Public Health and Sports Science, University of Exeter, Exeter, UK
Department of Medical Imaging, University of Exeter Medical School, Exeter, UK.
BMJ Open. 2023 Jul 31;13(7):e072432. doi: 10.1136/bmjopen-2023-072432.
The aim of this study was to explore healthcare professionals' principles for providing and delivering rehabilitation interventions for people with advanced dementia.
This was a qualitative study with three focus groups undertaken virtually. The data were analysed using a process of reflexive thematic analysis in order to gain an in-depth understanding of rehabilitation principles for this population.
20 healthcare professionals who were specialists in treating and rehabilitating people with advanced dementia were recruited. These healthcare professionals had a wide range of experience in a variety of different settings including primary care, secondary care as well as specialist mental health teams. Purposive sampling focused on the requirement for participants to have significant experience of treating people with dementia. Participants were from the UK and Denmark. Data collection was undertaken during August and September 2022.
Three overarching themes were developed following analysis-organisational culture, knowledge and personal values of the healthcare professional. The first explored how the culture of an organisation affects a person with advanced dementia as well as the healthcare professional. The organisation needed to promote positive approaches to person-centred care and provide effective situational leadership to embed such approaches. Knowledge was a key consideration and was closely linked to the personal values of the healthcare professional, which formed the final theme. This study suggests that the interrelationship of these three factors influences the outcomes for the person with dementia and effective outcomes required consideration of all domains.
Effective interventions for people with advanced dementia require the healthcare professional to have the knowledge about dementia and positive personal values, but the culture of the organisation is also key to ensure that the healthcare professional is able to deliver successful interventions.
本研究旨在探讨医疗保健专业人员为晚期痴呆症患者提供和实施康复干预的原则。
这是一项定性研究,采用虚拟方式进行了三个焦点小组。通过反思性主题分析过程分析数据,以深入了解这一人群的康复原则。
招募了 20 名专门治疗和康复晚期痴呆症患者的医疗保健专业人员。这些医疗保健专业人员在包括初级保健、二级保健以及专门的心理健康团队在内的各种不同环境中拥有广泛的经验。有目的地抽样重点是要求参与者有治疗痴呆症患者的丰富经验。参与者来自英国和丹麦。数据收集于 2022 年 8 月和 9 月进行。
分析后得出了三个总体主题——组织文化、医疗保健专业人员的知识和个人价值观。第一个主题探讨了组织文化如何影响晚期痴呆症患者以及医疗保健专业人员。组织需要提倡积极的以患者为中心的护理方法,并提供有效的情境领导,以嵌入这种方法。知识是一个关键考虑因素,与医疗保健专业人员的个人价值观密切相关,这构成了最后一个主题。本研究表明,这三个因素的相互关系影响了痴呆症患者的结果,而有效的结果需要考虑所有领域。
有效的晚期痴呆症干预措施需要医疗保健专业人员具备有关痴呆症的知识和积极的个人价值观,但组织文化也是确保医疗保健专业人员能够成功实施干预措施的关键。