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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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2
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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. [PMID: 38433345 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)
| | - Adriana Perez
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nancy Hodgson
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Moving toward more person-centered dementia care. Int Psychogeriatr 2022; 34:227-228. [PMID: 33818345 PMCID: PMC8490490 DOI: 10.1017/s1041610221000478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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4
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Suzuki M, Yoshimura H, Mimuro S, Sawaki K, Naito T, Inagaki K, Kanamori T, Matsushita K, Sasaki N, Ishihara T, Sakai I. [Effectiveness of programs developed for nurses to improve dementia nursing intervention ability in an acute care setting]. Nihon Ronen Igakkai Zasshi 2022; 59:67-78. [PMID: 35264536 DOI: 10.3143/geriatrics.59.67] [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] [Indexed: 06/14/2023]
Abstract
PURPOSE The number of hospitalizations of older patients with dementia who require medical treatment has increased and delirium or physical restriction have become problems in the acute care setting. Dementia nursing intervention ability developing program by e-learning assumed the quality improvement of dementia medical care and the nursing of older patients with dementia based on person-centered aimed at reduction of body restriction. The purpose of this study was to validate the effectiveness of the developed e-learning programs for nurses in the acute care setting of seven to one nursing standards. METHOD This study was conducted between April and December 2020. This study was introduced to the floor nurse of the hospital for suitable application. Interested nurses were asked to attend "Developing programs for Dementia nursing intervention ability (4 weeks)" at four different time points (1) before attendance (baseline), post-attendance (1 month later), (3) practiced 3 months post-attendance, and (4) practiced 6 months post-attendance. A questionnaire to evaluate program effectiveness asked about consciousness of the dementia nursing with four items on "Interest in nursing of people with dementia and so on (four items)".In the evaluation on the person-centered dementia care, using the Self-assessment Scale of Nursing Practice for Elderly Patients with Cognitive Impairment, the Approach to Dementia Questionnaire - Japanese Edition (19 items). In the evaluation of ethics, ethical sensitivity scale for clinical nurses (19 items), self-efficacy on reduction of the physical restriction (six items). A statistical analysis was conducted using the Bonferroni test as the multiple test method to compare baseline values with the values obtained 1, 3, and 6 months later. RESULTS A total of 70 subjects were analyzed in this study. They belonged to different wards including the surgical and internal wards from where 60 subjects (85.7%) were recruited. The average clinical experience of the nurses was 13.5±9.5 years. The degree of self-efficacy was assessed in terms of attaching mitten type gloves as a physical restraint to avoid the pulling of tubes used for intravenous feeding, central veins, normal feeding, etc. by the patients and so on. Most patients had cognitive functional disorder, including dementia [n = 30 (42.9%)]. The self-assessed scale of nursing practice for elderly people with cognitive impairment, which aimed to promote person-centered care in an acute care hospital, revealed that the total score of each of the Approaches to Dementia Questionnaire - Japanese Edition significantly increased just after intervention (1 month) in comparison to baseline, and 3 months and 6 months after intervention. CONCLUSION This study indicated that the program developed to improve dementia nursing intervention ability significantly increased the above-mentioned evolution and consciousness of nurses after the intervention program (1 month), followed by 3 months and 6 months later. Along with ethical sensitivity, practice aimed at person-centered care was also found to improve. It was suggested that the intervention program of this study was effective and that nurses could easily learn using their respective free time and practice.
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Affiliation(s)
- Mizue Suzuki
- Hamamatsu University School of Medicine Faculty of Nursing
| | | | | | | | | | - Keigo Inagaki
- Hamamatsu University School of Medicine Faculty of Nursing
| | | | | | | | | | - Ikuko Sakai
- Graduate School of Nursing, China University
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5
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Riquelme-Galindo J, Lillo-Crespo M. Designing Dementia Care Pathways to Transform Non Dementia-Friendly Hospitals: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179296. [PMID: 34501886 PMCID: PMC8431306 DOI: 10.3390/ijerph18179296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
People with dementia (PwD) occupy around 25% of the hospital beds. Once PwD are admitted to hospitals, their cognitive impairment is not considered in most of the cases. Thus, it causes an impact on the development of the disease becoming a stressful situation as care plans are not adapted to PwD. The aim of this study was to explore the published core elements when designing a dementia care pathway for hospital settings. A scoping review was conducted to provide an overview of the available research evidence and identify the knowledge gaps regarding the topic. This review highlights person-centered care, compassionate care and end-of-life process as some of the key elements that should integrate the framework when designing a dementia care pathway. Architectonical outdoor and indoor hospital elements have also been found to be considered when adapting the healthcare context to PwD. Findings provide information about the key points to focus on to successfully design dementia interventions in hospital environments within available resources, mostly in those contexts in which national dementia plans are in its infancy. Hospitals should transform their patients’ routes and processes considering the increasing demographic changes of people with cognitive impairment.
