Yous Marie-Lee, Boamah Sheila A, Hunter Paulette V, Coker Esther, Hadjistavropoulos Thomas, Sussman Tamara, Kaasalainen Sharon
School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Palliat Care Soc Pract. 2023 Apr 1;17:26323524231165319. doi: 10.1177/26323524231165319. eCollection 2023.
Meaningful engagement has been described as active participation based on a person's interests, preferences, personhood, or perceived value. It has many benefits for persons living with dementia in long-term care (LTC) homes, including improvement in physical and cognitive function, and mental health. People with advanced dementia continue to need and benefit from inclusion and social contact in LTC, yet there is not a well-developed understanding of how to support this. A tailored intervention called Namaste Care has been shown to be an effective approach to meaningfully engage residents in LTC, decrease behavioral symptoms, and improve their comfort and quality of life. There is a need to consider how best to deliver this intervention.
The aim of this study was to describe environmental, social, and sensory factors influencing meaningful engagement of persons with advanced dementia during Namaste Care implementation in LTC.
In this qualitative descriptive study, focus groups and interviews were conducted with families, volunteers, staff, and managers at two LTC homes. Directed content analysis was conducted. The Comprehensive Process Model of Engagement was used as a coding framework.
With respect to environmental attributes, participants emphasized that a designated quiet space and a small group format were helpful for engagement. In terms of social attributes, participants emphasized Namaste Care staff capacity to deliver individualized care. Regarding sensorial factors, familiarity with the activities delivered in the program was emphasized.
Findings reveal the need to offer small group programs that include adapted recreational and stimulating activities, such as Namaste Care, for residents at the end of life in LTC. Such programs facilitate meaningful engagement for persons with dementia as they focus on individual preferences, comfort, and inclusion while recognizing changing needs and abilities of residents.
有意义的参与被描述为基于个人兴趣、偏好、人格或感知价值的积极参与。对于长期护理（LTC）机构中的痴呆症患者而言，它有诸多益处，包括改善身体和认知功能以及心理健康。晚期痴呆症患者在长期护理机构中仍然需要并受益于融入和社交接触，但对于如何提供这种支持，目前尚未形成完善的理解。一种名为“合十礼护理”的量身定制干预措施已被证明是让长期护理机构居民进行有意义参与、减少行为症状并改善他们舒适度和生活质量的有效方法。有必要考虑如何以最佳方式实施这种干预措施。
本研究的目的是描述在长期护理机构实施合十礼护理期间影响晚期痴呆症患者进行有意义参与的环境、社会和感官因素。
在这项定性描述性研究中，对两家长期护理机构的家属、志愿者、工作人员和管理人员进行了焦点小组讨论和访谈。进行了定向内容分析。参与的综合过程模型被用作编码框架。
关于环境属性，参与者强调指定的安静空间和小组形式有助于参与。在社会属性方面，参与者强调合十礼护理工作人员提供个性化护理的能力。关于感官因素，强调了对该项目中开展活动的熟悉程度。
研究结果表明，有必要为长期护理机构中处于生命末期的居民提供包括适应性娱乐和刺激性活动（如合十礼护理）在内的小组项目。此类项目有助于痴呆症患者进行有意义的参与，因为它们关注个人偏好、舒适度和融入感，同时认识到居民不断变化的需求和能力。
