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Fang S, Zhi S, Song D, Sun J, Gao S, Wang Y, Sun J, Dong W. Dignity-preserving care of people with dementia in different nursing environments: a qualitative systematic review. Contemp Nurse 2024:1-18. [PMID: 38489476 DOI: 10.1080/10376178.2024.2327357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/01/2024] [Indexed: 03/17/2024]
Abstract
AIMS To systematically identify, evaluate and synthesize qualitative evidence about the dignity-related nursing experiences of people with dementia in families and nursing homes, summarize the similarities and differences and analyse the causes and influencing factors. METHODS A synthesis of qualitative studies retrieved from eight databases that were published before September 2022. Two reviewers independently screened and selected studies. Inclusion criteria were established according to the PICOS principle. Quality assessment was guided by Joanna Briggs Institute's Qualitative Assessment and Review Instrument and the structured topic synthesis method was used to summarise studies eligible for inclusion. RESULTS Three key themes were extracted from 14 included studies; the living environment, relationship needs and self-awareness, which focused on improving the dementia-centred nursing environment, meeting the needs of the relationship-centred nursing network, and finally, improving the self-awareness of people with dementia to promote dignity. CONCLUSION This systematic review shows people with dementia need to integrate into society and maintain their dignity in a dementia-friendly environment that is respectful, inclusive environment that promotes freedom.
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Affiliation(s)
- Shuyan Fang
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Shengze Zhi
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Dongpo Song
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Juanjuan Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Shizheng Gao
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Yonghong Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Wanhui Dong
- Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China
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Blomberg O, Svedin F, Farrand P, Brantnell A, von Essen L, Patriksson Karlsson J, Åberg AC, Woodford J. Adaptation of a guided low-intensity behavioral activation intervention for people with dementia in Sweden: a qualitative study exploring the needs and preferences of key stakeholders. BMC Geriatr 2024; 24:113. [PMID: 38291349 PMCID: PMC10826011 DOI: 10.1186/s12877-023-04606-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Despite depression being prevalent in people with dementia, contributing to negative health outcomes and placing increased burden on individuals and family members, access to psychological interventions is limited. A potential solution is guided low-intensity behavioral activation, supported by informal caregivers and guided by healthcare professionals. However, it is necessary to adapt interventions to meet the needs and preferences of key stakeholders to enhance acceptability and relevance. Study objectives were to: (1) explore needs and preferences concerning the content and delivery model of the guided low-intensity behavioral activation intervention; and (2) adapt the intervention to ensure cultural appropriateness, relevancy, and acceptability to people with dementia and their caregivers in Sweden. METHODS Semi-structured interviews and focus group discussions were conducted with key stakeholders, including healthcare professionals (n = 18), community stakeholders (n = 7), people with dementia (n = 8), and informal caregivers (n = 19). A draft of the written low-intensity behavioral activation intervention and a description of the proposed intervention delivery model were provided to participants. Open-ended questions explored the perceived relevance of the intervention, alongside needs and preferences concerning content and delivery. A manifest content analysis approach was adopted. RESULTS Content analysis resulted in three categories: Content, Delivery procedures, and Illness trajectory. Results highlighted a need to consider the intervention Content via increased cultural adaptation to the Swedish context, and increasing the inclusiveness of intervention content. Delivery procedures were identified as needing to be flexible given the unpredictable nature of caring for people with dementia, with the provision of additional guidance to informal caregivers supporting the intervention. Illness trajectory was viewed as essential to consider, with the intervention regarded as suitable for those early in the dementia trajectory, alongside a need to reduce workbook text to minimize burden given dementia symptomology. CONCLUSIONS The intervention and proposed delivery model were generally well received by all stakeholders. We were able to identify key adaptations to enhance cultural appropriateness, relevancy, and acceptability for a currently neglected population. Results will inform a feasibility study to explore the feasibility and acceptability of the intervention and study procedures to inform the design of a future superiority randomized controlled trial. TRIAL REGISTRATION/PROTOCOL Not applicable.
