1
|
Herulf Scholander L, Boström AM, Josephsson S, Vikström S. Approved or disregarded? Exploring arenas for narrative relations in geriatric care. Int J Qual Stud Health Well-being 2024; 19:2293130. [PMID: 38085755 DOI: 10.1080/17482631.2023.2293130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE The use of narration in healthcare has been accentuated as a response to the requested shift towards person-centred care. The notion of narrative relations refers to a process of involving several people in mutual and ongoing narrative exchange. This study aimed to explore how and where narrative relations may be adopted and enacted in everyday healthcare practice. METHODS The study has a qualitative, explorative design. Seven interprofessional focus group discussions with healthcare staff were prompted by vignettes. A multidisciplinary team of healthcare staff (n = 31) were recruited on a geriatric ward. Data were analysed using a constant comparative method. RESULTS A core theme shows how narrative relations are adopted and enacted both as part of an approved practice-the work procedures commonly approved as part of healthcare, and as a disregarded practice where covert but important narrative relations take place to support fundamental qualities of healthcare. Moreover, the findings consider arenas of healthcare practice where approved or disregarded practices are enacted in the clinic frontstage and the clinic backstage. CONCLUSIONS Narrative relations may take place in different arenas of healthcare practice yet simultaneously become a cohesive force interconnecting those arenas and uphold continuity. Impeded narrative relations in one arena may have unintended consequences in another.
Collapse
Affiliation(s)
- Lisa Herulf Scholander
- Division of Occupational Therapy, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
- R&D unit, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Anne-Marie Boström
- R&D unit, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Division of Nursing, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Staffan Josephsson
- Division of Occupational Therapy, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Vikström
- Division of Occupational Therapy, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
2
|
Flessa SJ, Harrison JD, Turnigan R, Rathfon M, Chandler M, Newton-Small J, Rogers SE. Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study. JMIR Aging 2024; 7:e59306. [PMID: 39331955 DOI: 10.2196/59306] [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: 04/08/2024] [Revised: 08/01/2024] [Accepted: 08/01/2024] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND Older adults with chronic or acute cognitive impairment, such as dementia or delirium, who are hospitalized face unique barriers to person-centered care and a higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life storytelling interventions have demonstrated promise in enhancing person-centered care by improving patient-care team relationships and providing information to enable care tailored to individual needs and values. OBJECTIVE This study aims to engage patients, care partners, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for use with older adults with dementia and at risk of delirium in the acute care hospital setting. METHODS We recruited patients with dementia or at risk of delirium who were hospitalized, their care partners, clinicians, and informaticists. A 3-stage co-design process that used a mixed methods data collection approach including in-depth interviews and surveys was completed. We used content analysis to analyze qualitative data and descriptive statistics to summarize quantitative data. RESULTS In total, 27 stakeholder informants (ie, patients, care partners, and interdisciplinary care team [IDT] members) participated. Stakeholders were unanimously interested in using patient life stories as a tool for hospital care through electronic health record (EHR) integration. Stakeholders shared potential topics for life stories to cover, including social support, information on patients' key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story-sharing methods, and barriers and facilitators. IDT members shared preferences on EHR integration, resulting in 3 co-designed mock-ups of EHR integration options. Stakeholders shared ways to optimize future acceptability and uptake, including engaging with the care team and promoting awareness of life stories, ensuring suitability to the acute environment (eg, distilling information in an easily digestible way), and addressing concerns for patient capacity and privacy (eg, engaging care partners when appropriate). Thoughts on potential impacts of life stories were also elicited, including improving patient- and care partner-IDT member relationships; humanizing patients; increasing clinical team, patient, and caregiver satisfaction; and enabling more specific, tailored care for patients with dementia and at risk of delirium. CONCLUSIONS This study resulted in a co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future intervention acceptability and uptake, including potential benefits, facilitators, and challenges in the acute care setting.
