School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland.
BMC Geriatr. 2024 Sep 20;24(1):776. doi: 10.1186/s12877-024-05343-0.
Currently, there are more than 55 million people living with dementia worldwide. Supporting people with dementia to live as independently as possible in their communities is a global public health objective. There is limited research exploring the implementation of such interventions in the community context. The aim of the review was to create and refine programme theory - in the form of context mechanism-outcome configurations - on how the characteristics of dementia-friendly communities (DFCs) as geographical locations interact with their social and organisational contexts to understand what works for whom and why.
This realist review sourced literature from 5 electronic databases: Cochrane Library, CINAHL, Medline, Scopus, PsychINFO and Google Scholar, as well as relevant websites such as Alzheimer's Society to identify grey literature. Methodological rigour was assessed using the Joanna Briggs Institute critical appraisal tool.
Seven papers were included in this realist review that focused on DFCs in a geographical context The implementation of DFC interventions emerged as a process characterised by two pivotal implementation phases, intricately linked with sub-interventions. The first intervention, termed Hierarchy Commitment (I1a/b), involves the formalisation of agreements by businesses and organizations, along with the implementation of dementia-friendly action plans. Additionally, Educational Resources (I1c) play a significant role in this phase, engaging individuals with dementia and their caregivers in educational initiatives. The second phase, Geographical/Environmental Requirements (I2), encompasses the establishment of effective dementia-friendly signage, accessible meeting places, and community support.
This realist review highlighted a theoretical framework that might guide the development of dementia-friendly communities to enhance the experiences of individuals with dementia and their caregivers within DFCs. Emphasising the need for a theoretical framework in developing geographical DFCs, the review outlines contextual elements, mechanisms, and outcomes, providing a foundation for future studies. The ultimate goal is to establish a robust body of evidence for the sustainable implementation of dementia-friendly communities, thereby improving the quality of life for those with dementia.
This study is registered as PROSPERO 2022 CRD42022317784.
目前，全球有超过 5500 万人患有痴呆症。支持痴呆症患者在社区中尽可能独立地生活是全球公共卫生目标。目前，关于在社区环境中实施此类干预措施的研究有限。本研究的目的是创建和完善方案理论——以情境-机制-结果配置的形式——了解痴呆症友好社区（DFC）作为地理位置的特征如何与社会和组织背景相互作用，以了解对谁有效以及为什么有效。
本真实主义综述从 5 个电子数据库（Cochrane Library、CINAHL、Medline、Scopus、PsychINFO 和 Google Scholar）以及阿尔茨海默病协会等相关网站来源文献，以确定灰色文献。使用 Joanna Briggs 研究所的批判性评估工具评估方法的严谨性。
本真实主义综述纳入了 7 篇专注于地理背景下 DFC 的论文。DFC 干预措施的实施是一个过程，其特点是两个关键的实施阶段，与子干预措施密切相关。第一个干预措施称为“层次结构承诺”（I1a/b），涉及企业和组织的正式协议，以及实施痴呆症友好行动计划。此外，教育资源（I1c）在这一阶段也发挥了重要作用，使痴呆症患者及其照顾者参与教育计划。第二阶段是“地理/环境要求”（I2），包括建立有效的痴呆症友好标识、无障碍会议场所和社区支持。
本真实主义综述强调了一个理论框架，该框架可能指导痴呆症友好社区的发展，以增强 DFC 中痴呆症患者及其照顾者的体验。该综述强调了在发展地理 DFC 方面需要一个理论框架，概述了情境要素、机制和结果，为未来的研究奠定了基础。最终目标是为痴呆症友好社区的可持续实施建立一个强有力的证据基础，从而提高痴呆症患者的生活质量。
本研究在 PROSPERO 注册，注册号为 2022 CRD42022317784。
