Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Australia.
Department of Aged Health, Chronic Care and Rehabilitation, Concord Hospital, Sydney, Australia.
J Alzheimers Dis. 2024;98(2):619-628. doi: 10.3233/JAD-231056.
Person-centered care is considered beneficial for persons with dementia.
To evaluate the impact of a person-centered knowledge translation intervention on the quality of healthcare and outcomes for persons with dementia.
Over nine months, sub-acute hospital nursing, allied health, and medical staff (n = 90) participated in online and/or face-to-face person-centered education and were supported by senior nursing, allied health, and medical staff champions (n = 8) to implement person-centered healthcare. The quality of healthcare service, ward climate and care delivery were evaluated pre/post study intervention. In the week following hospital admission (Time 1) and week of discharge (Time 3), agitation incidence (co-primary outcome) was assessed in participants with dementia (n = 80). Participant delirium (co-primary outcome), accidents/injuries, psychotropic medicines, length of stay, readmission and discharge destination (secondary outcomes) were compared with a retrospective group (n = 77) matched on demographics, cognition and function in activities of daily living.
Improvements occurred post-intervention in service quality by 17.5% (p = 0.369, phi = 0.08), ward climate by 18.1% (p = 0.291, phi = 0.08), and care quality by 50% (p = 0.000, phi = 0.37). Participant agitation did not change from Time 1 to Time 3 (p = 0.223). Relative to the retrospective group, significant reductions occurred in participant delirium (p = 0.000, phi = 0.73), incidents/injuries (p = 0.000, phi = 0.99), psychotropic medicine use (p = 0.030, phi = 0.09), and hospital readmissions within 30 days (p = 0.002, phi = 0.25), but not in discharge to home (p = 0.171).
When person-centered healthcare knowledge is translated through staff education and practice support, persons with dementia can experience improved healthcare services and clinical outcomes, while healthcare services can benefit through reductions in unplanned service use.
以患者为中心的护理被认为对痴呆患者有益。
评估以患者为中心的知识转化干预对痴呆患者的医疗保健质量和结局的影响。
在九个月的时间里，亚急性医院护理、联合健康和医务人员（n=90）参加了在线和/或面对面的以患者为中心的教育，并得到了高级护理、联合健康和医务人员（n=8）的支持，以实施以患者为中心的医疗保健。在研究干预前后评估了医疗服务质量、病房氛围和护理提供情况。在入院后的一周（时间 1）和出院的一周（时间 3），评估了患有痴呆症的参与者（n=80）的激越发生率（共同主要结局）。与在人口统计学、认知和日常生活活动功能上相匹配的回顾性组（n=77）相比，参与者的谵妄（共同主要结局）、意外/伤害、精神药物、住院时间、再入院和出院去向（次要结局）进行了比较。
干预后，服务质量提高了 17.5%（p=0.369，phi=0.08），病房氛围提高了 18.1%（p=0.291，phi=0.08），护理质量提高了 50%（p=0.000，phi=0.37）。参与者的激越情绪从时间 1 到时间 3 没有变化（p=0.223）。与回顾性组相比，参与者的谵妄（p=0.000，phi=0.73）、意外/伤害（p=0.000，phi=0.99）、精神药物使用（p=0.030，phi=0.09）和 30 天内再次住院（p=0.002，phi=0.25）显著减少，但出院回家（p=0.171）没有减少。
当通过员工教育和实践支持转化以患者为中心的医疗保健知识时，痴呆患者可以体验到更好的医疗保健服务和临床结局，而医疗保健服务可以通过减少计划外服务的使用而受益。