Collapse
Affiliation(s)
| | - James D Harrison
- Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Roniela Turnigan
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Megan Rathfon
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | | | | | - Stephanie E Rogers
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
3
|
Golenko X, Manchha A, Fowke A, Johnstone G, Lowthian JA. Reading Between the Lines: An Exploratory Pilot Study of a Co-creation Approach to Life Story Work in Aged Care in Australia. J Appl Gerontol 2024:7334648241274545. [PMID: 39176418 DOI: 10.1177/07334648241274545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Life story work (LSW) uses a narrative, reminiscence approach to capturing memories from one's life and has shown positive outcomes for participants. However, LSW in aged care has been criticized for being resource intensive, often involving care staff using pre-determined process and output formats. This pilot study explored participants' lived experiences of a novel co-creation approach to LSW conducted predominantly with university students and older adults in residential aged care and retirement communities, producing multi-modal outputs. Within a 12-month period, 33 LSW projects were completed (21 books, 5 posters, and 7 digital stories). Semi-structured interviews (n = 44) explored participants' lived experience of completing a LSW project. Findings indicate that working with students and adopting a flexible, co-creation approach that empowers participants to make decisions, engage in learning and reflection, and build meaningful relationships can maximize opportunities for transformative impacts, and enable providers to offer a LSW program despite finite resources.
Collapse
Affiliation(s)
- Xanthe Golenko
- Bolton Clarke Research Institute, Brisbane, QLD, Australia
- Griffith Business School, Griffith University, Nathan, QLD, Australia
| | - Asmita Manchha
- Bolton Clarke Research Institute, Brisbane, QLD, Australia
- Griffith Business School, Griffith University, Nathan, QLD, Australia
| | - Anna Fowke
- Bolton Clarke Research Institute, Brisbane, QLD, Australia
| | | | - Judy A Lowthian
- Bolton Clarke Research Institute, Melbourne, VIC, Australia
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- School of Public Health & Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, Australia
| |
Collapse
|
4
|
May AA, Dada S, Murray J. Identifying Components of a Person-Centered Augmentative and Alternative Communication Intervention for People With Dementia: Opinions of an International Expert Panel. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:2067-2082. [PMID: 38901000 DOI: 10.1044/2024_ajslp-23-00317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
PURPOSE Despite general agreement on the importance of person-centered care in speech-language pathology, guidelines for developing person-centered interventions for those with dementia are limited. This study aimed to obtain expert opinion on the components of a person-centered augmentative and alternative communication (AAC) intervention for persons with dementia. METHOD A modified electronic Delphi technique was employed in a single round. A purposively sampled panel of experts was invited to provide their opinion on three open-ended questions related to (a) the elements of person-centered care, (b) communication supports, and (c) the interaction outcomes of a person-centered intervention. Thirty-one experts from nine countries participated on the panel. The majority were speech-language pathologists primarily involved in research. Qualitative written data were coded and analyzed using content analysis. RESULTS Nine components were identified across the three open-ended questions: (a) the unique characteristics of the person with dementia, (b) working with a person with dementia, (c) preserving personhood, (d) a different view on person-centered care, (e) a range of communication supports, (f) supportive conversational partners, (g) designing communication supports, (h) interaction outcome measure, and (i) meaningful interaction outcomes. CONCLUSION This study identified nine components that are useful in guiding speech-language pathologists in crafting future person-centered AAC interventions for people with dementia.
