Kihlgren M, Kuremyr D, Norberg A, Bråne G, Karlson I, Engström B, Melin E
Centre for Caring Sciences, Orebro Medical Centre Hospital, Sweden.
Int J Nurs Stud. 1993 Feb;30(1):1-13. doi: 10.1016/0020-7489(93)90088-c.
Morning care is a complex and problematic task for the demented patient, who has problems in understanding and coping with the situation. A training programme of integrity promoting care was given to the staff of a long-term ward and improvements of care were implemented during a 3 month intervention period. To evaluate possible effects, different parameters were used and compared with the data of a control ward. This report describes how caregivers behaved towards demented patients during morning care, before and after the training, and how patients' behaviour changed. The results are based on behaviour samples from 10 patients and 10 caregivers during 99 video-recorded morning care sessions, "double blindly" analysed. The number of coding schemes was 483, each consisting of 93 questions. The most prominent differences observed after the intervention were the increased number of opportunities to take part in decisions and activities given to the patients by the caregivers, more co-operation from patients, and finally an increase in verbal contact initiated both by patients and caregivers. It seems reasonable to suggest that when the environment was made more adequate and the demented patients could cope with it, they could use latent abilities that were not manifest in a less adequate environment.
晨间护理对于患有痴呆症的患者来说是一项复杂且棘手的任务，这类患者在理解和应对这种情况时存在困难。针对一家长期病房的工作人员开展了一项促进完整性护理的培训项目，并在为期3个月的干预期内实施了护理改进措施。为评估可能产生的效果，采用了不同的参数，并与对照病房的数据进行比较。本报告描述了护理人员在培训前后的晨间护理过程中对痴呆症患者的行为表现，以及患者行为的变化。研究结果基于对10名患者和10名护理人员在99次视频记录的晨间护理过程中的行为样本进行“双盲”分析得出。编码方案的数量为483个，每个方案包含93个问题。干预后观察到的最显著差异包括：护理人员给予患者参与决策和活动的机会增多、患者的配合度提高，以及患者和护理人员发起的言语交流增加。有理由认为，当环境变得更加适宜且痴呆症患者能够应对时，他们可以发挥在不太适宜的环境中未表现出来的潜在能力。
