Good practice in the provision of care for people living with dementia in nursing homes: a systematic review

Laura Behan, Michael P O'Brien, Paul Dunbar, Niall McGrane, Aileen Keane, Carol Grogan, Laura M Keyes
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Abstract

Background The number of people living with dementia across the world is rising, and there is a high and ever increasing proportion of people with dementia living in nursing homes. It is increasingly important that care provision in these services accounts for the specific needs of this cohort. Manifestations of dementia are modifiable with high quality dementia specific care, as such, we need to understand what good practice looks like specifically in these settings. Aim To synthesise empirical research to identify the characteristics of quality in the provision of care for people living with dementia in nursing homes. Methods Four electronic academic databases were searched: Business Complete, CINAHL, MEDLINE and APA PsychInfo. Qualitative, quantitative or mixed-methods studies published between the years of 2020-2023, that aimed to identify determinants of high quality care for people with dementia living in nursing homes, were included. Themes relating to good practices were identified and narratively summarised. Vignettes illustrating good practice were constructed from the perspective of a provider, a staff member, a resident and a family member. Results After screening of 3,356 records, 30 articles were included. This included 16 qualitative descriptive studies, 11 cross-sectional studies, 2 mixed methods studies, and 1 cohort study. Sixteen themes were identified: determinants of care quality, outcomes, person-centred care, cultural impact, care planning, meaningful engagement, eating and meals, the role of family members, restrictive practices, psychotropic medications, activities, materials, health care, end of life care, staffing and staff training. Conclusions The literature identifies what constitutes high quality care for residents with dementia in nursing homes. These findings will guide those delivering care in nursing homes in their daily work and in the implementation of quality improvement processes. It will also direct regulators, policymakers and researchers when conducting future work in this important area.
疗养院为痴呆症患者提供护理的良好实践:系统综述
背景全世界痴呆症患者的人数在不断增加,住在疗养院的痴呆症患者比例很高,而且还在不断增加。这些服务机构提供的护理服务必须考虑到这一群体的特殊需求,这一点变得越来越重要。痴呆症的表现是可以通过高质量的痴呆症特殊护理来改变的,因此,我们需要了解在这些环境中的具体良好实践是什么样子的。方法检索了四个电子学术数据库:方法检索四个电子学术数据库:Business Complete、CINAHL、MEDLINE 和 APA PsychInfo。纳入了 2020-2023 年间发表的定性、定量或混合方法研究,这些研究旨在确定为居住在养老院的痴呆症患者提供高质量护理的决定因素。确定了与良好实践相关的主题,并对其进行了叙述性总结。从提供者、工作人员、住院者和家庭成员的角度编写了说明良好实践的小故事。其中包括 16 项定性描述研究、11 项横断面研究、2 项混合方法研究和 1 项队列研究。共确定了 16 个主题:护理质量的决定因素、结果、以人为本的护理、文化影响、护理计划、有意义的参与、饮食、家庭成员的角色、限制性做法、精神药物、活动、材料、医疗保健、临终关怀、人员配备和员工培训。这些研究结果将为养老院的护理人员在日常工作和实施质量改进过程中提供指导。它还将指导监管者、政策制定者和研究人员今后在这一重要领域开展工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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