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Affiliation(s)
- Jorge Riquelme-Galindo
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain;
- HLA Vistahermosa Hospital, 03015 Alicante, Spain
- Correspondence:
| | - Manuel Lillo-Crespo
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain;
- HLA Vistahermosa Hospital, 03015 Alicante, Spain
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6
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Boltz M, Kuzmik A, Resnick B, BeLue R. Recruiting and Retaining Dyads of Hospitalized Persons with Dementia and Family Caregivers. West J Nurs Res 2021; 44:319-327. [PMID: 34382886 DOI: 10.1177/01939459211032282] [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]
Abstract
Persons with dementia have high rates of hospitalization, and along with their caregivers commonly experience negative hospital outcomes. The recruitment and retention of acutely ill older adults with dementia and caregivers can pose a challenge to investigators and threaten the validity of findings. The challenges encountered in an ongoing cluster randomized clinical trial in dyads of hospitalized persons with dementia and family care partners are described. The trial tests the efficacy of a nurse-family partnership model that aims to improve the following: (a) the physical and cognitive recovery in hospitalized persons with dementia, and (b) caregiver preparedness and anxiety. Strategies that address challenges include careful preplanning and preparation with the hospital site, strong communication with dyads and between team members, and honoring preferences and needs related to communication.
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Affiliation(s)
- Marie Boltz
- The Pennsylvania State University, College of Nursing, University Park, PA, USA
| | - Ashley Kuzmik
- The Pennsylvania State University, College of Nursing, University Park, PA, USA
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7
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Petty S, Griffiths A, Coleston DM, Dening T. Improving emotional well-being for hospital-based patients with dementia. QUALITY IN AGEING AND OLDER ADULTS 2020. [DOI: 10.1108/qaoa-05-2020-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Improving hospital care for people with dementia is a well-established priority. There is limited research evidence to guide nursing staff in delivering person-centred care, particularly under conditions where patients are emotionally distressed. Misunderstood distress has negative implications for patient well-being and hospital resources. The purpose of this study is to use the expertise of nurses to recommend ways to care for the emotional well-being of patients with dementia that are achievable within the current hospital setting.
Design/methodology/approach
A qualitative study was conducted in two long-stay wards providing dementia care in a UK hospital. Nursing staff (n = 12) were asked about facilitators and barriers to providing emotion-focused care. Data were analysed using thematic analysis.
Findings
Nursing staff said that resources existed within the ward team, including ways to gather and present personal information about patients, share multidisciplinary and personal approaches, work around routine hospital tasks and agree an ethos of being connected with patients in their experience. Staff said these did not incur financial cost and did not depend upon staffing numbers but did take an emotional toll. Examples are given within each of these broader themes.
Research limitations/implications
The outcome is a short-list of recommended staff actions that hospital staff say could improve the emotional well-being of people with dementia when in hospital. These support and develop previous research.
Originality/value
In this paper, frontline nurses describe ways to improve person-centred hospital care for people with dementia.
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8
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Toubøl A, Moestrup L, Ryg J, Thomsen K, Nielsen DS. Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study. DEMENTIA 2020; 20:1501-1517. [PMID: 32930603 DOI: 10.1177/1471301220947848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The term dementia-friendly hospital is increasingly used to describe a variety of initiatives and strategies that are implemented to meet the challenges faced by patients with dementia during hospitalization. However, no definition of the dementia-friendly hospital currently exists. This qualitative focus group study aimed to describe stakeholders' perspectives of the dementia-friendly hospital. Four stakeholder groups were included: people with dementia, relatives, hospital staff, and representatives from the Danish Alzheimer Association. The thematic analysis suggests that a person-centered approach is a key feature. This approach is described as a continuously reflexive awareness of how to see the person behind the dementia diagnosis. We discuss possible revision of the current dementia discourse and the implications of the findings for future practice and research.
