'I know they are not trained in dementia': Addressing the need for specialist dementia training for home care workers
'I know they are not trained in dementia': Addressing the need for specialist dementia training for home care workers
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DOI：
10.1111/hsc.12880
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发表时间：
2019-10-23
影响因子：
2.4
通讯作者：
Dow, Briony
中科院分区：
文献类型：
--
作者：
Polacsek, Meg;Goh, Anita;Dow, Briony
全球人口老龄化意味着患有痴呆症的老年人数量迅速增加，其中大多数人住在自己的家中。呆在家里是健康和福祉的重要决定因素。随着护理需求的增加，老年人获得的社区支持的质量直接影响他们留在自己家中的能力。虽然许多人得到家庭护理人员的非正式支持，但家庭护理人员提供的正式支持往往使他们能够在家里呆更长时间。然而，为痴呆症患者提供社区护理可能具有挑战性。工作人员往往缺乏针对需求日益复杂的客户的痴呆症特定护理的培训，并且通常在没有直接监督的情况下工作。随着痴呆症患者以人为本的家庭护理需求的增加，迫切需要对家庭护理人员进行专业的痴呆症培训。在这项定性研究中，我们对一个有目的的样本（包括 15 名家庭护理人员和 4 名患有痴呆症的老年人）进行了深入访谈，以了解接受社区护理的经历。数据分析以布劳恩和克拉克的主题分析方法为指导，揭示了以下五个重叠的主题，涉及家庭护理人员对痴呆症的理解、以人为本的护理、沟通和融洽、相互协作以及组织限制对护理连续性的影响。尽管参与者承认服务提供者在充满挑战的环境下运作，但他们对家庭护理人员缺乏痴呆症知识和工作人员排班不一致感到沮丧。相反，对痴呆症生活经历的了解、有效的沟通和融洽关系以及护理的连续性极大地有助于获得积极的接受护理体验。这项研究的结果将用于告知培训计划的基本要素，该计划旨在培养和增强熟练的专业家庭护理人员的能力，以支持患有痴呆症的老年人尽可能长时间地在家中过上好的生活。
Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well-being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community-based care for people with dementia can be challenging. Workers often lack training in dementia-specific care for clients with increasingly complex needs, and typically work without direct supervision. As the demand for person-centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in-depth interviews of a purposive sample, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers' understanding of dementia, person-centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers' lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care. The findings of this study will be used to inform the essential elements of a training program aimed at enabling and empowering a skilled, specialist home care workforce to support older people with dementia to live well at home for as long as possible.