Mjørud Marit, Michelet Mona, Krohne Kariann, Bredholt Thea Cathrine, Evans Suzannah, Clare Linda
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
Dement Geriatr Cogn Dis Extra. 2025 Apr 15;15(1):69-77. doi: 10.1159/000545838. eCollection 2025 Jan-Dec.
People with dementia are eligible for rehabilitation for functional difficulties resulting from cognitive symptoms, but no method for this is used in Norwegian municipalities. GREAT cognitive rehabilitation (CR) is an approach which has shown significant positive effects. The study aimed to explore the experiences of dementia case managers using the GREAT CR approach to address the rehabilitation goals of people with dementia.
Six dementia case managers, from four Norwegian municipalities, participated. The pilot study had two phases: phase 1: the participants learnt the approach, and each used it with two clients, to become CR practitioners; phase 2: the participants could use CR in their normal practice. Their experiences were explored in two focus groups. The focus groups were audiotaped, transcribed, and analysed in line with directed content analysis.
Three categories were described: (1) the training and written material, (2) professional development, and (3) proposals for solutions on how to use CR in clinical practice. The case managers found it both engaging and challenging to use CR. They observed that the experience had changed their usual practice: they asked people with dementia more questions about their everyday functioning and resources. The most important barrier to implementing CR was lack of time, although funds were provided to allow municipalities to provide cover for participants' time, participants still found they lacked the time to use the approach as planned.
This study has demonstrated that it is feasible to implement CR in a Norwegian municipality if enough time is available and sufficient resources are provided. There is an urgent need to identify how healthcare services can be enabled to make rehabilitation methods like CR a regular part of post-diagnostic support.
患有痴呆症的人因认知症状导致功能困难，有资格接受康复治疗，但挪威各市镇未采用针对此情况的任何方法。GREAT认知康复（CR）是一种已显示出显著积极效果的方法。该研究旨在探索痴呆症个案管理人员使用GREAT CR方法实现痴呆症患者康复目标的经验。
来自挪威四个市镇的六名痴呆症个案管理人员参与了研究。试点研究分为两个阶段：第1阶段：参与者学习该方法，并分别与两名客户使用该方法，成为CR从业者；第2阶段：参与者可在正常工作中使用CR。通过两个焦点小组探讨了他们的经验。焦点小组进行了录音、转录，并根据定向内容分析法进行了分析。
描述了三个类别：（1）培训和书面材料，（2）专业发展，（3）关于如何在临床实践中使用CR的解决方案建议。个案管理人员发现使用CR既有趣又具有挑战性。他们观察到这种经历改变了他们的日常工作：他们向痴呆症患者询问了更多关于其日常功能和资源的问题。实施CR的最重要障碍是时间不足，尽管提供了资金以使市镇能够为参与者的时间提供保障，但参与者仍然发现他们没有时间按计划使用该方法。
本研究表明，如果有足够的时间并提供足够的资源，在挪威的一个市镇实施CR是可行的。迫切需要确定如何使医疗保健服务能够将CR等康复方法作为诊断后支持的常规组成部分。
