Good care in group home living for people with dementia. Experiences of residents, family and nursing staff
Good care in group home living for people with dementia. Experiences of residents, family and nursing staff
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DOI：
10.1111/j.1365-2702.2011.03759.x
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发表时间：
2011-09-01
影响因子：
4.2
通讯作者：
Abma, Tineke
中科院分区：
文献类型：
--
作者：
van Zadelhoff, Ezra;Verbeek, Hilde;Abma, Tineke
目的和目的：调查老年痴呆群体生活之家的居民及其家庭照顾者和护理人员的经历以及他们对护理过程的看法。背景：传统的痴呆症养老院存在去人格化、被动性、技能丧失和使用身体约束等缺陷。集体生活之家被视为常规疗养院的替代方案，但在这种新的护理环境下的经历很少被调查。设计：这项研究遵循自然主义设计。在荷兰南部的两个集体生活之家收集了6个月的定性数据。方法：在两个家庭的日常生活、照料和活动中进行系统的参与式观察。此外，还与住院医生、他们的家人和护理人员进行了半结构化访谈。这些数据被归纳分析，并与特隆托的护理伦理框架相关联。结果：各方认为，集体生活之家为个性化护理和关注居民的个人需求创造了结构性机会。对居民福祉的关注和反应的增加被视为良好关怀的标志，符合特隆托关怀伦理模式的关怀和接受关怀的阶段。然而，在承担责任和开展护理的各个阶段出现了紧张局势。并不是所有的居民和家庭成员都愿意或有能力承担责任并进行自我照顾。结论：集体生活之家为良好的照顾创造了条件，并激发了注意力和反应能力。这些疗养院的紧张关系可能与新的职责和任务分工有关。临床实践：关注需求和响应的价值观对于护理人员在疗养院环境中为痴呆症患者提供良好的护理非常重要。
Aims and objectives: To investigate experiences of residents, their family caregivers and nursing staff in group living homes for older people with dementia and their perception of the care process.Background: Traditional nursing homes for people with dementia have several shortcomings related to depersonalisation, passivity, loss of skills and use of physical restraints. Group living homes are seen as an alternative to regular nursing homes, but experiences with this new care setting have rarely been investigated.Design: The study followed a naturalistic design. Qualitative data were collected over a period of 6 months in two group living homes located in the southern part of the Netherlands.Methods: Systematic participatory observations were carried out during daily life, care and activities in both homes. In addition, semi-structured interviews were held with residents, their family and nursing staff. These data were inductively analysed and related to Tronto's care ethical framework.Results: According to all parties, group living homes create structural opportunities for individualised care and attention to the residents' personal needs. The increased attentiveness and responsiveness for residents' well-being was seen as a sign of good care and fits with the phases of caring about and receiving care of Tronto's care ethical model. However, tensions occurred relating to the phases of taking responsibility and carrying out care. Not all residents and family members want or are able to take responsibility and perform self-care.Conclusions: Group living homes create conditions for good care and stimulate attentiveness and responsiveness. Tensions in these homes may relate to the new division of responsibilities and tasks.Relevance to clinical practice: Values of attention to needs and responsiveness are of high importance for nursing staff to provide good care for people with dementia in a nursing home setting.