Collapse
Affiliation(s)
- Adele A May
- Centre for Augmentative & Alternative Communication, University of Pretoria, South Africa
| | - Shakila Dada
- Centre for Augmentative & Alternative Communication, University of Pretoria, South Africa
| | - Janice Murray
- Centre for Augmentative & Alternative Communication, University of Pretoria, South Africa
- Faculty of Health and Education, Manchester Metropolitan University, United Kingdom
| |
Collapse
|
5
|
Han MX, Ross L, Hemingway L, Anderson D, Gosling C. Out-of-hospital paramedic interactions with people living with dementia: a scoping review. Age Ageing 2024; 53:afae143. [PMID: 38994589 DOI: 10.1093/ageing/afae143] [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: 11/17/2023] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Dementia encompasses neurodegenerative disorders that account for a global estimated healthcare expenditure of 1.3 trillion US dollars. In Australia, one in 12 people aged ≥65 has a diagnosis of dementia and it is the second leading cause of death. Paramedics play a crucial role in person-centred dementia care, particularly in the community. While consensus has been established on paramedicine's integration into interdisciplinary care teams, there remains a lack of clarity regarding the paramedic role in dementia care. OBJECTIVE This study aimed to examine and report paramedic interactions with people living with dementia in the out-of-hospital setting. DESIGN AND SETTING This was a scoping review study of paramedics and people living with dementia within the out-of-hospital setting. METHODS This study was guided by the Joanna Briggs Institute (JBI) scoping review framework. Databases were searched without date limits, up to 4 April 2023. These encompassed OVID Medline, CINAHL, Scopus, APA PsycInfo and OVID Embase. Articles were included if they were primary, peer-reviewed studies in English and reporting on paramedic-specific interactions with people living with dementia in the out-of-hospital setting. Data extraction was performed based on study setting, design, population and key findings. RESULTS Twenty-nine articles were included in the thematic analysis. Four themes emerged: need for training, patterns of attendances, patterns of documentation and the integrative potential of paramedicine. Paramedics reported feeling ill-equipped and unprepared in caring for patients living with dementia due to challenges in assessment and management of caregiver tensions. They were often called as a last resort due to poor service integration and a lack of alternative care pathways. Despite high conveyance rates, there was low incidence of paramedic interventions initiated. Underdocumentation of dementia and pain was found. CONCLUSION Emergency ambulance conveyance of people living with dementia is a surface reaction compounded by a lack of direction for paramedics in the provision of out-of-hospital care. There is a pressing need for establishment of research and educational priorities to improve paramedic training in dementia-specific skillsets.
Collapse
Affiliation(s)
- Ming Xuan Han
- Department of Paramedicine, Monash University Peninsula Campus, Frankston, Victoria 3199, Australia
| | - Linda Ross
- Department of Paramedicine, Monash University Peninsula Campus, Frankston, Victoria 3199, Australia
| | - Liam Hemingway
- Department of Paramedicine, Monash University Peninsula Campus, Frankston, Victoria 3199, Australia
| | - David Anderson
- Department of Paramedicine, Monash University Peninsula Campus, Frankston, Victoria 3199, Australia
- Ambulance Victoria, Doncaster, Victoria 3108, Australia
| | - Cameron Gosling
- Department of Paramedicine, Monash University Peninsula Campus, Frankston, Victoria 3199, Australia
| |
Collapse
|
6
|
Dixon CA, Roos V, Katjene M, Hoffman J. Effective Relationships Between Younger Caregivers and Older Care Recipients Across a Continuum of Formal Residential Care Settings: A Scoping Review and a Critical Analysis. Public Health Rev 2024; 45:1606562. [PMID: 38601905 PMCID: PMC11004294 DOI: 10.3389/phrs.2024.1606562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
Objective: This article aims to conduct a scoping review of what constitutes effective relational interactions between caregivers (CGs) and older persons (OPs) across formal residential care settings. Methods: A scoping review of publications between January 2000 and December 2021 yielded 10,929 articles, and after removing duplicates and applying exclusion criteria, 36 articles were analysed. Results: Articles were scrutinised for interactions involving both CGs and OPs, using a thematic framework analysis to identify effective relational constructs. Four themes emerged: 1) Diverse perspectives on the same context: for OPs it is home, and for CGs, workplace. 2) CGs move for a one-up position and OPs submit to a one-down, or as friends. 3) Relational qualities have been mostly associated with CGs, confirming care as a unidirectional action 4). Relationships between CGs and OPs result either in effective or ineffective care outcomes. Conclusion: The dual meanings attached to the same context limit the authentic interactions between CGs and OPs. We propose a relational caregiving approach by considering the interactions of both CGs and OPs, changing the relational definition, and demonstrating effective relational qualities.