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Affiliation(s)
- Annemarie Toubøl
- 138728Health Sciences Research Center, UCL University College, Denmark
| | - Lene Moestrup
- Health Sciences Research Center, 138728UCL University College, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Dorthe S Nielsen
- Centre for Global Health, 6174University of Southern Denmark, Denmark
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9
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Surr CA, Sass C, Burnley N, Drury M, Smith SJ, Parveen S, Burden S, Oyebode J. Components of impactful dementia training for general hospital staff: a collective case study. Aging Ment Health 2020; 24:511-521. [PMID: 30596270 DOI: 10.1080/13607863.2018.1531382] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background and objectives: People with dementia occupy around one quarter of general hospital beds, with concerns consistently raised about care quality. Improving workforce knowledge, skills and attitudes is a mechanism for addressing this. However little is known about effective ways of training healthcare staff about dementia. This study aimed to understand models of dementia training most likely to lead to improved practice and better care experiences for people with dementia, and to understand barriers and facilitators to implementation.Method: A collective case study was conducted in three National Health Service Acute Hospital Trusts in England. Multiple data sources were used including interviews with training leads/facilitators, ward managers and staff who had attended training; satisfaction surveys with patients with dementia and/or carers; and observations of care using Dementia Care Mapping.Results: Interactive face-to-face training designed for general hospital staff was valued. Simulation and experiential learning methods were felt to be beneficial by some staff and stressful and distressing by others. Skilled delivery by an experienced and enthusiastic facilitator was identified as important. Staff identified learning and practice changes made following their training. However, observations revealed not all staff had the knowledge, attitudes and skills needed to deliver good care. Patient and carer satisfaction with care was mixed. A major barrier to training implementation was lack of resources. Supportive managers, organisational culture and strong leadership were key facilitators.Conclusion: Dementia training can lead to improved care practices. There are a range of key barriers and facilitators to implementation that must be considered.
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Affiliation(s)
- Claire A Surr
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Cara Sass
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Natasha Burnley
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Michelle Drury
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Sarah J Smith
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Sahdia Parveen
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Sarah Burden
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Jan Oyebode
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
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10
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Toubøl A, Moestrup L, Ryg J, Thomsen K, Nielsen DS. "Even Though I Have Dementia, I Prefer That They Are Personable": A Qualitative Focused Ethnography Study in a Danish General Hospital Setting. Glob Qual Nurs Res 2020; 7:2333393619899388. [PMID: 31976359 PMCID: PMC6958651 DOI: 10.1177/2333393619899388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 01/01/2023] Open
Abstract
Patients with dementia often face challenges in hospital settings due to cognitive impairment. The aim of this study is to explore the encounter between patients with dementia and hospital staff, from the patient perspective. Focused ethnography guided the method for data collection and the analytical approach was abductive. The findings, based on 10 observations of patients with dementia and their encounter with hospital staff in a variety of hospital settings, reveal that staff often seem to not see the person beyond the dementia diagnosis. The findings also show, however, that significant moments are constantly negotiated during encounters between patients with dementia and hospital staff, moments which occasionally allow staff to see the patients to be seen as the person they are. A rethinking of the current dementia discourse is discussed, recommending attention to the two-way interaction between patients with dementia and hospital staff, and within this an awareness of a personable approach.
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Affiliation(s)
- Annemarie Toubøl
- University College Lillebaelt, Vejle, Denmark.,University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
| | | | - Jesper Ryg
- University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
| | | | - Dorthe Susanne Nielsen
- University College Lillebaelt, Vejle, Denmark.,University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
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11
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The securitisation of dementia: socialities of securitisation on secure dementia care units. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19001247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractNearly 50 million people around the world live with dementia, with statistics predicting a steady increase in prevalence for the foreseeable future. There is a need for comprehensive and compassionate dementia care. Long-term care homes have built special care units for people living with middle- to late-stage dementia. Among other services, these care units often use innovative security technologies that monitor and curtail movement beyond unit exit doors. As care-givers and technology developers grapple with the ethical dilemma of autonomy and risk management, researchers are beginning to investigate the social impact of these security technologies. The present research contributes to this line of inquiry. Fieldwork was carried out on two secure long-term care units for people living with dementia. Ethnographic accounts will illustrate how security technology creates socialities of securitisation on a secure dementia unit. Using securitisation theory, I will argue that dementia has been redefined, shifting it from a health issue to a security issue. The discursive construction of dementia as a security issue will be considered in terms of the co-constructed notions of vulnerability, risk, security threat and security challenge with respect to people living with dementia. The paper investigates how securitisation influences the ethics of dementia care.
