James Tiffeny, Leverton Monica, Samsi Kritika, Newton Christina
NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London, London, UK.
Independent Researcher, London, UK.
Int J Geriatr Psychiatry. 2025 May;40(5):e70101. doi: 10.1002/gps.70101.
People who work in health and social care frequently come into contact with people living with dementia, highlighting the need for a dementia aware and competent workforce. Some health and care services have implemented 'Dementia Champions' (DCs) to address this, but the role is rarely seen in domiciliary homecare services. We aim to conceptualise the DC role across health and social care to learn how it is implemented in practice and consider how it can be applied to homecare.
We conducted 30 semi-structured interviews with health and social care workers who either work as DCs or have experience/knowledge of working with them. We used framework analysis to analyse the data, informed by a Theory of Change (ToC) approach which involved identifying the 'inputs' involved in the role (tasks and responsibilities); and the short, medium, and long-term mechanisms required to implement, embed, and maintain the role.
We identified key tasks and responsibilities of a DC which varied between and within sectors and services. The was a lack of role clarity and rarely a role description, which was considered a barrier to the role's success. The DC role is typically voluntary with no remuneration and performed on top of existing roles with no protected time for specific DC tasks. DCs typically take on the role due to a passion for good dementia care and a desire to make a difference, meaning feedback and feeling valued were important. The DC role provides an opportunity for career development, which was considered essential to retaining DCs, and health and social care workers generally. We present these findings as five themes which map onto our ToC framework to explore how the DC role is implemented, embedded, and maintained in practice.
Across all services, there is need for role clarity, with a DC role description at the outset to set out the tasks, responsibilities, and boundaries of the role. The DC role needs protected time for workers to implement it and undertake training. We will use these findings to develop and refine our ToC framework to reflect its applicability for the homecare sector.
从事健康与社会护理工作的人员经常与痴呆症患者接触，这凸显了打造一支了解痴呆症且具备相应能力的员工队伍的必要性。一些健康与护理服务机构已设立“痴呆症倡导者”（DC）来解决这一问题，但该角色在居家护理服务中却很少见。我们旨在对健康与社会护理领域的DC角色进行概念化梳理，以了解其在实际中的实施方式，并思考如何将其应用于居家护理。
我们对担任DC或有与DC共事经验/了解相关情况的健康与社会护理工作者进行了30次半结构化访谈。我们采用框架分析法对数据进行分析，该方法以变革理论（ToC）为指导，涉及确定该角色所涉及的“投入”（任务和职责）；以及实施、嵌入和维持该角色所需的短期、中期和长期机制。
我们确定了DC的关键任务和职责，这些任务和职责在不同部门和服务之间以及内部存在差异。存在角色不明确的情况，且很少有角色描述，这被认为是该角色取得成功的障碍。DC角色通常是自愿的，没有报酬，且是在现有角色之上履行，没有专门用于特定DC任务的受保护时间。DC通常因对优质痴呆症护理的热情以及想要有所作为而承担该角色，这意味着反馈和被重视的感觉很重要。DC角色为职业发展提供了机会，这被认为对于留住DC以及总体上留住健康与社会护理工作者至关重要。我们将这些发现归纳为五个主题，这些主题与我们的ToC框架相对应，以探讨DC角色在实际中是如何实施、嵌入和维持的。
在所有服务中，都需要明确角色，从一开始就制定DC角色描述，以明确该角色的任务、职责和界限。DC角色需要为工作人员提供受保护的时间来实施该角色并接受培训。我们将利用这些发现来开发和完善我们的ToC框架，以反映其对居家护理部门的适用性。
