为家庭护理人员制定一份关于患有痴呆症的养老院居民病情进展和姑息治疗需求的问题提示清单。
Developing a question prompt list for family caregivers concerning the progression and palliative care needs of nursing home residents living with dementia.
作者信息
Thompson Genevieve N, Hack Thomas F, Chochinov Harvey Max, Roger Kerstin, St John Philip D, McClement Susan E
机构信息
College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, Manitoba R3T 2N2, Canada.
Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, PZ433-771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada.
出版信息
PEC Innov. 2023 May 3;2:100160. doi: 10.1016/j.pecinn.2023.100160. eCollection 2023 Dec.
OBJECTIVE
Communication around a palliative approach to dementia care often is problematic or occurs infrequently in nursing homes (NH). Question prompt lists (QPLs), are evidence-based lists designed to improve communication by facilitating discussions within a specific population. This study aimed to develop a QPL concerning the progression and palliative care needs of residents living with dementia.
METHODS
A mixed-methods design in 2 phases. In phase 1, potential questions for inclusion in the QPL were identified using interviews with NH care providers, palliative care clinicians and family caregivers. An international group of experts reviewed the QPL. In phase 2, NH care providers and family caregivers reviewed the QPL assessing the clarity, sensitivity, importance, and relevance of each item.
RESULTS
From 127 initial questions, 30 questions were included in the first draft of the QPL. After review by experts, including family caregivers, the QPL was finalized with 38 questions covering eight content areas.
CONCLUSION
Our study has developed a QPL for persons living with dementia in NHs and their caregivers to initiate conversations to clarify questions they may have regarding the progression of dementia, end of life care, and the NH environment. Further work is needed to evaluate its effectiveness and determine optimal use in clinical practice.
INNOVATION
This unique QPL is anticipated to facilitate discussions around dementia care, including self-care for family caregivers.
目的
在养老院（NH）中，围绕痴呆症姑息治疗方法的沟通往往存在问题或很少发生。问题提示清单（QPLs）是基于证据的清单，旨在通过促进特定人群内部的讨论来改善沟通。本研究旨在制定一份关于痴呆症患者病情进展和姑息治疗需求的QPL。
方法
采用两阶段的混合方法设计。在第一阶段，通过对NH护理人员、姑息治疗临床医生和家庭护理人员进行访谈，确定可能纳入QPL的问题。一个国际专家小组对QPL进行了审查。在第二阶段，NH护理人员和家庭护理人员对QPL进行了审查，评估了每个项目的清晰度、敏感性、重要性和相关性。
结果
从127个初始问题中，30个问题被纳入QPL的初稿。在包括家庭护理人员在内的专家审查后，QPL最终确定为38个问题，涵盖八个内容领域。
结论
我们的研究为NH中的痴呆症患者及其护理人员制定了一份QPL，以发起对话，澄清他们可能对痴呆症进展、临终护理和NH环境存在的疑问。需要进一步开展工作来评估其有效性，并确定在临床实践中的最佳使用方式。
创新
这份独特的QPL预计将促进围绕痴呆症护理的讨论，包括家庭护理人员的自我护理。
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