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迈向确立痴呆症护理服务人权质量标准。

Towards Establishing Quality Standards on Human Rights for Services in Dementia Care.

机构信息

World Health Organization Collaborating Centre on Mental Health, Disability and Human Rights, Institute of Mental Health, University of Nottingham, Nottingham, UK.

Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.

出版信息

Int J Older People Nurs. 2024 Sep;19(5):e12643. doi: 10.1111/opn.12643.

Abstract

BACKGROUND

People with dementia often experience violations of fundamental human rights and impeded access to healthcare. This study aims to investigate the views of experts regarding the use of the United Nations Convention on the Rights of People with Disabilities (CRPD) principles as quality standards for human rights-based care.

METHODS

A single-round Delphi e-consultation with 15 dementia experts was designed to evaluate each CRPD principle and collect feedback on their views about the application of the CRPD principles in dementia care.

RESULTS

The CRPD principles were fully endorsed as quality standards; however, several experts commented on the complexities of the use of CRPD principles in relation to information disclosure, capacity assessment, stakeholders' involvement in decision-making, respecting needs and preferences, holistic approaches in care practice, and protection against abuse, neglect and discrimination.

CONCLUSIONS

These findings indicate the CRPD quality standards were fully applicable for people with dementia although some clarification around interpretation could assist in their use. Future research should elaborate on further points of support and guidance for dementia care providing examples of good practice from across the globe, and develop a concordant, human rights-based scheme for the implementation and evaluation of dementia services.

IMPLICATIONS FOR PRACTICE

This study suggests that the CRPD can serve as a benchmark for human rights-based practices in dementia services globally that could enhance nursing care practice. Nursing staff are encouraged to consider human rights in relation to the complexities associated with people with dementia, their caregivers, and other services involved in their care.

摘要

背景

痴呆症患者常常会经历基本人权受到侵犯和医疗保健受限的情况。本研究旨在调查专家对使用《联合国残疾人权利公约》(CRPD)原则作为基于人权的护理质量标准的看法。

方法

设计了一次 15 名痴呆症专家的单轮德尔菲电子咨询,以评估每个 CRPD 原则,并收集他们对在痴呆症护理中应用 CRPD 原则的看法的反馈。

结果

CRPD 原则被完全认可为质量标准;然而,一些专家对在信息披露、能力评估、利益相关者参与决策、尊重需求和偏好、护理实践中的整体方法以及防止虐待、忽视和歧视方面使用 CRPD 原则的复杂性发表了评论。

结论

这些发现表明,尽管在解释方面需要进一步澄清,但 CRPD 质量标准完全适用于痴呆症患者。未来的研究应详细说明进一步支持和指导痴呆症护理的要点,提供全球范围内的良好实践范例,并制定一个一致的、基于人权的痴呆症服务实施和评估方案。

实践意义

本研究表明,CRPD 可以作为全球痴呆症服务中基于人权的实践的基准,从而增强护理实践。鼓励护理人员在考虑与痴呆症患者及其照顾者以及参与其护理的其他服务相关的复杂性时,考虑人权问题。

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