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Affiliation(s)
- Oscar Blomberg
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 85, Sweden
| | - Frida Svedin
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 85, Sweden
| | - Paul Farrand
- Clinical Psychology, Education, Development and Research (CEDAR), Psychology, University of Exeter, Perry Road, EX4 4QG, Devon, UK
| | - Anders Brantnell
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 85, Sweden
- Industrial Engineering and Management, Department of Civil and Industrial Engineering, Uppsala University, Uppsala, 751 21, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 85, Sweden
| | - Johanna Patriksson Karlsson
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 85, Sweden
| | - Anna Cristina Åberg
- Department of Medical Science, School of Health and Welfare, Dalarna University, Falun, 791 88, Sweden
- Clinical Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, 751 22, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 85, Sweden.
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Bielderman A, van Corven CTM, Koopmans RTCM, Leontjevas R, de Vugt ME, Bakker C, Gerritsen DL. Evaluation of the SPAN intervention for people living with young-onset dementia in the community and their family caregivers: a randomized controlled trial. Aging Ment Health 2024; 28:275-284. [PMID: 37776001 DOI: 10.1080/13607863.2023.2260335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of the SPAN-intervention, a psychosocial intervention aiming at improving a sense of usefulness and engaging in meaningful activities, for community-dwelling people living with young-onset dementia (YOD) and their family caregivers. METHODS A cluster-randomized controlled trial with two parallel groups (SPAN-intervention vs. care as usual) with assessments at baseline and five-month follow-up was performed. Sixty-one persons living with YOD and their family caregivers were included (SPAN-intervention group: n = 35; care as usual group: n = 26). Outcomes included, for the person living with YOD, empowerment (operationalized by self-management abilities using the SMAS-30; primary outcome), quality of life, neuropsychiatric symptoms, disability, apathy; and, for the family caregiver, quality of life, emotional distress, sense of competence. Data were analyzed using linear mixed models. RESULTS We found no statistically significant effects of the SPAN-intervention on empowerment, nor on the secondary outcome measures for persons living with YOD or their family caregivers. CONCLUSION Although the SPAN-intervention may provide concrete opportunities to engage in activities and stimulate reciprocity, such as meaningful social activities, this study did not demonstrate intervention effects. Additional qualitative evaluations may provide more insight into the implementation process and experiences of people living with YOD and their family caregivers.This trial was registered at ClinicalTrials.gov (NCT02937883).
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Affiliation(s)
- Annemiek Bielderman
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Charlotte T M van Corven
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- De Waalboog 'Joachim en Anna', Center for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Faculty of Psychology, Open University of The Netherlands, Heerlen, the Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
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Nijsten JMH, Plouvier AOA, Smalbrugge M, Koopmans RTCM, Leontjevas R, Gerritsen DL. The development and feasibility evaluation of a program to identify and manage apathy in people with dementia: the SABA program. Aging Ment Health 2024; 28:227-237. [PMID: 37382202 DOI: 10.1080/13607863.2023.2228252] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To develop and evaluate feasibility of a program for family and professional caregivers to identify and manage apathy in people with dementia: the Shared Action for Breaking through Apathy program (SABA). METHODS A theory- and practice-based intervention was developed and tested among ten persons with apathy and dementia in two Dutch nursing homes from 2019 to 2021. Feasibility was evaluated with interviews with family caregivers (n = 7) and professional caregivers (n = 4) and two multidisciplinary focus groups with professional caregivers (n = 5 and n = 6). RESULTS SABA was found feasible for identifying and managing apathy. Caregivers mentioned increased knowledge and awareness regarding recognizing apathy and its impact on their relationship with the person with apathy. They experienced increased skills to manage apathy, a greater focus on small-scale activities and increased appreciation of small moments of success. The content, form and accessibility of the program's materials were considered facilitating by all stakeholders, as was the compatibility of the procedures with the usual way of working. The expertise and involvement of stakeholders, staff stability and the support of an ambassador and/or manager were facilitating, while insufficient collaboration was a barrier. Organizational and external aspects like not prioritizing apathy, staff discontinuity, and the Covid-19 pandemic were perceived as barriers. A stimulating physical environment with small-scale living rooms, and access to supplies for activities were considered facilitating. CONCLUSIONS SABA empowers family and professional caregivers to successfully identify and manage apathy. For implementation, it is important to take into account the facilitators and barriers resulting from our study.
