Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany.
Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
BMC Geriatr. 2023 Oct 19;23(1):678. doi: 10.1186/s12877-023-04312-3.
To become a dementia-friendly hospital (DFH) is increasingly being discussed in health care practice, research, politics and society. In our previous integrative review, we identified six characteristics of DFHs. To thoroughly discuss and contextualize these characteristics in relation to hospitals in Germany, we involved professional dementia experts in our review process.
At the end of our review process, we involved professional dementia experts at the 'contributing' level of the ACTIVE framework to discuss and reflect on the six DFH characteristics we identified. We conducted a group process in the form of a one-day workshop. The workshop consisted of four steps: 1. presentation of review results (input), 2. modification of DFH characteristics and rating of their relevance in smaller working groups, 3. discussion of group results in plenary and 4. questionnaire for prioritization and rating of feasibility. The data were analyzed in MAXQDA using content analysis and descriptive statistics.
A total of 16 professional dementia experts working in hospitals participated in the workshop. All the previously identified characteristics of a DFH were rated as relevant or very relevant for patients with dementia, their relatives and health care professionals from the professional dementia experts' perspective. They made a few modifications of the six characteristics at the level of subcategories, aspects, and descriptions. The feasibility of the characteristics in hospitals was critically discussed regarding resources, hospital structures and processes, the role of nurses, and the current care situation of people with dementia in hospitals. More than half of the subcategories of the characteristics were considered very difficult or difficult to implement by most professional dementia experts.
The involvement of professional dementia experts helped us contextualize our review findings within the German hospital setting. These results highlight the need to consider resources, funding options, influencing factors, and the current situation and culture of care provided by hospitals before implementing DFH characteristics. Beside the involvement of professional dementia experts and various health care professionals, the involvement of other stakeholders, such as people with dementia and their relatives, is necessary in future research for the development of a DFH.
在医疗保健实践、研究、政治和社会中,越来越多地讨论成为一个对痴呆症友好的医院(DFH)。在我们之前的综合评价中,我们确定了 DFH 的六个特征。为了彻底讨论并将这些特征与德国的医院联系起来,我们在评价过程中邀请了专业的痴呆症专家。
在评价过程结束时,我们邀请了 ACTIVE 框架中具有“贡献”水平的专业痴呆症专家,以讨论和反思我们确定的六个 DFH 特征。我们以为期一天的研讨会的形式进行了小组讨论。研讨会由四个步骤组成:1. 介绍评价结果(输入),2. 修改 DFH 特征并在较小的工作组中对其相关性进行评分,3. 在全体会议上讨论小组结果,4. 进行优先排序和可行性评分的问卷调查。使用 MAXQDA 对数据进行内容分析和描述性统计分析。
共有 16 名在医院工作的专业痴呆症专家参加了研讨会。所有之前确定的 DFH 特征都被认为与痴呆症患者、他们的亲属以及专业痴呆症专家从专业角度来看的医疗保健专业人员相关或非常相关。他们在子类别、方面和描述方面对六个特征进行了一些修改。专家们就特征在医院中的可行性进行了激烈讨论,涉及资源、医院结构和流程、护士的角色以及医院中痴呆症患者的当前护理情况。大多数专业痴呆症专家认为,这些特征的子类别中有一半以上非常困难或难以实施。
专业痴呆症专家的参与帮助我们将评价结果置于德国医院环境中进行了背景化。这些结果强调了在实施 DFH 特征之前,需要考虑资源、资金选择、影响因素以及医院提供的当前护理情况和文化。除了专业痴呆症专家和各种医疗保健专业人员的参与外,在未来的研究中,还需要其他利益相关者的参与,例如痴呆症患者及其亲属,以制定 DFH。