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Casarez A, Smith JG. Associations between hospital organizational features, person-centred care and nurse-sensitive outcomes for persons with dementia in acute care: A systematic literature review. J Adv Nurs 2024. [PMID: 38515225 DOI: 10.1111/jan.16155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
AIM(S) The aim of this systematic literature review was to determine the extent and quality of quantitative evidence regarding associations between hospital organizational features, person-centred care (PCC) and nursing-sensitive outcomes among persons with dementia in the acute care setting. DESIGN Systematic review. METHODS Key terms were utilized to guide searches in four databases. The two reviewers deduplicated articles and came to a consensus for the final sample using inclusion and exclusion criteria. DATA SOURCES MEDLINE/OVID, CINHAL, COCHRANE and WEB OF SCIENCE. RESULTS There were 10 studies included. PCC was associated with better outcomes for persons with dementia (i.e. decreased restraint use, decreased length of stay, increased involvement with families and the patient, and increased nurse confidence and competence in caring for this population). Of the studies, none explicitly identified an association between nursing-sensitive outcomes, PCC and hospital organizational features in the acute care setting among persons with dementia. CONCLUSION This review highlights a clinically significant gap in knowledge regarding associations between hospital organizational features, PCC and nursing sensitive outcomes. The impact of face-to-face dementia competency training as a standard practice among acute care facilities, the importance of leadership engagement, support and involvement to improve nurse confidence and competence in caring for persons with dementia needs to be explored. IMPACT STATEMENT These findings support future research to understand the relationship between organization features and patient-centred care and how these collectively impact nursing-sensitive outcomes, specifically in persons with dementia in acute care settings.
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Affiliation(s)
- Amber Casarez
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Jessica G Smith
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
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Munsterman E, Perez A, Hodgson N, Cacchione P. Dementia friendly in the context of hospitalization: A concept analysis using the Walker & Avant Method. J Adv Nurs 2024:10.1111/jan.16133. [PMID: 38433345 PMCID: PMC11369123 DOI: 10.1111/jan.16133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/06/2023] [Accepted: 02/17/2024] [Indexed: 03/05/2024]
Abstract
AIM(S) To evaluate the literature to inform and propose a conceptual definition for dementia friendly in the context of hospitalization. METHODS The Walker & Avant method for concept analysis was utilized for this review. DATA SOURCES (INCLUDE SEARCH DATES) Initial search conducted June 2022. Repeated search conducted in February 2023. Databases for the literature search include Scopus, PubMed, CINAHL, PsycINFO, and AGELINE. RESULTS Five attributes of the concept of dementia friendly in the context of hospitalization were identified including: staff knowledge/education, environmental modification, person-centred care, nursing care delivery and inclusion of family caregivers. Based on these attributes a conceptual definition is proposed. CONCLUSION A clarified definition for dementia friendly in the context of hospitalization will aid in understanding the concept, provide guidance for hospitals seeking to implement dementia-friendly interventions and benefit researchers aiming to study the impact of such programs. REPORTING METHOD: n/a. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Ellen Munsterman
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Adriana Perez
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Nancy Hodgson
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Pamela Cacchione
- School of Nursing, University of Pennsylvania, Philadelphia, USA
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Manietta C, Purwins D, Reinhard A, Feige M, Knecht C, Alpers B, Roes M. Contextualizing the results of an integrative review on the characteristics of dementia-friendly hospitals: a workshop with professional dementia experts. BMC Geriatr 2023; 23:678. [PMID: 37858073 PMCID: PMC10585930 DOI: 10.1186/s12877-023-04312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/13/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND To become a dementia-friendly hospital (DFH) is increasingly being discussed in health care practice, research, politics and society. In our previous integrative review, we identified six characteristics of DFHs. To thoroughly discuss and contextualize these characteristics in relation to hospitals in Germany, we involved professional dementia experts in our review process. METHODS At the end of our review process, we involved professional dementia experts at the 'contributing' level of the ACTIVE framework to discuss and reflect on the six DFH characteristics we identified. We conducted a group process in the form of a one-day workshop. The workshop consisted of four steps: 1. presentation of review results (input), 2. modification of DFH characteristics and rating of their relevance in smaller working groups, 3. discussion of group results in plenary and 4. questionnaire for prioritization and rating of feasibility. The data were analyzed in MAXQDA using content analysis and descriptive statistics. RESULTS A total of 16 professional dementia experts working in hospitals participated in the workshop. All the previously identified characteristics of a DFH were rated as relevant or very relevant for patients with dementia, their relatives and health care professionals from the professional dementia experts' perspective. They made a few modifications of the six characteristics at the level of subcategories, aspects, and descriptions. The feasibility of the characteristics in hospitals was critically discussed regarding resources, hospital structures and processes, the role of nurses, and the current care situation of people with dementia in hospitals. More than half of the subcategories of the characteristics were considered very difficult or difficult to implement by most professional dementia experts. CONCLUSION The involvement of professional dementia experts helped us contextualize our review findings within the German hospital setting. These results highlight the need to consider resources, funding options, influencing factors, and the current situation and culture of care provided by hospitals before implementing DFH characteristics. Beside the involvement of professional dementia experts and various health care professionals, the involvement of other stakeholders, such as people with dementia and their relatives, is necessary in future research for the development of a DFH.
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Affiliation(s)
- Christina Manietta
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany.
