Lauridsen Sigurd, Skov Sofie Smedegaard, Thorup Lucca-Mathilde, Berg Marie-Eva, Folker Anna Paldam, Simonsen Peter, Schou-Juul Frederik
The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
Department for the Study of Culture, University of Southern Denmark, University of Southern Denmark Campusvej 55, 5230 Odense, Denmark.
Int J Nurs Stud Adv. 2025 Jan 15;8:100294. doi: 10.1016/j.ijnsa.2025.100294. eCollection 2025 Jun.
The global population living with dementia is rapidly increasing, with projections estimated at 78 million by 2030 and 132 million by 2050 due to ageing demographics. Despite the increasing prevalence of dementia, effective treatments remain limited. High-quality care is critical, but it presents complex ethical challenges, including balancing autonomy with best interests, addressing the needs of individuals with dementia and their caregivers, and equitably allocating resources. To address these challenges, we introduced the CARE programme, a systematic approach to ethics work, in nursing homes to enhance the ethical self-efficacy of nursing home staff.
This study assessed the feasibility of the CARE programme in a community-based Danish nursing home setting. Using the framework of Bowen et al. and a mixed-methods research design, we conducted six face-to-face focus group interviews with nursing home staff, two telephone interviews with nursing home managers, and a survey among 90 participants. Data were collected in the spring and fall of 2022.
Quantitative data were analysed using STATA for descriptive statistics, while qualitative data were processed using a six-step template analysis framework.
The results indicate high feasibility and acceptance of the CARE programme among the nursing home staff. To a high/some degree, 97 % expressed satisfaction, 95 % found the programme relevant to their work, 90 % believed it would improve dementia care, and 82 % felt better equipped to handle ethical dilemmas. Both the management and staff acknowledged the programme's effectiveness in filling the critical gap in ethics training in nursing homes. Appreciation for external facilitation, participation from multiple nursing homes, and cross-institutional group work emphasised the value of the programme.
The quantitative results indicate high levels of satisfaction and relevance, with the majority of participants believing that the program improves care and enhances their ability to manage ethical issues. Qualitative insights further emphasize the program's success in meeting the need for ethics training, facilitated by external researchers and cross-institutional collaboration. Full implementation of the CARE programme requires a cultural shift in nursing homes that advocates for universal staff involvement in ethics training and promotes open dialogue about ethical issues. Moreover, policy changes may be necessary to secure funding and establish minimum training standards for nursing home staff.
由于人口老龄化，全球痴呆症患者数量正在迅速增加，预计到2030年将达到7800万，到2050年将达到1.32亿。尽管痴呆症的患病率不断上升，但有效的治疗方法仍然有限。高质量的护理至关重要，但它带来了复杂的伦理挑战，包括在自主权与最大利益之间取得平衡、满足痴呆症患者及其护理人员的需求以及公平分配资源。为应对这些挑战，我们在养老院引入了CARE计划，这是一种系统的伦理工作方法，以提高养老院工作人员的伦理自我效能感。
本研究评估了CARE计划在丹麦一家社区养老院环境中的可行性。我们采用鲍恩等人的框架和混合方法研究设计，对养老院工作人员进行了六次面对面焦点小组访谈，对养老院管理人员进行了两次电话访谈，并对90名参与者进行了一项调查。数据于2022年春季和秋季收集。
定量数据使用STATA进行描述性统计分析，而定性数据使用六步模板分析框架进行处理。
结果表明，CARE计划在养老院工作人员中具有很高的可行性和接受度。在很大程度上，97%的人表示满意，95%的人认为该计划与他们的工作相关，90%的人认为它将改善痴呆症护理，82%的人觉得自己处理伦理困境的能力有所提高。管理层和工作人员都承认该计划在填补养老院伦理培训关键空白方面的有效性。对外部协助、多个养老院的参与以及跨机构小组工作的赞赏强调了该计划的价值。
定量结果表明满意度和相关性很高，大多数参与者认为该计划改善了护理并增强了他们处理伦理问题的能力。定性见解进一步强调了该计划在满足伦理培训需求方面的成功，这得益于外部研究人员和跨机构合作。全面实施CARE计划需要养老院进行文化转变，倡导全体工作人员参与伦理培训，并促进关于伦理问题的公开对话。此外，可能需要政策变革以确保资金并为养老院工作人员制定最低培训标准。
