Community and Primary Care Research Group, University of Plymouth, Plymouth, UK.
Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK.
Dementia (London). 2023 Oct;22(7):1461-1486. doi: 10.1177/14713012231185281. Epub 2023 Jun 24.
Practitioner understanding of patients' preferences, wishes and needs is essential for personalised health care i.e., focusing on 'what matters' to people based on their individual life situation. To develop such an understanding, dementia practitioners need to use communication practices that help people share their experiences, preferences, and priorities. Following the COVID-19 pandemic, dementia support is likely to continue to be delivered both remotely and in-person. This study analysed multiple sources of qualitative data to examine the views of practitioners, people living with dementia and carers, and researchers on how an understanding of what matters to people living with dementia can be developed remotely via telephone and video call. Access to environmental stimuli, the remote use of visual tools, peoples' tendency to downplay or omit details about their troubles and carers' ability to disclose privately were interpreted, through thematic analysis, to be factors affecting how practitioners sought to develop understanding remotely. Cumulatively, findings show that while remote support created unique challenges to practitioners' ability to develop understanding for personalised care, practitioners developed adaptive strategies to overcome some of these challenges. Further research should examine how, when and for whom these adapted practices for remote personalised care work, informing the development of evidence-based guidance and training on how practitioners can remotely develop the understanding required for personalised care.
从业者对患者偏好、意愿和需求的理解对于个性化医疗至关重要,即根据个人生活情况关注“对人们重要的事情”。为了培养这种理解,痴呆症从业者需要使用有助于人们分享经验、偏好和优先事项的沟通实践。在 COVID-19 大流行之后,痴呆症支持可能继续通过远程和面对面的方式提供。本研究分析了多种定性数据来源,以探讨从业者、与痴呆症患者生活在一起的人和护理人员以及研究人员的观点,即如何通过电话和视频电话远程了解对与痴呆症患者重要的事情。通过主题分析,对环境刺激的获取、远程使用视觉工具、人们倾向于淡化或省略其烦恼的细节以及护理人员披露隐私的能力进行了解释,这些因素影响了从业者远程寻求理解的方式。总之,研究结果表明,尽管远程支持给从业者为个性化护理培养理解的能力带来了独特的挑战,但从业者制定了适应性策略来克服其中的一些挑战。进一步的研究应探讨这些远程个性化护理的适应性实践在何时以及对哪些人有效,为从业者如何远程发展个性化护理所需的理解提供循证指导和培训。