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
| | - Daniel Purwins
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Anneke Reinhard
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
| | - Melanie Feige
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christiane Knecht
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
- FH Münster University of Applied Sciences, Münster, Germany
| | - Birgit Alpers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Roes
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Krier D, de Boer B, Hiligsmann M, Wittwer J, Amieva H. Evaluation of Dementia-Friendly Initiatives, Small-Scale Homelike Residential Care, and Dementia Village Models: A Scoping Review. J Am Med Dir Assoc 2023; 24:1020-1027.e1. [PMID: 37121264 DOI: 10.1016/j.jamda.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Numerous initiatives are emerging to improve the care management of persons suffering from Alzheimer's disease or related disorders (ADRD). The aim of this review is to identify research evaluations of initiatives in long-term care facilities and those making society more inclusive. DESIGN Scoping review with systematic search of PubMed. SETTING AND PARTICIPANTS Reviewed articles focused on the impact of (1) dementia-friendly initiatives (DFIs), (2) small-scale homelike (SSHL) facilities, and (3) dementia/Alzheimer villages. The intervention targets people (or their carers) with dementia or cognitive impairment. METHODS A scoping review was performed on PubMed, including papers published up to November 2022. Further hand-searching from reference lists and the gray literature was carried out. RESULTS A total of 477 articles were identified initially, and finally 12 more specifically related to the impact of DFI (n = 4) and SSHL facilities (n = 8) were selected. They included preliminary effectiveness analyses on DFI-related training and awareness intervention and comparative studies on an SSHL model. Scarce but promising results were found on the physical functioning, social participation, and quality of life for older adults living in SSHL facilities compared to those living in conventional nursing homes. No quantitative evaluation on dementia villages was published. CONCLUSIONS AND IMPLICATIONS The article highlights the lack of studies providing data on the efficacy of such innovative facilities on clinical, economic, and social outcomes. Such data are essential to better characterize these models and assess their potential efficiency and reproducibility.
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Affiliation(s)
- Damien Krier
- Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France.
| | - Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Jérôme Wittwer
- Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
| | - Hélène Amieva
- Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
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Rosi A, Govoni S, Del Signore F, Tassorelli C, Cappa S, Allegri N. Italian Dementia-Friendly Hospital Trial (IDENTITÀ): efficacy of a dementia care intervention for hospital staff. Aging Ment Health 2022; 27:921-929. [PMID: 35773241 DOI: 10.1080/13607863.2022.2084507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study investigated the short-term impact and the retention of a dementia care intervention for healthcare staff working in an Italian acute hospital setting. Additionally, we identified the predictors of improvement across the intervention. Sixty-two healthcare staff from an Italian public hospital participated in a dementia care intervention consisting of 5 modules delivered in a 5-hour training program focusing on dementia management, knowledge, and care. A pre-test/post-test and six-months follow-up design was used to evaluate participants' changes in knowledge, attitudes, and confidence in dementia. The intervention significantly improved healthcare staff's dementia knowledge and confidence immediately after the end of the intervention. No significant changes were observed from post-test to follow-up, indicating retention of these outcomes over six months. Regarding attitude to dementia, we found an immediate improvement only in the Recognition of Personhood scale. Looking at the predictors of improvement, healthcare staff with lower levels of knowledge, attitudes, and confidence in dementia at pre-test were those who improved more following the intervention. These findings provide further evidence that dementia care interventions are suitable initiatives to promote knowledge and skills required to manage the needs of people with dementia in an acute hospital setting.
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Affiliation(s)
- Alessia Rosi
- Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy
| | - Stefano Govoni
- Drug Sciences Department, University of Pavia, Pavia, Italy.,CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Federica Del Signore
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Brain and Behavioral Sciences Department, University of Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Cappa
- IRCCS Mondino Foundation, Pavia, Italy.,University School for Advanced Studies, IUSS, Pavia, Italy
| | - Nicola Allegri
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
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Manietta C, Purwins D, Reinhard A, Knecht C, Roes M. Characteristics of dementia-friendly hospitals: an integrative review. BMC Geriatr 2022; 22:468. [PMID: 35641899 PMCID: PMC9158310 DOI: 10.1186/s12877-022-03103-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dementia-friendly initiatives are becoming common in society, politics, and research, including health care. Regarding efforts to improve care for patients with dementia in hospitals, the term dementia-friendly hospital is being used increasingly. However, a theoretical understanding of this term and the underlying concept are missing. This integrative review aims to identify current descriptions of dementia-friendly hospitals and to analyze their characteristics. METHODS An integrative review was conducted. The databases MEDLINE, CINAHL, PsycInfo, Cochrane Library, and additional resources were searched. Two reviewers independently screened publications for inclusion. We extracted data from the included publications and analyzed the descriptions of dementia-friendly hospitals using inductive content analysis in an iterative process. RESULTS We identified 4191 records and included 34 publications on 17 descriptions of dementia-friendly hospitals. These were found in the context of practice projects (n = 8), recommendations (n = 6) and research (n = 3). Our analysis resulted in six characteristics of dementia-friendly hospitals. Characteristics related to the patients and their care are continuity, person-centeredness, consideration of phenomena within dementia and environment. Additional characteristics are valuing relatives and knowledge and expertise within the hospital. CONCLUSION Dementia-friendly hospitals are currently characterized more by healthcare practices and professional dementia experts than by the results of empirical studies. Additionally, the perspective of people with dementia is underrepresented in current descriptions. Accordingly, further research is needed that involves people with dementia in order to develop a theoretical understanding and suitable concepts of dementia-friendly hospitals, since their perspective is essential.
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Affiliation(s)
- Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany. .,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
| | - Daniel Purwins
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany.,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Anneke Reinhard
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
| | - Christiane Knecht
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.,FH Münster University of Applied Sciences, Münster, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany.,Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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