Davies-Abbott Ian, Daunt Joanne, Roberts Emma
University of Bradford, United Kingdom of Great Britain and Northern Ireland.
Cardiff and Vale University Health Board, University Hospital Llandough, United Kingdom of Great Britain and Northern Ireland.
Dementia (London). 2025 Feb;24(2):310-322. doi: 10.1177/14713012241274994. Epub 2024 Aug 16.
Stigmatising language concerning people living with dementia can cause potentially harmful and dehumanising consequences. Language used about people living with dementia in mental health wards may focus on medical perspectives and suggest custodial relationships with patients rather than person-centred accounts of individuals. This language could have a devastating impact on the provision of person-centred care. This study investigated the relationship between accounts of people living with dementia written in healthcare case notes and clinical practice at three dementia specialist wards in Wales, UK. Language guidance was provided to ward staff to assess whether stigmatising language could be reduced and whether this influenced the provision of person-centred care. Dementia Care Mapping was adapted to analyse case note entries for enhancing and detracting accounts of people living with dementia at three data collection points. These were compared to the results of routine DCM observations of care across the three wards. The healthcare case notes of 117 people living with dementia, encompassing 4, 522 entries over ten months were analysed. DCM observations of 38 people living with dementia within the three wards were compared against the case note results. Person-centred language guidance was shared with care staff following each data collection point. Following the provision of person-centered language guidance, the use of personally enhancing language was observed to increase across all three wards. Non-person-centred case note entries predominantly focussed on Labelling language, whilst language concerning Invalidation and Objectification also occurred frequently compared to other DCM domains. Person centred language typically concerned Acknowledgement. A relationship between case note entries and practice was evident in some domains although findings were inconsistent. The findings highlight the importance of addressing stigmatising language in healthcare and suggest that further studies to support the anti-stigma agenda in dementia care are required.
关于痴呆症患者的污名化语言可能会导致潜在的有害和非人性化后果。在精神科病房中使用的关于痴呆症患者的语言可能侧重于医学视角，并暗示与患者的监护关系，而不是以个人为中心对个体的描述。这种语言可能会对提供以个人为中心的护理产生毁灭性影响。本研究调查了英国威尔士三个痴呆症专科病房中医疗保健病例记录中关于痴呆症患者的描述与临床实践之间的关系。向病房工作人员提供了语言指导，以评估是否可以减少污名化语言，以及这是否会影响以个人为中心的护理的提供。对痴呆症护理映射进行了调整，以分析病例记录条目，以增强和减少在三个数据收集点对痴呆症患者的描述。将这些与三个病房常规痴呆症护理映射观察结果进行比较。分析了117名痴呆症患者的医疗保健病例记录，涵盖了十个月内的4522条记录。将三个病房中38名痴呆症患者的痴呆症护理映射观察结果与病例记录结果进行了比较。在每个数据收集点之后，与护理人员分享了以个人为中心的语言指导。在提供以个人为中心的语言指导之后，观察到所有三个病房中使用增强个人形象语言的情况都有所增加。非以个人为中心的病例记录条目主要集中在标签语言上，而与其他痴呆症护理映射领域相比，关于无效化和客观化的语言也经常出现。以个人为中心的语言通常涉及认可。尽管结果不一致，但在某些领域，病例记录条目与实践之间的关系是明显的。研究结果强调了解决医疗保健中污名化语言的重要性，并表明需要进一步开展研究以支持痴呆症护理中的反污名议程。
