Reschke-Hernández Alaine E, Vasil Martina, King Emma, Woolums Carson
School of Music, University of Kentucky Lexington Kentucky USA.
Sanders-Brown Center on Aging, University of Kentucky Lexington Kentucky USA.
Alzheimers Dement (N Y). 2025 Apr 24;11(2):e70091. doi: 10.1002/trc2.70091. eCollection 2025 Apr-Jun.
Non-pharmacological complementary and supportive care programs (CSCP, e.g., music therapy) are provided in addition to standard medical care for persons with dementia (PWD). Care staff observations are critical in assessing the clinical impact of CSCP on PWD. However, little is known about care staff experiences of CSCP and what factors influence documentation of outcomes. We sought to understand how care staff in Kentucky describe the clinically meaningful impact of CSCP on residents and themselves and learn what conditions enable and prohibit documentation.
Four care staff from four dementia care facilities in Kentucky (representing non-profit, for-profit; rural, suburban, and urban areas) participated in this qualitative multiple case study. Participants were selected to reflect diverse care roles, identities, and experience. We collected data from eight semi-structured interviews (two per participant), 24 journal entries, four observations, photographs, and publicly available facility data. The use of multiple data types helped triangulate findings and enrich the analysis. Data were coded and analyzed for emerging themes.
Participants described CSCP as enhancing residents' holistic well-being and being person-centered. CSCP also improved participants' well-being and enhanced their sense of purpose. Primary documentation barriers were lack of time, prioritizing resident care over documentation, and top-down regulations. Technology both enabled and prohibited documentation, with routine being a key facilitator.
Our findings indicate that CSCP improve PWD's quality of life by fostering engagement, joy, and personalized care, consistent with person-centered care principles. Staff also benefit from reduced stress and improved morale. However, barriers exist, including time constraints and documentation challenges. Results may inform directions for future research, translation of CSCP from research to practice, and feasible measurement of clinically meaningful outcomes. The study underscores the importance of addressing systemic issues and advocating for policies that support sustainable, quality dementia care while enhancing both resident and staff well-being.
Care staff view person-centered care programs as vital for residents' well-being.Complementary programs reduce burnout and boost morale in demanding care settings.Feasible documentation is crucial to track meaningful outcomes within time limits.Results emphasize the need for policies that support care staff and quality care.
除了为痴呆症患者（PWD）提供标准医疗护理外，还提供非药物补充和支持性护理计划（CSCP，例如音乐疗法）。护理人员的观察对于评估CSCP对PWD的临床影响至关重要。然而，对于护理人员对CSCP的体验以及哪些因素影响结果记录，我们知之甚少。我们试图了解肯塔基州的护理人员如何描述CSCP对居民和他们自己的临床意义重大的影响，并了解哪些条件促进和阻碍记录。
来自肯塔基州四个痴呆症护理机构（代表非营利性、营利性；农村、郊区和城市地区）的四名护理人员参与了这项定性多案例研究。参与者的选择反映了不同的护理角色、身份和经验。我们从八次半结构化访谈（每位参与者两次）、24篇日志、四次观察、照片以及公开可用的机构数据中收集数据。使用多种数据类型有助于对结果进行三角测量并丰富分析。对数据进行编码并分析以找出新出现的主题。
参与者将CSCP描述为增强居民的整体幸福感且以个人为中心。CSCP还改善了参与者的幸福感并增强了他们的使命感。主要的记录障碍包括时间不足、将居民护理置于记录之上的优先级安排以及自上而下的规定。技术既促进也阻碍记录，常规操作是关键的促进因素。
我们的研究结果表明，CSCP通过促进参与、愉悦和个性化护理，符合以个人为中心的护理原则，从而提高PWD的生活质量。工作人员也从减轻压力和提高士气中受益。然而，障碍依然存在，包括时间限制和记录挑战。结果可能为未来研究的方向、将CSCP从研究转化为实践以及对临床意义重大的结果进行可行测量提供参考。该研究强调了解决系统性问题以及倡导支持可持续、高质量痴呆症护理同时提高居民和工作人员幸福感的政策的重要性。
护理人员认为以个人为中心的护理计划对居民的幸福感至关重要。补充计划在要求苛刻的护理环境中可减少倦怠并提高士气。可行的记录对于在时间限制内跟踪有意义的结果至关重要。结果强调需要支持护理人员和优质护理的政策。