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Affiliation(s)
- Johanna M H Nijsten
- Research Institute for Medical Innovation, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
- Archipel Landrijt, Expertise Center for Specialized Care, Eindhoven, The Netherlands
| | - Annette O A Plouvier
- Research Institute for Medical Innovation, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Aging & Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Raymond T C M Koopmans
- Research Institute for Medical Innovation, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
- Waalboog, location Joachim and Anna, Center for Specialised Geriatric Care, Nijmegen, The Netherlands
| | - Ruslan Leontjevas
- Research Institute for Medical Innovation, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Debby L Gerritsen
- Research Institute for Medical Innovation, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Nijmegen, The Netherlands
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Louis-Delsoin C, Ruiz-Rodrigo A, Rousseau J. Understanding the home environment of older adults living with dementia: A scoping review of assessment tools. Home Health Care Serv Q 2024; 43:54-86. [PMID: 38146743 DOI: 10.1080/01621424.2023.2290708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Rigorous assessments to better understand the person-environment interaction are essential to comprehend how neurocognitive disorders influence in-home functioning of older people living with dementia. No recent synthesis identifies validated instruments targeting the human (e.g. caregivers) and nonhuman (e.g. objects) elements of the home environment interacting with this population and used with the perspective of aging in place. Consequently, following Arksey and O'Malley's (2005) scoping review method, 2,182 articles were identified in six databases and in gray literature. Two reviewers independently selected 23 relevant articles describing 19 validated assessment tools targeting elements of the home interacting with older people with dementia, namely: nonhuman environment (n = 13), human environment (n = 3), and person-environment interaction (n = 3). This overview highlights the scarcity of tools addressing the human environment and the person-environment interaction to foster sustainable at-home living for older people with neurocognitive disorders, demonstrating the need to incorporate new evidence-based, holistic methods into dementia home care.
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Affiliation(s)
- Cindy Louis-Delsoin
- School of rehabilitation, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Alicia Ruiz-Rodrigo
- School of rehabilitation, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Jacqueline Rousseau
- School of rehabilitation, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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Ni YX, Li Z, Zhou LL, Gong S. Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study. BMJ Open 2023; 13:e077419. [PMID: 38056941 PMCID: PMC10711852 DOI: 10.1136/bmjopen-2023-077419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES Despite early mobilisation as a key component of enhanced recovery after surgery pathways for pancreatic surgery, the implementation of early mobilisation remains unsatisfactory. What factors influence the implementation of early mobilisation from the lens of all stakeholders is unclear. The aim of this study was to identify the influencing factors of early mobilisation in pancreatic surgery from the perspective of patients, family members and health professionals. DESIGN A qualitative descriptive design using individual interviews and focus groups. SETTING AND PARTICIPANTS Twenty-two patients undergoing pancreatic surgery, 10 family members and 10 healthcare professionals from a large university teaching hospital in China. METHODS We collected data on participants' views on factors influencing early mobilisation after pancreatic surgery. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis. RESULTS Three main categories that influenced the implementation of early mobilisation in pancreatic surgery were identified: (1) attitude towards early postoperative mobilisation (eg, perceived advantages or disadvantages of early mobilisation), (2) subjective norm (eg, impact from health professionals, family members and fellow patients) and (3) perceived behavioural control (eg, knowledge, abilities, resources and environment). CONCLUSION Factors influencing early mobilisation are diverse and multidimensional. The successful implementation of early mobilisation requires the dedication of both patients and healthcare professionals.
