individual interviews took place with family carers ( = 12), health care professionals involved in delivering the service ( = 32) and senior professionals ( = 5) responsible for service commissioning in palliative or dementia care.
One hundred people with dementia were referred to the service between May 2016 and December 2017. Thirty-eight of the 42 people who died, achieved their preferred place of care and died at home. Four themes were derived from the data 'Impact of Dementia', 'Value of the Service', 'Information and Learning Needs' and 'Working in Partnership'.
Positive outcomes resulted from this best practice model; achievement of preferred place of care and death at home, dual benefits of therapies for patients and families and partnership in cross working and learning between services. Replication of this model should be considered internationally.
痴呆症患者及其照顾者通常无法公平地获得临终关怀,这是一个国际关注的问题。为这一人群提供姑息治疗的最佳实践领域存在,并且敦促临终关怀机构对痴呆症友好。
本研究旨在评估“临终关怀支持痴呆症伙伴关系”模式与国际最佳实践领域的匹配情况。
使用形成性评价框架进行三阶段监测、小组访谈和个人访谈研究。
设置/参与者:该伙伴关系模式是一家大型专业姑息治疗临终关怀机构、一家痴呆症慈善机构和英国一家医疗保健信托基金之间的合作。对服务文件进行了监测活动和服务成功关键指标的文献回顾。对家庭照顾者( = 12)、参与提供服务的医疗保健专业人员( = 32)和负责姑息或痴呆症护理服务委托的高级专业人员( = 5)进行了小组访谈和个人访谈。
2016 年 5 月至 2017 年 12 月期间,向该服务转介了 100 名痴呆症患者。在 42 名死亡的人中,有 38 人实现了他们首选的护理地点,并在家中去世。从数据中得出了四个主题:“痴呆症的影响”、“服务的价值”、“信息和学习需求”以及“合作”。
该最佳实践模型产生了积极的结果;实现了首选的护理地点和在家中死亡,为患者和家庭带来了治疗的双重益处,以及在跨服务的合作和学习方面的合作。应在国际上考虑复制这种模式。