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描述德国养老院不同类型护理单元中以患者为中心的痴呆症护理现状:一项聚合性混合方法研究。

Describing the status quo of person-centred dementia care in different types of care units in German nursing homes: A convergent mixed methods study.

作者信息

Hoffmann-Hoffrichter Anna Louisa, Rommerskirch-Manietta Mike, Bergmann Johannes Michael, Roes Martina, Holle Bernhard, Palm Rebecca

机构信息

German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany.

Witten/ Herdecke University (UW/H), Faculty of Health, Department of Nursing Science, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany.

出版信息

Int J Nurs Stud Adv. 2024 Aug 10;7:100233. doi: 10.1016/j.ijnsa.2024.100233. eCollection 2024 Dec.

Abstract

BACKGROUND

The policies and mission statements of nursing homes support the implementation of person-centred dementia care. The Dementia Policy Questionnaire assesses the content of person-centred dementia care in policies. To date, it is unknown whether these policies exist exclusively in dementia care units and whether the policies are consistent with the mission statements of nursing homes.

OBJECTIVE

We aimed to (1) investigate nursing home care unit types regarding the existence of policies measured by the Dementia Policy Questionnaire, (2) explore whether these policies are addressed in the mission statements of the nursing homes, and (3) integrate both results.

DESIGN

This is a convergent mixed methods study performed with a quantitative and qualitative dataset that was collected in the BeStaDem survey (2020).

SETTING

The BeStaDem survey included licensed nursing homes in Germany.

PARTICIPANTS

A total of 134 nursing home administrators provided informed consent to participate in the BeStaDem survey.

METHODS

For quantitative data, we performed Fisher's exact test to identify differences in the Dementia Policy Questionnaire item distribution of several types of care units (aim 1). To support the results of Fisher's exact test, we additionally applied logistic regression analysis. For qualitative data, we analyzed the mission statements deductively with the qualitative content analysis method (aim 2). For integration, we used a convergent triangulation approach (aim 3).

RESULTS

The quantitative data collected from 134 German nursing homes show significant associations among person-centred dementia care policies, such as behavior assessment, and nursing homes with dementia care units. Regarding the qualitative data, of the 60 mission statements in total, eight mission statements of nursing homes with dementia care units exclusively address aspects such as dementia-specific interventions. The convergent triangulation approach shows that the answers given by the nursing homes in the quantitative survey are not always consistent with what they address in their mission statements.

CONCLUSIONS

Nursing homes with dementia care units provide more person-centred dementia care policies than other care unit types do but mostly do not address these aspects in their mission statements. The implementation of person-centredness benefits from the existence of policies and mission statements if nursing homes clearly address what is meant by person-centred dementia care in their nursing home.

摘要

背景

养老院的政策和使命声明支持以患者为中心的痴呆症护理的实施。痴呆症政策问卷评估了政策中以患者为中心的痴呆症护理的内容。迄今为止,尚不清楚这些政策是否仅存在于痴呆症护理单元中,以及这些政策是否与养老院的使命声明一致。

目的

我们旨在(1)调查养老院护理单元类型与痴呆症政策问卷所衡量的政策存在情况之间的关系,(2)探讨这些政策在养老院的使命声明中是否有所涉及,以及(3)整合这两个结果。

设计

这是一项采用收敛性混合方法的研究,使用了在BeStaDem调查(2020年)中收集的定量和定性数据集。

背景

BeStaDem调查涵盖了德国的持牌养老院。

参与者

共有134名养老院管理人员提供了知情同意书,参与BeStaDem调查。

方法

对于定量数据,我们进行了Fisher精确检验,以确定几种类型护理单元在痴呆症政策问卷项目分布上的差异(目标1)。为了支持Fisher精确检验的结果,我们还应用了逻辑回归分析。对于定性数据,我们使用定性内容分析法对使命声明进行演绎分析(目标2)。为了整合,我们采用了收敛性三角测量法(目标3)。

结果

从134家德国养老院收集的定量数据显示,以患者为中心的痴呆症护理政策(如行为评估)与设有痴呆症护理单元的养老院之间存在显著关联。关于定性数据,在总共60份使命声明中,设有痴呆症护理单元的养老院的8份使命声明专门涉及痴呆症特定干预等方面。收敛性三角测量法表明,养老院在定量调查中给出的答案并不总是与他们在使命声明中所涉及的内容一致。

结论

设有痴呆症护理单元的养老院比其他护理单元类型提供更多以患者为中心的痴呆症护理政策,但大多在其使命声明中未涉及这些方面。如果养老院在其护理院中明确阐述以患者为中心的痴呆症护理的含义,那么以患者为中心的实施将受益于政策和使命声明的存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7992/11381747/5fddd5c0159c/gr1.jpg

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