Collapse
Affiliation(s)
- Carol-Ann Dixon
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Vera Roos
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Matthews Katjene
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
| | - Jaco Hoffman
- Optentia Research Unit, North West University, Vanderbijlpark, South Africa
- Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
7
|
Subramaniam P, Thillainathan P, Mat Ghani NA, Sharma S. Life Story Book to enhance communication in persons with dementia: A systematic review of reviews. PLoS One 2023; 18:e0291620. [PMID: 37796820 PMCID: PMC10553343 DOI: 10.1371/journal.pone.0291620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 09/03/2023] [Indexed: 10/07/2023] Open
Abstract
The Life Story Book has been commonly used in promoting person-centred care in older adults, especially for persons with dementia. This involves collecting the life stories and memories of the person living with dementia and compiling them into a book or folder, which is used by staff or family to assist the person recall these memories. Evidence on the use, benefits and influences of the Life Story Book in dementia care is limited. This systematic literature review aimed to collect past reviews and provide a thorough overview of the use, benefits, and impact of the Life Story Book for the person with dementia, the relatives, family, and caregivers. The electronic databases PubMed, Scopus, Science Direct and Web of Science as well as grey literature through Google Scholar were searched to select the relevant studies. Seven studies that meet the inclusion criteria were selected and data synthesised. Findings revealed that the use of the Life Story Book has no specific guidelines and has been described with numerous characteristics and varied implementation methods. The Life Story Book intervention is found to provide positive outcomes for the person with dementia and the carers involved. Six out of the seven studies reported that Life Story Book enhanced communication between persons with dementia, relatives, care staff, and residents. The review extends the current evidence on the usage of the Life Story Book in dementia care and confirms that the use of life stories leads to better care in various settings. However, more research is needed to reveal the potential of the Life Story Book in enhancing communication. Guidelines and training are also required to make the best use of the Life Story Book.
Collapse
Affiliation(s)
- Ponnusamy Subramaniam
- Clinical Psychology & Behavioural Health Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Preyaangka Thillainathan
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Speech Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Amirah Mat Ghani
- Speech Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shobha Sharma
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Speech Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Dhavernas C. The biography project: Student learning outcomes in aged care life narrative placements. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:274-285. [PMID: 34791987 DOI: 10.1080/02701960.2021.2005038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Australia's Royal Commission into Aged Care Quality and Safety has reported abuses, neglect and a level of systemic apathy and unwillingness to innovate across the nation's aged care sector. Isolation and loneliness stand out as the sector's two most pernicious problems which the current pandemic has only exacerbated. To attempt to ameliorate the situation, the author created a fieldwork intervention that puts undergraduate students into aged care facilities to work with residents on discussing, transcribing, editing and publishing the resident's biography. The "Biography Project" provides much needed contact and connection for residents but also touches on the quality of relationships with family, friends and care staff and supports intergenerational connections for undergraduate students. The article describes the project and its outcomes for students in the hopes of providing a model for geriatric education that could be implemented elsewhere.
Collapse
Affiliation(s)
- Catherine Dhavernas
- School of Humanities, Languages and Social Science, Centre for Social and Cultural Research, Griffith University, Queensland, Australia
| |
Collapse
|
9
|
Herulf Scholander L, Boström AM, Josephsson S, Vikström S. Engaging in narrative relations in everyday work on a geriatric ward: A qualitative study with healthcare professionals. J Clin Nurs 2022. [PMID: 36734355 DOI: 10.1111/jocn.16480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023]
Abstract
AIMS AND OBJECTIVES To explore healthcare professionals' experiences and reflections about narration in their everyday work. BACKGROUND The need for integrated and people-centred healthcare for older adults has highlighted the relevance of narration in healthcare practice. Although theoretical foundations vary, different frameworks building on narration have been proposed for translating person-centredness philosophies into practice. However, to understand how theoretical knowledge on narration can be adopted into clinical work, we need to learn how healthcare staff understand narration from their experiential knowledge and practice. DESIGN The research process followed guidelines from Constructivist Grounded Theory as described by Charmaz. The study adheres to the COREQ guidelines. METHODS Data collection entailed interprofessional focus groups discussions with healthcare staff (n = 31). Vignettes depicting realistic scenarios were used to encourage participants to reflect on clinical practice. Data were analysed via a constant comparative method. RESULTS One core theme arose from the analysis. The core theme showed how narration was a relational process that people engaged in to pursue and uphold several foundational qualities in healthcare practice presented in the following subthemes: preventing simplistic understandings of people and situations; supporting trustful relations; supporting continuity and coherence; and learning from coworkers. However, a minor theme raised awareness of narrative relations as a double-edged sword. CONCLUSIONS By acknowledging the mutual and multifacetted nature of narration in everyday practice, this study shows how healthcare professionals' engagement in narrative relations may contribute to upholding several foundational qualities which resonate with philosophies of person-centredness in everyday healthcare practice. RELEVANCE TO CLINICAL PRACTICE Recognition of both the advantages and possible risks embedded in narrative relations in healthcare practice emphasises the obligation to collectively reflect on the repercussions of narrative relations in any local context. PATIENT OR PUBLIC CONTRIBUTION Healthcare professionals contributed by sharing their experiential knowledge and reflections on narration in practice.