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12
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Jensen AM, Pedersen BD, Wilson RL, Bang Olsen R, Hounsgaard L. Nurses’ experiences of delivering acute orthopaedic care to patients with dementia. Int J Older People Nurs 2019; 14:e12271. [DOI: 10.1111/opn.12271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/17/2019] [Accepted: 07/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Anders Møller Jensen
- Department of Clinical Research, OPEN, Odense Patient data Explorative Network Odense University Hospital University of Southern Denmark Odense Denmark
- Faculty of Health Sciences, VIA Ageing & Dementia ‐ Center for Research VIA University College Holstebro Denmark
| | - Birthe D. Pedersen
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Rhonda L. Wilson
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Faculty of Health, School of Nursing, Midwifery and Public Health University of Canberra Bruce ACT Australia
- Department of Regional Health Research, Faculty of Health Sciences, Center for Psychiatric Nursing and Health Research University of Southern Denmark Odense Denmark
| | - Rolf Bang Olsen
- Department of Clinical Research, OPEN, Odense Patient data Explorative Network Odense University Hospital University of Southern Denmark Odense Denmark
- Faculty of Health Sciences, VIA Ageing & Dementia ‐ Center for Research VIA University College Holstebro Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Faculty of Health, School of Nursing, Midwifery and Public Health University of Canberra Bruce ACT Australia
- Department of Regional Health Research, Faculty of Health Sciences, Center for Psychiatric Nursing and Health Research University of Southern Denmark Odense Denmark
| | - Lise Hounsgaard
- Department of Clinical Research, OPEN, Odense Patient data Explorative Network Odense University Hospital University of Southern Denmark Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
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13
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The acute care experience of older persons with cognitive impairment and their families: A qualitative study. Int J Nurs Stud 2019; 96:44-52. [DOI: 10.1016/j.ijnurstu.2018.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/21/2018] [Accepted: 11/24/2018] [Indexed: 11/24/2022]
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14
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Xidous D, Grey T, Kennelly SP, McHale C, O'Neill D. Dementia Friendly Hospital Design: Key Issues for Patients and Accompanying Persons in an Irish Acute Care Public Hospital. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2019; 13:48-67. [PMID: 31084297 DOI: 10.1177/1937586719845120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Research was conducted to investigate the impact of the hospital environment on older people including patients with dementia and their accompanying persons (APs). The article presents key research findings in the case study hospital. BACKGROUND For many patients, the hospital is challenging due to the busy, unfamiliar, and stressful nature of the environment. For a person with dementia, the hospital experience can be exacerbated by cognitive impairment and behavioral or psychological symptoms and can therefore prove to be a frightening, distressing, and disorientating place. METHOD The findings are based on a stakeholder engagement process where the research team spent approximately 150 hr observing within the hospital, administered 95 questionnaires to patients and/or APs, and conducted 12 structured interviews with patients and APs. A thematic analysis was employed to analyze and generate key themes emerging from the process. RESULTS Themes were grouped into overarching issues and design issues across spatial scales. CONCLUSION This research confirms the negative impact of the acute hospital setting on older people with cognitive impairments including dementia and delirium. The multiple perspectives captured in this study, including most importantly people with dementia, ensure that stakeholder needs can be used to inform the design of the hospital environment. The research points to the value of understanding the lived experience of the person with dementia and APs. The voices of patients, particularly persons with dementia and their APs, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities.
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Affiliation(s)
- Dimitra Xidous
- TrinityHaus Research Centre, Trinity College Dublin, Dublin, Ireland
| | - Tom Grey
- TrinityHaus Research Centre, Trinity College Dublin, Dublin, Ireland
| | - S P Kennelly
- Centre for Ageing, Neuroscience and the Humanities, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - Cathy McHale
- Centre for Ageing, Neuroscience and the Humanities, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - Desmond O'Neill
- TrinityHaus Research Centre, Trinity College Dublin, Dublin, Ireland.,Centre for Ageing, Neuroscience and the Humanities, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
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15
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Petty S, Dening T, Griffiths A, Coleston DM. Importance of personal and professional experience for hospital staff in person-centred dementia care: a cross-sectional interview study using freelisting in a UK hospital ward. BMJ Open 2019; 9:e025655. [PMID: 31048438 PMCID: PMC6502240 DOI: 10.1136/bmjopen-2018-025655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/23/2018] [Accepted: 01/30/2019] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To detail how hospital staff with differing personal and professional caregiving experiences approach the care of patients with dementia, in order to make practical recommendations for practice. DESIGN Cross-sectional qualitative interviews. SETTING A UK hospital ward providing dementia care. PARTICIPANTS A complete hospital ward staff team, constituting 47 hospital staff from 10 professions. METHODS Hospital staff were asked to list their approaches to emotion-focused care in individual, ethnographic freelisting interviews. Cultural consensus analysis was used to detail variations in approaches to dementia care between staff subgroups. MAIN OUTCOME MEASURES The most salient listed descriptions of care emphasised by staff members with personal experience of dementia caregiving when compared with staff members without such experience, and descriptions from staff newer to the profession compared with staff with more years of professional dementia caregiving experience. RESULTS Subgroups of hospital staff showed different patterns of responses both in how they noticed the emotional distress of patients with dementia, and in prioritised responses that they deemed to work. Hospital staff with professional experience of dementia caregiving and staff with fewer years of professional experience prioritised mutual communication and getting to know each patient. CONCLUSIONS Subgroups of hospital staff with personal caregiving experiences and fewer years of professional care experience were more likely to describe person-centred care as their routine ways of working with patients with dementia. It is recommended that personal experience and the novice curiosity of hospital staff be considered as valuable resources that exist within multidisciplinary staff teams that could enhance staff training to improve the hospital care for patients with dementia.
