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长期护理机构中痴呆症护理的障碍和促进因素:定性系统评价和荟萃综合的方案。

Barriers and facilitators to dementia care in long-term care facilities: protocol for a qualitative systematic review and meta-synthesis.

机构信息

Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

School of Nursing, The Open University of Shaanxi, Xi'an, Shaanxi, China.

出版信息

BMJ Open. 2023 Nov 1;13(11):e076058. doi: 10.1136/bmjopen-2023-076058.


DOI:10.1136/bmjopen-2023-076058
PMID:37914310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10626821/
Abstract

INTRODUCTION: Long-term care needs for people with dementia are predicted to increase due to increased life expectancy and dementia diagnoses. Most published meta- syntheses of dementia care focus on hospitals or home settings. When focusing on long-term care facilities, most reviews about dementia care only focus on a single outcome, such as feeding, behavioural symptoms management, palliative care and others, which is limited. The present study aims to synthesise qualitative data and examine barriers and facilitators to caring for people with dementia in long-term care facilities. METHODS AND ANALYSIS: This is the protocol for our systematic review and meta-synthesis, which describes the design of this study, and we plan to complete the study from October 2023 to November 2024. The systematic review and meta-synthesis will follow the Joanna Briggs Institute (JBI) guidance for systematic reviews of qualitative evidence. Nine databases (five English and four Chinese) were searched, including Embase, Web of Science, Medline, CINAHL, PsycINFO and Wan Fang Data, China National Knowledge Infrastructure, VIP and Chinese Biomedical Medicine, from inception to August 2023. Qualitative and mixed-approach research about barriers and facilitators to caring for people with dementia in long-term care facilities, which are reported in English or Chinese, will be included. Covidence software will help with study selection, assessment and data extraction. The JBI Critical Appraisal Checklist for Qualitative Research (2020) will be used for included studies' quality assessment. Data extraction will be based on the JBI Qualitative Assessment and Review Instrument Data Extraction Tool for Qualitative Research. The JBI aggregation approach will be used to synthesise data. We will use the JBI ConQual tool to assess the credibility and dependability of each synthesised finding to establish confidence in the synthesised findings. All review steps will be managed by two reviewers independently, and disparities will be discussed. If consensus cannot reach a resolution, a third reviewer will be consulted. ETHICS AND DISSEMINATION: The present study is a secondary analysis of published qualitative data. So ethical approval is not required. The findings may be disseminated through peer-reviewed publications, conference papers or elsewhere. PROSPERO REGISTRATION NUMBER: The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in May 2022, and the registration number is CRD42022326178.

摘要

介绍:由于预期寿命的延长和痴呆症的诊断,患有痴呆症的人的长期护理需求预计将会增加。大多数关于痴呆症护理的已发表的元综合研究都集中在医院或家庭环境上。当专注于长期护理机构时,大多数关于痴呆症护理的综述仅关注单一的结果,如喂养、行为症状管理、姑息治疗等,这是有限的。本研究旨在综合定性数据,并研究长期护理机构中照顾痴呆症患者的障碍和促进因素。

方法和分析:这是我们的系统综述和元综合的方案,描述了本研究的设计,我们计划从 2023 年 10 月至 2024 年 11 月完成这项研究。系统综述和元综合将遵循乔安娜·布里格斯研究所(JBI)关于定性证据系统综述的指南。从成立到 2023 年 8 月,我们将在 9 个数据库(5 个英文数据库和 4 个中文数据库)中进行搜索,包括 Embase、Web of Science、Medline、CINAHL、PsycINFO 和万方数据、中国知网、维普和中国生物医学文献数据库。纳入研究将包括用英文或中文报告的关于长期护理机构中照顾痴呆症患者的障碍和促进因素的定性和混合方法研究。将使用 JBI 定性研究的批判性评价检查表(2020 年)对纳入研究进行质量评价。数据提取将基于 JBI 定性评估和审查工具定性研究数据提取工具。将使用 JBI 综合方法来综合数据。我们将使用 JBI ConQual 工具来评估每个综合发现的可信度和可靠性,以建立对综合发现的信心。所有的综述步骤都将由两位评审员独立进行管理,如果存在分歧,将进行讨论。如果无法达成共识,将咨询第三位评审员。

伦理和传播:本研究是对已发表的定性数据的二次分析,因此不需要伦理批准。研究结果可能会通过同行评议的出版物、会议论文或其他途径传播。

PROSPERO 注册号:该方案于 2022 年 5 月在国际前瞻性系统评价登记册(PROSPERO)中注册,注册号为 CRD42022326178。

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引用本文的文献

[1]
Decline in activities of daily living in the rarer dementias.

Gen Psychiatr. 2025-6-8

[2]
A qualitative study on the subjective experience of prolonged care among family members of patients with moderate to severe dementia.

BMC Palliat Care. 2025-4-29

本文引用的文献

[1]
Prevalence of Malnutrition in People with Dementia in Long-Term Care: A Systematic Review and Meta-Analysis.

Nutrients. 2023-6-28

[2]
The positive aspects of caregiving in dementia: A scoping review and bibliometric analysis.

Front Public Health. 2022

[3]
Prevalence and Factors Associated with Pain in Nursing Home Residents: A Systematic Review of the Literature.

J Am Med Dir Assoc. 2022-12

[4]
Strategies used by care home staff to manage behaviour that challenges in dementia: A systematic review of qualitative studies.

Int J Nurs Stud. 2022-9

[5]
How to implement person-centred care and support for dementia in outpatient and home/community settings: Scoping review.

BMC Health Serv Res. 2022-4-22

[6]
Optimizing mealtime care for people with dementia from the perspective of formal caregivers: A systematic review of qualitative research.

Int J Nurs Stud. 2021-11

[7]
Towards a middle-range theory of 'Stability of home-based care arrangements for people living with dementia' (SoCA-Dem): findings from a meta-study on mixed research.

BMJ Open. 2021-4-14

[8]
Nursing home staff's perceptions of barriers and needs in implementing person-centred care for people living with dementia: A qualitative study.

J Clin Nurs. 2022-7

[9]
Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study.

Lancet Public Health. 2020-12

[10]
Understanding dementia care in care home setting in China: An exploratory qualitative study.

Health Soc Care Community. 2021-9

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