Moenke Linda, Handley Melanie, Goodman Claire
Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, Hatfield, UK.
National Institute for Health Research (NIHR), Applied Research Collaboration (ARC) East of England, Cambridgeshire, UK.
J Nurs Manag. 2023 May 17;2023:9872272. doi: 10.1155/2023/9872272. eCollection 2023.
Care home managers' leadership is recognised as directly influencing the care received by people living with dementia. What enables care home managers to promote and sustain person-centred care for residents is less well understood.
A mixed-methods systematic review synthesised evidence on care home managers' leadership on the delivery of person-centred care for people living with dementia. Electronic databases (PubMed, Scopus, Cochrane Library, CINAHL, and Google Scholar) were searched between 2009-2021. Thematic synthesis identified commonalities, facilitators, and barriers to managers enabling person-centred care.
Twenty-one studies met the inclusion criteria. Approaches demonstrated by care home managers that enabled person-centred care for people living with dementia included valuing and recognising staffs' work; involving residents and relatives in decision making; providing feedback to staff; promoting a positive work environment and care culture; and involving staff in organisational changes. Barriers to person-centred care were a lack of organisational support for care home managers; staff shortages; managers not having time to work with staff; manager-staff turnover; limited access to dementia training; and a lack of leadership education and training for care home managers.
Care home managers are central to the delivery of person-centred care for people living with dementia. The review identified key resources and activities that support this work. The wide variation in leadership approach and a persistent lack of detail about the frequency of educational and organisational support demonstrate a need to explore what enables care home managers to support their staff to deliver person-centred care.
养老院管理人员的领导力被认为直接影响着痴呆症患者所接受的护理。然而，对于促使养老院管理人员为居民推广并持续提供以人为本的护理的因素，人们了解得较少。
一项混合方法的系统综述综合了关于养老院管理人员在为痴呆症患者提供以人为本的护理方面的领导力的证据。在2009年至2021年期间检索了电子数据库（PubMed、Scopus、Cochrane图书馆、CINAHL和谷歌学术）。主题综合确定了管理人员实现以人为本护理的共性、促进因素和障碍。
21项研究符合纳入标准。养老院管理人员展示的实现为痴呆症患者提供以人为本护理的方法包括重视和认可员工的工作；让居民和亲属参与决策；向员工提供反馈；营造积极的工作环境和护理文化；以及让员工参与组织变革。以人为本护理的障碍包括养老院管理人员缺乏组织支持；人员短缺；管理人员没有时间与员工合作；管理人员与员工流动；获得痴呆症培训的机会有限；以及养老院管理人员缺乏领导力教育和培训。
养老院管理人员对于为痴呆症患者提供以人为本的护理至关重要。该综述确定了支持这项工作的关键资源和活动。领导方式的广泛差异以及持续缺乏关于教育和组织支持频率的详细信息表明，有必要探索是什么使养老院管理人员能够支持其员工提供以人为本的护理。