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Affiliation(s)
- Stephanie Petty
- Specialist Older Adults Psychology, The Retreat, York, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tom Dening
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Amanda Griffiths
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Donna Maria Coleston
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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16
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Lin R, Chen HY, Li H, Li J. Effects of creative expression therapy on Chinese elderly patients with dementia: an exploratory randomized controlled trial. Neuropsychiatr Dis Treat 2019; 15:2171-2180. [PMID: 31440055 PMCID: PMC6679675 DOI: 10.2147/ndt.s200045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 04/24/2019] [Indexed: 01/10/2023] Open
Abstract
Purpose: This study aimed to evaluate the effect of creative expression (CE) therapy on cognition, communication, emotion, and quality-of-life in people with dementia. Methods: One hundred individuals were included in this study, of whom 91 completed the study (mean age=84.33). The participants were randomly assigned to an intervention group (n=43) and a control group (n=48), and received the CE program or standard cognitive (SC) training twice a week for 6 weeks, respectively. Both groups were submitted to extensive neuropsychological tests, as follows - Mini-Mental State Examination (MMSE), Quality of Life-Alzheimer's Disease (QOL-AD), Cornell Scale for Depression in Dementia (CSDD), Functional Assessment of Communication Skills (FACS) at baseline, 1-, and 4 -weeks post-intervention, and the Observed Emotion Rating Scale (OERS) was measured during the intervention period at weeks 3 and 6. Results: The participants demonstrated significant improvements in cognitive function, quality-of-life, depression degree, communication ability, and emotion status (P<0.05) at post-intervention, which were maintained at 1-month follow-up. Conclusion: This study provides preliminary evidence that CE therapy developed in the study benefits elderly Chinese with dementia. The findings indicated that non-pharmacological intervention programs - CE therapy - can be applied in the management of neuropsychiatric symptoms of dementia.
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Affiliation(s)
- Rong Lin
- Department of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Hui-Ying Chen
- Fujian Provincial Hospital , Fuzhou, People's Republic of China
| | - Hong Li
- Department of Nursing, Fujian Medical University, Fuzhou, People's Republic of China.,Fujian Provincial Hospital , Fuzhou, People's Republic of China
| | - Jing Li
- Fujian Provincial Hospital , Fuzhou, People's Republic of China
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Jensen AM, Pedersen BD, Olsen RB, Wilson RL, Hounsgaard L. "If only they could understand me!" Acute hospital care experiences of patients with Alzheimer's disease. DEMENTIA 2018; 19:2332-2353. [PMID: 30587029 DOI: 10.1177/1471301218820483] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with dementia as co-morbidity find hospital stays challenging, because the focus is primarily on the somatic cause for the admission, with less emphasis on the needs pertaining to dementia-related support and care. This results in poorer holistic outcomes, compared to patients without dementia, and an increased cost for the healthcare sector and, society as a whole. The quest is to make hospitals a dementia-friendly context, because this is likely to lead to better patient outcomes for people with dementia generally; however, further research is required to understand where gains may be made in this regard. This study conducted participant observation research strategies to follow patient journeys with Alzheimer's disease admitted to orthopaedic wards, to learn about their experiences as patients. Longitudinal data were gathered by following patients on both day and evening shifts within a specialist orthopaedic hospital ward, commencing at patient admission and concluding at time of discharge. The data were interpreted from a phenomenological-hermeneutic perspective, inspired by Ricoeur's interpretation theory. The study revealed a communication style among nurses who failed to take into account the comprehensive needs of patients with dementia, in terms of timely information exchange and clinical relevance. Patients expressed the desire to be more fully engaged in the care decision-making, together with indicating their appreciation of the work of the health professionals who cared for them. The data revealed that the process of getting to know the patient at the beginning of every shift left little room to alleviate patients' experienced distress, caused by being in hospital. This resulted in patients who were less involved in the caring situation, or, if a patient took the initiative to act, intentions ended up being misinterpreted as disruptive behaviour. The findings have relevance for staff and ward management who are interested to strive to enhance the patient journey as a dementia-friendly hospital.