Collapse
Affiliation(s)
- Lisa Herulf Scholander
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,R&D Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Anne-Marie Boström
- R&D Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
| | - Staffan Josephsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Sofia Vikström
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
10
|
Muller A, Missotten P, Adam S. Examining the Impact of Fictional Life Story of Resident with Dementia on Staff Levels of Empathy, Self-confidence, Workload Burden, and Perception of Resident: A Cross-sectional Survey in Long-term Care Communities. Clin Gerontol 2022; 45:956-967. [PMID: 33263495 DOI: 10.1080/07317115.2020.1845897] [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: 10/22/2022]
Abstract
OBJECTIVES Determine the impact of fictional life story on staff members levels of empathy, self-confidence, workload burden, and perception of resident before the implementation of care for new resident with dementia in long-term care community. METHODS An online cross-sectional survey based on two fictive clinical vignettes was used: one vignette described a resident with typical medical information (e.g., level of autonomy, health status, medication …), while the other contained typical medical information and life story information. The two vignettes were visually similar. The order in which vignettes were read was counterbalanced. Staff members (n = 95) were asked to consider the care needed by these residents and to assess, with a visual analogue scale, the amount of useful information provided by vignettes, their self-confidence and level of empathy, their perception of the resident's level of sympathy, his dependence, and the associated workload. RESULTS After reading the vignette containing life story information, staff members considered that they had more useful information and empathy for the resident. They also felt more confident about the care. They perceived the resident as more sympathetic and less dependent, and the workload seemed lighter to them compared to the case described in the vignette that did not contain life story information. CONCLUSIONS This quantitative study shows, in clinical fictive situations, the positive impact of life story on staff members before care begins. CLINICAL IMPLICATIONS Results highlight the importance of considering life story early. Getting to know residents should be the first step of care.
Collapse
Affiliation(s)
- Adeline Muller
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| | | | - Stephane Adam
- Psychology of Aging Unit, University of Liège, Liège, Belgium
| |
Collapse
|
11
|
Sjögren K, Bergland Å, Kirkevold M, Lindkvist M, Lood Q, Sandman PO, Vassbø TK, Edvardsson D. Effects of a person-centred and thriving-promoting intervention on nursing home residents' experiences of thriving and person-centredness of the environment. Nurs Open 2022; 9:2117-2129. [PMID: 35485234 PMCID: PMC9190681 DOI: 10.1002/nop2.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/25/2022] [Accepted: 04/03/2022] [Indexed: 11/09/2022] Open
Abstract
AIM To evaluate the effects of a person-centred and thriving-promoting intervention on nursing home residents´ experiences of thriving and person-centredness of the environment, and to evaluate if the effects varied between female and male residents. DESIGN A multi-centre, non-equivalent controlled group before-after intervention design. METHODS Six nursing homes in Australia, Norway and Sweden were allocated to either intervention or control group. The intervention comprised a staff educational programme. A survey using proxy-ratings by staff was administered before (T0), immediately after (T1) and six months after (T2) the intervention. The sample varied between 205 and 292 residents. Linear regression models were used to explore effects. RESULTS Statistically significant effects were found on experiences of thriving and person-centredness of the environment. These effects were significant for male residents but not for female residents. The results emphasize the importance of individually tailored social and recreational activities.
