Putting responsive behaviours in place: Examining how formal and informal carers understand the actions of people with dementia
Putting responsive behaviours in place: Examining how formal and informal carers understand the actions of people with dementia
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DOI：
10.1016/j.socscimed.2018.03.017
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发表时间：
2018-05-01
影响因子：
5.4
通讯作者：
Wrathall, M. A.
中科院分区：
文献类型：
--
作者：
Herron, R. V.;Wrathall, M. A.
与大喊大叫或三振出局的痴呆症患者一起生活和工作是非常困难的，有时甚至是有害的。人们普遍认为，这些行为可能是对社会和物理环境的反应，但很少有人关注环境在不同环境中引发和响应这些行为时所起的作用。通过对27名正式和非正式护理人员的半结构化访谈，本文研究了护理人员如何理解痴呆症患者与环境的关系。我们确定了影响痴呆症患者行为和护理人员与他们合作能力的个人、人际、当地环境、宏观尺度和时间动态。根据关系思维和结构性暴力的概念，我们认为与攻击性行为相关的许多问题和解决方案都位于痴呆症患者之外的更广泛的关系和护理系统中。最后，我们讨论了这些理解如何能够为家庭和社区护理系统的发展提供信息。
Living alongside and working with people with dementia who yell or strike out can be very demanding and sometimes harmful. It is generally understood that such actions may be a response to the social and physical environment, yet very little attention has been paid to understanding what role the environment plays in eliciting and responding to these actions across different settings. Drawing on 27 semi-structured interviews with formal and informal carers, this article examines how carers understand the actions of people with dementia in relation to their environment. We identify individual, interpersonal, local environmental, macro-scale and temporal dynamics that influence the actions of people with dementia and carers' capacities to work with them. Drawing on relational thinking and the concept of structural violence, we argue that many of the problems and solutions associated with aggressive actions are located outside the person with dementia in broader relations and systems of care. We conclude with a discussion of how these understandings can inform developments in the systems of home and community care.