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Affiliation(s)
- Yun-Xia Ni
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Zhi Li
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Li-Li Zhou
- Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Shu Gong
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
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Zhang S, Li J, Zou J, Ai Y, Qin S, Xiao X, Hu H, Wang Y. Empowerment of the older adults in the context of Chinese culture: an evolutionary concept analysis. Front Psychol 2023; 14:1271315. [PMID: 38022912 PMCID: PMC10666161 DOI: 10.3389/fpsyg.2023.1271315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background With the increasing focus on addressing the challenges of aging, researchers have begun to recognize the potential impact of empowering older individuals in addressing retirement issues. However, within different cultural contexts, there still needs to be a more precise analysis regarding the definition of empowering older individuals. Objective To define and analyze the concept of empowering older individuals within the cultural context of China. Method Using Rodgers' concept analysis approach, a search was conducted in five databases (PubMed, Web of Science, China National Knowledge Infrastructure, Wan fang Data, and VIP Chinese Journal Platform) for studies on empowering older individuals from the time the databases were established until February 2023. The main disciplines involved in the search included nursing, medicine, and public health. Results Out of the 7,028 studies, 50 articles met the inclusion criteria. The identified attributes are as follows: support system, belief change, and behavioral autonomy. The antecedents were grouped into four categories: physical obstacles, psychological concerns, personal needs and external challenges. The consequences were determined to be improved quality of life, reduced burden of old-age care, gain respect, and self-actualization. Conclusion Empowering older individuals is a dynamic and evolving concept that involves aligning personal aspirations with appropriate external resources and expressing a certain degree of belief and behavioral change. This study deepens our understanding of empowering older individuals through comprehensive concept analysis, and the identified attributes, antecedents, and consequences of empowering older individuals can be utilized in practice, education, and research.
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Affiliation(s)
- Shibo Zhang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Junfeng Li
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University (CQMU-WCH), Chongqing, China
| | - Jingjie Zou
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Siqi Qin
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xixi Xiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yuncui Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
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Ziebuhr B, Zanasi M, Bueno Aguado Y, Losada Durán R, Dening T, Tournier I, Niedderer K, Diaz A, Druschke D, Almeida R, Holthoff-Detto V. Living Well with Dementia: Feeling Empowered through Interaction with Their Social Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6080. [PMID: 37372667 DOI: 10.3390/ijerph20126080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
This study was designed to advance our understanding of how feelings of empowerment in people living with dementia still residing at home can be promoted. We conducted qualitative interviews with 12 participants with mild-to-moderate stages of dementia in Germany and Spain as part of a European study on mindful design for dementia. A qualitative thematic content analysis was performed to elicit the key features of the experience reported by the interviewees. Three overarching categories were identified: the first category 'experiencing changes in personal life and coping with changes in life' covered losses and coping strategies; the second category 'retaining a sense of usefulness' included social participation and the need for activities with others; the third category 'feeling empowered' covered reflections on lifetime achievements, accomplishments in the present life, being in control and self-worth. Participants placed a strong emphasis on continuity and on the importance of making active decisions and meaningful social contributions. Empowerment within the person living with dementia was achieved through their interactions with their social environment, including the significance of communication about their needs and wishes and enabling shared decision-making and interactions with others in reciprocity.
