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以人为主的实践与蒙台梭利在老年痴呆和老年住宅护理中的交集。

Intersection between person-centred practice and Montessori for dementia and ageing in residential aged care.

机构信息

Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic 3004, Australia.

Baptcare, Head Office, Melbourne, Vic 3124, Australia.

出版信息

Age Ageing. 2024 Oct 1;53(10). doi: 10.1093/ageing/afae217.

Abstract

BACKGROUND

Internationally, person-centred care (PCC) is embedded in the language of regulations and mandated to be practised in residential aged care (RAC). Despite this, PCC has not been fully adopted in RAC in Australia and internationally, and concerns about the quality of care persist. Over the past 2 decades, Montessori for dementia and ageing has been introduced in RAC to support and inform a cultural change towards PCC. This study aimed to examine the intersection between the goals and approaches of Montessori and PCC in RAC.

METHODS

This qualitative descriptive study reports on a secondary analysis of qualitative data from focus groups (FGs) and interviews with residents, family-members, staff, and volunteers from eight RAC homes in Victoria, Australia. Sixteen FGs and 36 interviews were conducted. A qualitative deductive approach using researcher-developed Montessori for dementia and ageing framework for data analysis was applied.

RESULTS

Findings provide support for the intersection between PCC and Montessori with participants' descriptions of PCC aligning with many of the goals and approaches of Montessori. Participants most commonly described Montessori approaches of engagement in daily tasks with purposeful roles and promoting cognitive abilities through multi-sensory stimulation. Least frequently-described approaches included focusing on residents' strengths/abilities, maintaining function, using familiar objects, and guided repetition.

CONCLUSIONS

Findings have important implications for practice to use Montessori as a vehicle that supports and upskills the workforce to deliver care that is person-centred. Future research must examine the resources required to support the implementation and sustainability of Montessori as a vehicle for PCC.

摘要

背景

在国际上,以患者为中心的护理(PCC)被纳入法规语言,并要求在养老院(RAC)中实施。尽管如此,PCC 在澳大利亚和国际上的养老院中并未得到充分采用,人们对护理质量的担忧依然存在。在过去的 20 年中,为了支持并推动向以患者为中心的护理转变,针对痴呆症和老龄化的蒙台梭利方法已被引入养老院。本研究旨在探讨养老院中蒙台梭利方法与 PCC 的目标和方法的交叉点。

方法

本定性描述性研究报告了对澳大利亚维多利亚州 8 家养老院的居民、家属、工作人员和志愿者的焦点小组(FG)和访谈的定性数据的二次分析。共进行了 16 个 FG 和 36 次访谈。采用研究者开发的蒙台梭利用于痴呆症和老龄化的框架进行定性演绎分析。

结果

研究结果为 PCC 与蒙台梭利之间的交叉点提供了支持,参与者对 PCC 的描述与蒙台梭利的许多目标和方法一致。参与者最常描述的蒙台梭利方法是让居民有目的、有意义地参与日常任务,并通过多感官刺激来促进认知能力。描述最少的方法包括关注居民的优势/能力、维持功能、使用熟悉的物品和引导重复。

结论

这些发现对实践具有重要意义,即利用蒙台梭利作为一种工具,支持和提高劳动力的技能,以提供以患者为中心的护理。未来的研究必须研究支持蒙台梭利作为 PCC 工具的实施和可持续性所需的资源。

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