Bergmann Johannes Michael, Hoffmann Anna Louisa, Müller-Widmer René, Palm Rebecca
Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) e.V., Witten, North Rhine-Westphalia, Germany.
Witten/Herdecke University, Faculty of Health, School of Nursing Science, Witten, North Rhine-Westphalia, Germany.
Innov Aging. 2023 Jun 23;7(6):igad062. doi: 10.1093/geroni/igad062. eCollection 2023.
Dementia-specific care units vary in their organizational characteristics and are difficult to compare in empirical studies. Based on a representative sample of care units in German nursing homes, we present a typology of organizational characteristics focusing on dementia-specific care structures. We also examine the relationships between organizational types and the provision of nonpharmacological interventions for people with dementia.
Data were collected in a Germany-wide survey of a stratified randomized sample of 134 care units using a standardized questionnaire administered during telephone interviews with nursing home administrators or their representatives. The typology was developed based on a factor analysis of mixed data and a hierarchical cluster analysis.
We identified 4 types of care units: Dementia Care Units (DCUs; = 40), Dementia Special Care Units (DSCUs; = 17), Usual Separated Care Units ( = 58), and Usual Incorporated Care Units ( = 19). All care unit types clearly differed in their organizational characteristics. The specialization of DSCUs was agreed upon with cost bearers and included admission criteria, higher costs, and better staff conditions. Dementia Care Units without specialization did not have these characteristics. Three of seven nonpharmacological interventions were associated with the DSCUs and two with DCUs, but not with the other care unit types.
Researchers can use the typology to define and describe care units in empirical studies and improve the understanding and comparability of the context. A clear definition of care units also improves international comparisons.
针对痴呆症的护理单元在组织特征方面存在差异,在实证研究中难以进行比较。基于德国养老院护理单元的代表性样本,我们提出了一种侧重于痴呆症特定护理结构的组织特征类型学。我们还研究了组织类型与为痴呆症患者提供非药物干预措施之间的关系。
通过对134个护理单元的分层随机样本进行全德范围内的调查来收集数据,使用在与养老院管理人员或其代表进行电话访谈时发放的标准化问卷。该类型学是基于对混合数据的因子分析和层次聚类分析而制定的。
我们确定了4种护理单元类型:痴呆症护理单元(DCUs;n = 40)、痴呆症特殊护理单元(DSCUs;n = 17)、常规隔离护理单元(n = 58)和常规合并护理单元(n = 19)。所有护理单元类型在组织特征上明显不同。DSCUs的专业化得到了费用承担方的认可,包括入院标准、更高的费用和更好的员工条件。没有专业化的痴呆症护理单元则没有这些特征。七种非药物干预措施中的三种与DSCUs相关,两种与DCUs相关,但与其他护理单元类型无关。
研究人员可以使用该类型学在实证研究中定义和描述护理单元,并提高对背景的理解和可比性。护理单元的明确定义也有助于国际比较。