Collapse
Affiliation(s)
- Karin Sjögren
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Ådel Bergland
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Qarin Lood
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Health and Rehabilitation, Centre for Ageing and Health - AgeCap, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | | | - Tove Karin Vassbø
- Lovisenberg Diaconal University College, Oslo, Norway.,Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
12
|
Guna D, Milburn-Curtis C, Zhang H, Goh HS. Effectiveness of the Biography and Life Storybook for Nursing Home Residents: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084749. [PMID: 35457616 PMCID: PMC9028384 DOI: 10.3390/ijerph19084749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 12/03/2022]
Abstract
There are currently limited studies that have examined the use of the biography and life storybook (BLSB) among the Asian older adult populations in the long-term care setting. This quasi-experimental study aimed to examine its impact on life satisfaction scores, depression, and quality of life among nursing home residents in Singapore. Two wards were assigned to either the intervention or control group. The intervention group was assigned to the BLSB intervention, which comprised eight nurse-facilitated structured sessions over three months and their usual daily activities, whereas the control group was assigned to the routine activities. A total of 74 nursing home residents completed the study, with 37 in each group. The BLSB intervention improved depression, quality of life, and life satisfaction for nursing home residents in Singapore, with significant results observed across all three outcomes over the 3-month period. The study findings support the use of BLSB as an effective reminiscence-based intervention for older adults in an Asian nursing home setting.
Collapse
Affiliation(s)
- Doraisamy Guna
- Nursing Administration, Sunlove Nursing Home, Singapore 534190, Singapore
- Correspondence:
| | | | - Hui Zhang
- Alice Lee Centre for Nursing Studies, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; (H.Z.); (H.S.G.)
| | - Hongli Sam Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore; (H.Z.); (H.S.G.)
| |
Collapse
|
13
|
Stargatt J, Bhar S, Bhowmik J, Al Mahmud A. Digital Storytelling for Health-Related Outcomes in Older Adults: Systematic Review. J Med Internet Res 2022; 24:e28113. [PMID: 35019845 PMCID: PMC8792772 DOI: 10.2196/28113] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/28/2021] [Accepted: 10/22/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Older adults face a unique set of challenges and may experience a range of psychological comorbidities. Digital storytelling is an emerging tool for sharing and recording lived experiences and may have the potential to support well-being but is yet to be systematically reviewed for use among older adults. OBJECTIVE The aim of this review is to examine the methods for creating digital stories, the health-related outcomes associated with creating digital stories, and the potential for implementing digital storytelling with older adults. METHODS We systematically searched electronic databases to identify articles published in English that reported on at least one health-related outcome of digital storytelling for participants aged ≥60 years. Data were extracted and synthesized using qualitative content analysis and summarized in tables. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. RESULTS A total of 8 studies were included in the review. Participants were primarily community-dwelling older adults living with dementia, involving family caregivers and professional care staff. Studies have taken various approaches to digital storytelling and reported diverse benefits associated with digital storytelling, including improvements in mood, memory, social engagement, and quality of relationships. Although the potential for implementation was not widely examined, some studies have presented evidence for acceptability and feasibility. Generally, studies were of high quality, despite the absence of comparator groups and confounder analyses. CONCLUSIONS The evidence reviewed suggests that despite the various approaches taken, digital storytelling shows promise as an effective approach for supporting well-being in older adults. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42019145922; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145922. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/15512.
Collapse
Affiliation(s)
- Jennifer Stargatt
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Jahar Bhowmik
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Abdullah Al Mahmud
- Centre for Design Innovation, School of Design, Swinburne University of Technology, Hawthorn, Australia
| |
Collapse
|
14
|
Rykkje L, Holm AL, Hem MH. Norwegian Nurses' Reflections Upon Experiences of Ethical Challenges in Older People Care: A Qualitative Thematic Analysis. SAGE Open Nurs 2021; 7:23779608211057938. [PMID: 34869863 PMCID: PMC8640321 DOI: 10.1177/23779608211057938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction Internationally, aging populations have increased needs for health care services, and often specialized care is required. However, services for older people tend to be underfunded, resulting in lack of qualified staff and poor quality care. Resource shortages lead to ethical challenges and insufficient nursing care. Therefore, quality in daily care for older people also depends upon the nurses’ ability to make complex, ethical decisions in their practice. Objectives To explore ethical challenges experienced by nurses caring for older people in clinical practice, and to provide examples of management for the challenges. Methods The data collected were written reflection notes by Norwegian continuous education students in advanced gerontology. Forty two of 83 notes were included and a thematic analysis in six steps was utilized. Findings There are three main themes: (1) meeting vulnerability, discomfort, and suffering, (2) collaboration with relatives, and (3) struggling to perform professional care. Conclusion Nurses strive to “do what is in the patients’ best interest”, and this is fostered through collaboration, professionalism, care, and presence. Nurses’ ethical competencies may develop when reflecting upon their own care performance. Building ethical competencies should be a priority in both nursing education and clinical practice. However, to improve care quality, nurses also need professional knowledge about older people care and ethical awareness should be supported by the workplace.