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Affiliation(s)
- Anders Møller Jensen
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; VIA Ageing & Dementia - Center for research, Faculty of Health Sciences, VIA University College, Denmark
| | - Birthe D Pedersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Rhonda L Wilson
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Faculty of Health Sciences, Department of Regional Health Research, Center for Psychiatric Nursing and Health Research, University of Southern Denmark, Odense, Denmark
| | - Lise Hounsgaard
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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Petty S, Dening T, Griffiths A, Coleston DM. Meeting the Emotional Needs of Hospital Patients With Dementia: A Freelisting Study With Ward Staff. THE GERONTOLOGIST 2018; 60:155-164. [DOI: 10.1093/geront/gny151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Stephanie Petty
- The Retreat, York
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, UK
| | - Tom Dening
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, UK
| | - Amanda Griffiths
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, UK
| | - Donna Maria Coleston
- Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham, UK
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19
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Tauber-Gilmore M, Norton C, Procter S, Murrells T, Addis G, Baillie L, Velasco P, Athwal P, Kayani S, Zahran Z. Development of tools to measure dignity for older people in acute hospitals. J Clin Nurs 2018; 27:3706-3718. [DOI: 10.1111/jocn.14490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Christine Norton
- Florence Nightingale Faculty of Nursing and Midwifery; King's College London; London UK
| | - Sue Procter
- School of Health and Social Science; Buckinghamshire New University; High Wycombe Buckinghamshire UK
| | - Trevor Murrells
- Florence Nightingale Faculty of Nursing and Midwifery; King's College London; London UK
| | - Gulen Addis
- Department of Applied Health and Exercise Science; School of Health & Social Science; Buckingham New University; Uxbridge, Middlesex UK
| | - Lesley Baillie
- Faculty of Wellbeing, Education and Language Studies; The Open University; Milton Keynes UK
| | - Pauline Velasco
- Florence Nightingale Faculty of Nursing and Midwifery; King's College London; London UK
| | - Preet Athwal
- Florence Nightingale Faculty of Nursing and Midwifery; King's College London; London UK
| | - Saeema Kayani
- Florence Nightingale Faculty of Nursing and Midwifery; King's College London; London UK
| | - Zainab Zahran
- Florence Nightingale Faculty of Nursing and Midwifery; King's College London; London UK
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20
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Godfrey M, Young J, Shannon R, Skingley A, Woolley R, Arrojo F, Brooker D, Manley K, Surr C. The Person, Interactions and Environment Programme to improve care of people with dementia in hospital: a multisite study. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06230] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Improving the care of people with dementia on acute hospital wards is a policy priority. Person-centred care is a marker of care quality; delivering such care is a goal of service improvement.
Objectives
The Person, Interactions and Environment (PIE) Programme comprises an observation tool and a systematic approach to implement and embed a person-centred approach in routine care for hospitalised patients with dementia. The study aims were to evaluate PIE as a method to improve the care of older people with dementia on acute hospital wards, and develop insight into what person-centred care might look like in practice in this setting.
Methods
We performed a longitudinal comparative case study design in 10 purposively selected wards in five trusts in three English regions, alongside an embedded process evaluation. Data were collected from multiple sources: staff, patients, relatives, organisational aggregate information and documents. Mixed methods were employed: ethnographic observation; interviews and questionnaires; patient case studies (patient observation and conversations ‘in the moment’, interviews with relatives and case records); and patient and ward aggregate data. Data were synthesised to create individual case studies of PIE implementation and outcomes in context of ward structure, organisation, patient profile and process of care delivery. A cross-case comparison facilitated a descriptive and explanatory account of PIE implementation in context, the pattern of variation, what shaped it and the consequences flowing from it. Quantitative data were analysed using simple descriptive statistics. A qualitative data analysis employed grounded theory methods.
Results
The study furthered the understanding of the dimensions of care quality for older people with dementia on acute hospital wards and the environmental, organisational and cultural factors that shaped delivery. Only two wards fully implemented PIE, sustaining and embedding change over 18 months. The remaining wards either did not install PIE (‘non-implementers’) or were ‘partial implementers’. The interaction between micro-level contextual factors [aspects of leadership (drivers, facilitators, team, networks), fit with strategic initiatives and salience with valued goals] and meso- and macro-level organisational factors were the main barriers to PIE adoption. Evidence suggests that the programme, where implemented, directly affected improvements in ward practice, with a positive impact on the experiences of patients and caregivers, although the heterogeneity of need and severity of impairment meant that some of the more visible changes did not affect everyone equally.
Limitations
Although PIE has the potential to improve the care of people with dementia when implemented, findings are indicative only: data on clinical outcomes were not systematically collected, and PIE was not adopted on most study wards.
Research implications
Further research is required to identify more precisely the skill mix and resources necessary to provide person-focused care to hospitalised people with dementia, across the spectrum of need, including those with moderate and severe impairment. Implementing innovations to change practices in complex organisations requires a more in-depth understanding of the contextual factors that have an impact on the capacity of organisations to absorb and embed new practices.
