Science of Care Institute, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M4M 2B5, Canada.
Ontario Shores Centre for Mental Health Science, Whitby, ON, L1N 5S9, Canada.
BMC Geriatr. 2024 Aug 17;24(1):690. doi: 10.1186/s12877-024-05250-4.
One way of standardizing practice and improving patient safety is by introducing clinical care pathways; however, such pathways are typically geared towards assisting clinicians and healthcare organizations with evidence-based practice. Many dementia care pathways exist with no agreed-upon version of a care pathway and with little data on experiences about their use or outcomes. The objectives of the review were: (1) to identify the dementia care pathway's purpose, methods used to deploy the pathway, and expected user types; (2) to identify the care pathway's core components, expected outcomes, and implications for persons with dementia and their care partners; and (3) determine the extent of involvement by persons with dementia and/or their care partners in developing, implementing, and evaluating the care pathways.
We systematically searched six literature databases for published literature in the English language in September 2023 utilizing Arskey and O'Malley's scoping review framework.
The findings from the dementia care pathways (n = 13) demonstrated assistance in dementia diagnostic and management practices for clinicians and offered structured care processes in clinical settings. For this reason, these pathways emphasized assessment and interventional post-diagnostic support, with less emphasis on community-based integrated dementia care.
Future dementia care pathway development can seek the involvement of persons with dementia and care partners in designing, implementing and evaluating such pathways, ensuring that outcome measures properly reflect the impact on persons with lived dementia experience and their care partners.
通过引入临床护理路径来规范实践和提高患者安全性是一种方法；然而，这些路径通常旨在帮助临床医生和医疗保健组织进行循证实践。有许多痴呆症护理路径，但没有一个被普遍认可的护理路径版本，而且关于其使用或结果的数据也很少。本次综述的目的是：（1）确定痴呆症护理路径的目的、部署路径所使用的方法以及预期的用户类型；（2）确定护理路径的核心组成部分、预期结果以及对痴呆症患者及其护理伙伴的影响；（3）确定痴呆症患者及其护理伙伴在制定、实施和评估护理路径方面的参与程度。
我们在 2023 年 9 月，利用 Arskey 和 O'Malley 的范围综述框架，系统地在六个英文文献数据库中搜索了已发表的文献。
痴呆症护理路径的研究结果（n=13）表明，这些路径为临床医生提供了痴呆症诊断和管理实践方面的帮助，并在临床环境中提供了结构化的护理流程。出于这个原因，这些路径强调了诊断后的评估和干预支持，而对社区为基础的综合痴呆症护理的重视较少。
未来的痴呆症护理路径发展可以寻求痴呆症患者和护理伙伴参与设计、实施和评估这些路径，以确保评估指标能正确反映对有实际痴呆症经历的患者及其护理伙伴的影响。
