Supporting activity engagement by family carers at home: maintenance of agency and personhood in dementia.
Supporting activity engagement by family carers at home: maintenance of agency and personhood in dementia.
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DOI：
10.1080/17482631.2016.1267316
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发表时间：
2017-12
影响因子：
1.8
通讯作者：
Coleman P
中科院分区：
文献类型：
--
作者：
Chung PYF;Ellis-Hill C;Coleman P
一篇探索性的论文描述了家庭照顾者如何通过照顾之旅，重申和促进痴呆症患者的代理。代理是痴呆症护理中的一个重要概念，对促进福祉和提供以人为本的护理至关重要。本文基于一项研究的主要发现之一，该研究探讨了家庭照顾者在家庭环境中与亲属参与日常活动的经验。在研究管理和伦理批准之后，通过当地社区精神卫生团队招募了15名痴呆症患者的住院护理人员，对他们进行了30次深度访谈（初始和后续）。然后进行了五个焦点小组，共有21名参与者通过护理人员支持小组获得。访谈和焦点小组被转录、编码并使用扎根理论方法进行分析。研究结果显示了家庭照顾者在其亲属的日常活动中鼓励和维持自主和控制（代理）感的过程。护理人员使用的主要策略包括：不评判；价值感的：促进价值感的；承担适当的风险；保持亲属身份的连续性；通过愉快的活动增强与亲人角色和身份的联系感；防止不活动和关注代理的身体来源。缺乏对护理人员的支持可能最终对痴呆症患者机构的维持构成风险。这项研究提供了一个更深入的了解过程中使用的家庭护理人员，以支持痴呆症患者的机构。如果从业者要确定和制定更现实的干预策略，并与家庭照顾者建立有效的伙伴关系，这一点至关重要。对创建痴呆症友好社区的影响进行了讨论。
An explorative paper to describe how family carers, through the caregiving journey, reaffirm and promote the agency of people with dementia. Agency is an important concept in dementia care and is crucial to the promotion of wellbeing and the delivery of person-centred care. This article is based on one of the key findings of a study that explored family carers’ experiences of engaging their relatives in daily activities in domestic settings. Following research governance and ethical approval, 30 in-depth interviews (initial and follow-up) were carried out with 15 resident-carers of people with dementia who were recruited via local community mental health teams. Then five focus groups were conducted with 21 participants accessed through carers support groups. Interviews and focus groups were transcribed, coded and analysed using a grounded theory method. Findings showed the process in which family carers encouraged and sustained a sense of autonomy and control (agency) in their relative’s daily activities. Key strategies used by carers included: being non-judgemental; facilitating a sense of worth; taking calculated risks; maintaining the continuity of their relative’s identity; enhancing a sense of connection with their relative’s role and identity using enjoyable activities; preventing inactivity and attending to the bodily source of the agency. Lack of support for carers could ultimately pose a risk to the maintenance of the agency of people with dementia. This study provides a deeper insight into the process used by home carers to support the agency of people with dementia. This is essential if practitioners are to identify and develop more realistic intervention strategies and to work in effective partnership with family carers. The implications for the creation of dementia-friendly communities are discussed.