Funding
The National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Mary Godfrey
- Academic Unit of Elderly Care and Rehabilitation, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - John Young
- Academic Unit of Elderly Care and Rehabilitation, Faculty of Medicine and Health, University of Leeds, Leeds, UK
- Bradford Institute for Health Research (BIHR), Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rosemary Shannon
- Bradford Institute for Health Research (BIHR), Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Ann Skingley
- Sidney de Haan Research Centre for Arts and Health, Faculty of Health and Wellbeing, Canterbury Christ Church University, Canterbury, UK
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Rosemary Woolley
- Bradford Institute for Health Research (BIHR), Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Frank Arrojo
- Patient and public involvement representative, Alzheimer’s Society Research Network
| | - Dawn Brooker
- Association for Dementia Studies, Institute of Health and Society, University of Worcester, Worcester, UK
| | - Kim Manley
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
- England Centre for Practice Development, Faculty of Health and Wellbeing, Canterbury Christ Church University, Canterbury, UK
| | - Claire Surr
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
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21
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Naef R, Ernst J, Bürgi C, Petry H. Quality of acute care for persons with cognitive impairment and their families: A scoping review. Int J Nurs Stud 2018; 85:80-89. [PMID: 29859348 DOI: 10.1016/j.ijnurstu.2018.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND An increasing number of older persons with cognitive impairment use inpatient services for co-occurring acute illness. Research has demonstrated that persons with cognitive impairment face more adverse health outcomes during hospitalization than their age counterparts without cognitive impairment. As hospitals tend to be ill equipped to meet the complex care needs of this population, various initiatives underscore the need to better utilize existing evidence to improve quality of care. OBJECTIVES To map the extent of knowledge about quality of acute care in inpatient settings, and to synthesize knowledge on strategies to improve quality care for persons with cognitive impairment and their families. DESIGN A scoping review using Arksey and O'Malley's methodological framework. DATA SOURCES CINAHL and Medline were searched and reference lists of pertinent articles screened to identify publications regarding acute care for persons with cognitive impairment. REVIEW METHODS Two reviewers independently screened and identified publications based on eligibility criteria. Publications were included if they targeted acute care issues relating to persons with cognitive impairment 65 years or older, their family members, or health professionals caring for them, and were published after 2000 in English or German. Publications were read and data were extracted using a predefined template. Thematic analysis was conducted by two reviewers. RESULTS Of the 1445 identified publications, 66 were included. Quality of acute inpatient services pertained to structural (such as staff capacity and knowledge) and process dimensions (such as forming a caring relationship, assessing and intervening). Strategies identified to improve care quality included interventions at the point of care, such as specific tools and specialist roles to improve patient outcomes, as well as educational and training interventions to enable staff to care for this patient group. CONCLUSIONS There is a discrepancy between clearly defined best practice for persons with cognitive impairment utilising inpatient services, and the quality of care actually experienced by patients, family members, and staff. Research reveals a sobering picture of inadequate care and manifold challenges encountered by this patient group, family members and staff alike. Promising strategies to improve care quality target health professionals' knowledge and capacity to work with this group and include specific tools and models of care, such as specialist roles and units. Organisation-wide efforts to ensure quality care for this patient group are needed, as is further research to determine which implementation and intervention strategies achieve the most beneficial outcomes for all involved.
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Affiliation(s)
- Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.
| | - Jutta Ernst
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Catherine Bürgi
- Division of Abdomen-Metabolism, University Hospital Zurich, Zurich, Switzerland
| | - Heidi Petry
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
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Abstract
Background Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.
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Affiliation(s)
| | - Kezia Scales
- PHI (Paraprofessional Healthcare Institute), Bronx, NY, USA
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23
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Hung L, Phinney A, Chaudhury H, Rodney P, Tabamo J, Bohl D. "Little things matter!" Exploring the perspectives of patients with dementia about the hospital environment. Int J Older People Nurs 2017; 12:e12153. [PMID: 28418180 PMCID: PMC5574000 DOI: 10.1111/opn.12153] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/07/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Recognising demographic changes and importance of the environment in influencing the care experience of patients with dementia, there is a need for developing the knowledge base to improve hospital environments. Involving patients in the development of the hospital environment can be a way to create more responsive services. To date, few studies have involved the direct voice of patients with dementia about their experiences of the hospital environment. DESIGN AND METHOD Using an action research approach, we worked with patients with dementia and a team of interdisciplinary staff on a medical unit to improve dementia care. The insights provided by patients with dementia in the early phase shaped actions undertaken at the later stage to develop person-centred care within a medical ward. We used methods including go-along interviews, video recording and participant observation to enable rich data generation. AIM This study explores the perspectives of patients with dementia about the hospital environment. RESULTS The participants indicated that a supportive hospital environment would need to be a place of enabling independence, a place of safety, a place of supporting social interactions and a place of respect. CONCLUSIONS Patient participants persuasively articulated the supportive and unsupportive elements in the environment that affected their well-being and care experiences. They provided useful insights and pointed out practical solutions for improvement. Action research offers patients not only opportunities to voice their opinion, but also possibilities to contribute to hospital service development. IMPLICATIONS FOR PRACTICE This is the first study that demonstrates the possibility of using go-along interviews and videoing with patients with dementia staying in a hospital for environmental redesign. Researchers, hospital leaders and designers should further explore strategies to best support the involvement of patients with dementia in design and redesign of hospital environments.
