Quality of life of residents with dementia in traditional versus small-scale long-term care settings: A quasi-experimental study
Quality of life of residents with dementia in traditional versus small-scale long-term care settings: A quasi-experimental study
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DOI：
10.1016/j.ijnurstu.2012.02.007
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发表时间：
2012-08-01
影响因子：
8.1
通讯作者：
Schols, Jos M. G. A.
中科院分区：
文献类型：
--
作者：
de Rooij, Alida H. P. M.;Luijkx, Katrien G.;Schols, Jos M. G. A.
背景：全球痴呆症患者的数量正在增加，导致需要更多的住院护理。在回应批评传统的医疗方法，住宅痴呆症护理，许多大型疗养院正在改造他们的传统护理设施到更多的家庭一样的小规模living facilities.Objectives：本研究探讨了假设的好处，小规模生活的居民患有痴呆症，相比传统的长期护理在荷兰和比利时。主要结果是生活质量，分为九个不同的domains.Design：该研究有一个纵向设计在一年的时间interval.Settings：五个长期护理设置在荷兰和比利时包含四个传统的和十二个小规模的生活单位参加了这项研究。数据来自179名痴呆症患者（年龄> 65岁）（荷兰小规模N = 51，传统N = 51，比利时小规模N = 47，传统N = 30）。护士和护理助理进行了培训，以填写调查问卷。结果：在荷兰的样本中，居民在小规模的设置有较高的平均分数的“社会关系”，“积极的影响”，和“有一些事情要做”比居民在传统的设置。此外，“照顾者关系”和“负面影响”的平均得分保持稳定，随着时间的推移，在小规模的设置，但在传统的设置下降的居民。这些差异不能用行为特征、行为干预或社会互动的差异来解释。在比利时的样本中，发现传统环境和小规模环境之间的差异较小。然而，据报道，小规模环境中的居民比传统环境中的居民经历的“负面影响”要少，这可以用抑郁症的差异来解释。然而，随着时间的推移，居民在传统环境中“感觉更自在”，而在小规模环境中没有发现这种增加。此外，平均生活质量得分的“不安的行为”，“有事情做”和“社会关系”下降，在小规模的设置，但保持稳定，在传统settings.Conclusions：小规模和传统的设置似乎有有益的影响不同领域的生活质量的居民痴呆症。未来的研究应更多地关注所提供的护理的质量和内容，而不是长期护理环境的规模和设计的影响。(C)2012爱思唯尔有限公司保留所有权利。
Background: The number of people living with dementia worldwide is increasing, resulting in a need for more residential care. In response to criticism of the traditional medical approach to residential dementia care, many large nursing homes are transforming their traditional care facilities into more home-like small-scale living facilities.Objectives: This study examined the assumed benefits of small-scale living for residents with dementia, compared to traditional long-term care in the Netherlands and Belgium. The primary outcome was quality of life, divided into nine different domains.Design: The study had a longitudinal design within a one-year time interval.Settings: Five long-term care settings in the Netherlands and Belgium containing four traditional and twelve small-scale living units participated in the study.Participants: Data were obtained from 179 residents with dementia (age > 65 years) (Dutch small-scale N = 51, traditional N = 51, Belgian small-scale N = 47, traditional N = 30).Methods: Nurses and nursing assistants were trained to fill in the questionnaires.Results: In the Dutch sample, residents in small-scale settings had higher mean scores on 'social relations', 'positive affect', and 'having something to do' than residents in traditional settings. Moreover, mean scores on 'caregiver relation' and 'negative affect' remained stable over time among residents in small-scale settings, but decreased in traditional settings. These differences could not be explained by differences in behavioural characteristics, behavioural interventions, or social interaction. In the Belgian sample, fewer differences were found between traditional and small-scale settings. Nevertheless, residents in small-scale settings were reported to experience less 'negative affect' than those in traditional settings, which could be explained by differences in depression. Over time, however, residents 'felt more at home' in traditional settings, whereas no such increase was found for small-scale settings. Moreover, the mean quality of life scores on 'restless behaviour', 'having something to do' and 'social relations' decreased in small-scale settings, but remained stable in traditional settings.Conclusions: Both small-scale and traditional settings appear to have beneficial effects on different domains of quality of life of residents with dementia. Future research should focus more on the quality and content of the care provided, than on the effects of the scale and design of the environment in long-term care settings. (C) 2012 Elsevier Ltd. All rights reserved.