Collapse
Affiliation(s)
- Linda Rykkje
- Faculty of Health Studies, VID Specialized University, Bergen, Norway
| | - Anne Lise Holm
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Marit Helene Hem
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| |
Collapse
|
15
|
Ejaz FK, Rose M, Polk B. Evaluating Nursing Home Resident and Staff Experiences With a Life Story Program. J Appl Gerontol 2021; 41:124-133. [PMID: 33880958 DOI: 10.1177/07334648211008682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Life story programs hold promise for improving person-centered care and relationships between nursing home residents and staff. A pilot life story intervention study in 16 nursing homes provided residents with complimentary biographical life story books and summaries, and staff with action plans to enhance care planning. Trained volunteers and program staff collected life stories, and researchers interviewed 170 residents at three points in time. Overall, residents had positive experiences with the program, but were less willing to share their books with others afterwards. They also experienced a decrease in depression (Patient Health Questionnaire-8 [PHQ-8]) over time. Surveys of 92 staff demonstrated increases over time in perceived importance of knowing residents' life stories. Administrator/admissions staff found it conditionally feasible to incorporate the program into admission processes. Practice implications of life story work include opportunities to help staff learn more about residents they care for, improve person-centered care, and honor resident preferences in care planning.
Collapse
Affiliation(s)
- Farida K Ejaz
- Benjamin Rose Institute on Aging, Cleveland, OH, USA
| | - Miriam Rose
- Benjamin Rose Institute on Aging, Cleveland, OH, USA
| | - Brian Polk
- Benjamin Rose Institute on Aging, Cleveland, OH, USA
| |
Collapse
|
16
|
Thoft DS, Møller AK, Møller AKK. Evaluating a digital life story app in a nursing home context - A qualitative study. J Clin Nurs 2021; 31:1884-1895. [PMID: 33590641 DOI: 10.1111/jocn.15714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/08/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate how digital life stories can be used to support person-centred care focusing on benefits and challenges experienced by the staff and the management team in a nursing home context. BACKGROUND Life story work can be used to support person-centred care and help people with dementia maintain their identity. The use of digital life stories provides opportunities to easily share the content between staff and relatives and combine different types of multimedia, for example pictures, videos, text and sound. DESIGN Six healthcare professionals and two members of the management team at a nursing home were recruited. Participant observations with informal interviews of the formal health career were conducted in two day shifts and two night shifts. Field notes were taken during the observations. Also, individual semi-structured interviews were held with four of the recruited participants. This article adheres to the Standards for Reporting Qualitative Research (SRQR). RESULTS Themes revealed were (1) person-centred care and life story work as interrelated approaches; (2) Pros and cons related to the My Life Story app; and how (3) Time and information and communication technology (ICT) can restrict life story work. CONCLUSION Digital life stories can be used to support a person-centred care approach. However, a number of challenges exist related to digital life story work. When using digital life stories, it is important to ensure the staff time and competences needed to work with, for example an app and that visible support and encouragement are provided by the management team. RELEVANCE TO CLINICAL PRACTICE Challenges are revealed when life story work is embedded in the culture and everyday work of a nursing home. It is of great importance to clinical practice to be aware of and address these challenges in order to succeed with digital life story work.
Collapse
Affiliation(s)
- Diana S Thoft
- University College Northern Denmark, Aalborg, Denmark
| | | | | |
Collapse
|