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Affiliation(s)
- Lillian Hung
- School of NursingUniversity of British ColumbiaVancouverBCCanada
| | - Alison Phinney
- School of NursingUniversity of British ColumbiaVancouverBCCanada
| | | | - Paddy Rodney
- School of NursingUniversity of British ColumbiaVancouverBCCanada
| | | | - Doris Bohl
- Vancouver Coastal HealthVancouverBCCanada
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24
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Brooke J, Ojo O. Elements of a sustainable, competent, and empathetic workforce to support patients with dementia during an acute hospital stay: A comprehensive literature review. Int J Health Plann Manage 2017; 33:e10-e25. [PMID: 28836694 DOI: 10.1002/hpm.2448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 07/18/2017] [Indexed: 11/06/2022] Open
Abstract
Internationally, there has been a focus on the development of acute hospital workforces to support and care for people with dementia. Recommendations and initiatives to improve person-centred care in acute hospitals have included: education and training, dementia-specific roles, clinical leads, and environment changes. The aim of this literature review is to understand the elements of a sustainable, competent, and empathetic acute hospital workforce providing person-centred care for patients with dementia. The following databases were searched for literature published in English from January 1, 2006, to August 1, 2016: CINHAL, MEDLINE, PsychINFO, PubMed, and Science Direct. A thematic analysis was applied to develop a meta-synthesis of the data. A total of 12 papers with a range of methodological approaches from various countries were included. Emergent themes were as follows: understanding the current workforce, implementation and evaluation of training, and exploration of new and existing roles. An important element was the sustainability of acute hospital workforces competent in dementia care, as studies highlighted an ageing nursing population and a high turnover of staff. Dementia awareness training was sustainable, although there was a lack of consistency in the length, content, and delivery, which had a viable impact on the provision of empathetic and person-centred care. The lack of consistency of training and specialist dementia roles restricts recommendations from a robust evidence base.
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Affiliation(s)
- Joanne Brooke
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, The Colonnade, Gipsy Lane Campus, Oxford, UK
| | - Omorogieva Ojo
- Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London, UK
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25
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Abstract
PURPOSE OF REVIEW This review discusses the concept of 'dementia-friendly communities' and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. RECENT FINDINGS Definitions of 'dementia-friendly communities' reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning). Existing research has covered a wide range of topic areas relevant to 'dementia-friendly communities'. However, these studies remain qualitative and exploratory by nature and do not evaluate how dementia-friendly communities impact health and quality of life of people living with dementia and their caregivers. In healthcare settings, being dementia friendly can mean the inclusion of people with dementia in treatment discussion and decision-making, as well as the provision of first, adequate and appropriate service to people with dementia at an equivalent standard of any patient, second, person-centered care, and third, a physical environment following dementia-friendly design guidelines. SUMMARY Research incorporating more robust study designs to evaluate dementia-friendly communities is needed. Being dementia-friendly in healthcare settings requires improvement in multiple areas - some may be achieved by environmental modifications while others may be improved by staff education.
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Brooke J, Semlyen J. Exploring the impact of dementia-friendly ward environments on the provision of care: A qualitative thematic analysis. DEMENTIA 2017; 18:685-700. [PMID: 28103705 DOI: 10.1177/1471301216689402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia-friendly wards are recent developments to improve care for patients with dementia in acute hospitals. This qualitative study used focus groups to understand the impact of dementia friendly ward environments on nurses experiences of caring for acutely unwell patients with dementia. Qualified nurses and health care assistants working in an acute NHS Trust in England discussed their perceptions and experiences of working in a dementia-friendly ward environment. Four themes developed from the thematic analysis: (1) 'It doesn't look like a hospital': A changed environment, (2) 'More options to provide person-centred care': No one size fits all, (3) 'Before you could not see the patients': A constant nurse presence and (4) 'The ward remains the same': Resistance to change. Recommendations and implementations for practice are discussed.
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Affiliation(s)
- Joanne Brooke
- Faculty of Health and Life Science, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Joanna Semlyen
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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