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Affiliation(s)
- Berit Ziebuhr
- St. Hedwig Kliniken Berlin, Alexianer Krankenhaus Hedwigshoehe, Berlin 12526, Germany
| | - Michele Zanasi
- St. Hedwig Kliniken Berlin, Alexianer Krankenhaus Hedwigshoehe, Berlin 12526, Germany
| | | | | | - Tom Dening
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK
| | - Isabelle Tournier
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
- Department of Psychology, Laboratoire Cliniques Pathologique et Interculturelle, Université Toulouse 2 Jean Jaurès, 31058 Toulouse, France
| | - Kristina Niedderer
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
| | - Ana Diaz
- Alzheimer Europe, 1417 Luxembourg, Luxembourg
| | - Diana Druschke
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, 01307 Dresden, Germany
| | - Rosa Almeida
- Fundación INTRAS, RDi Projects Department, 47016 Valladolid, Spain
| | - Vjera Holthoff-Detto
- St. Hedwig Kliniken Berlin, Alexianer Krankenhaus Hedwigshoehe, Berlin 12526, Germany
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Alexianer Krankenhaus Hedwigshoehe, 12526 Berlin, Germany
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Tournier I, Orton L, Dening T, Ahmed A, Holthoff-Detto V, Niedderer K. An Investigation of the Wishes, Needs, Opportunities and Challenges of Accessing Meaningful Activities for People Living with Mild to Moderate Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5358. [PMID: 37047971 PMCID: PMC10093974 DOI: 10.3390/ijerph20075358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/13/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
Many people are keen to be actively involved in social life and activities, but even at an early stage, dementia can have a negative impact on social participation and access to leisure activities. As part of the IDoService project, this study has investigated people's needs and wishes, barriers and facilitators to identify opportunities for improving access to meaningful activities. Individual and focus group interviews were conducted with 5 people living with mild to moderate dementia, 2 familial and 2 professional care partners, as well as 12 people working in the field of dementia and/or community activities. Thematic analysis has highlighted the benefits of participating in meaningful activities, such as empowerment and pride, social contacts, and feeling useful to others. A number of barriers to participation relating to individual and environmental factors were reported. Even where participants praised dementia-friendly activities and facilities, they advocated activities inclusive for all and mentioned that some people might be reluctant to participate in dementia-labelled activities because they may not be suitable for their needs. These results indicate the need for developing tailored opportunities for people with mild to moderate dementia and provide valuable insights for researchers, service providers, policymakers and charities wanting to improve access.
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Affiliation(s)
- Isabelle Tournier
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
- Department of Psychology, Laboratoire Cliniques Pathologique et Interculturelle, Université Toulouse 2 Jean Jaurès, 31058 Toulouse, France
| | - Laura Orton
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
| | - Tom Dening
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Anya Ahmed
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester M15 6GX, UK
| | - Vjera Holthoff-Detto
- Alexianer Krankenhaus Hedwigshöhe, 12526 Berlin, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine Carl Gustav Carus, University of Technology Dresden, 01307 Dresden, Germany
| | - Kristina Niedderer
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
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David MCB, Kolanko M, Del Giovane M, Lai H, True J, Beal E, Li LM, Nilforooshan R, Barnaghi P, Malhotra PA, Rostill H, Wingfield D, Wilson D, Daniels S, Sharp DJ, Scott G. Remote Monitoring of Physiology in People Living With Dementia: An Observational Cohort Study. JMIR Aging 2023; 6:e43777. [PMID: 36892931 PMCID: PMC10037178 DOI: 10.2196/43777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Internet of Things (IoT) technology enables physiological measurements to be recorded at home from people living with dementia and monitored remotely. However, measurements from people with dementia in this context have not been previously studied. We report on the distribution of physiological measurements from 82 people with dementia over approximately 2 years. OBJECTIVE Our objective was to characterize the physiology of people with dementia when measured in the context of their own homes. We also wanted to explore the possible use of an alerts-based system for detecting health deterioration and discuss the potential applications and limitations of this kind of system. METHODS We performed a longitudinal community-based cohort study of people with dementia using "Minder," our IoT remote monitoring platform. All people with dementia received a blood pressure machine for systolic and diastolic blood pressure, a pulse oximeter measuring oxygen saturation and heart rate, body weight scales, and a thermometer, and were asked to use each device once a day at any time. Timings, distributions, and abnormalities in measurements were examined, including the rate of significant abnormalities ("alerts") defined by various standardized criteria. We used our own study criteria for alerts and compared them with the National Early Warning Score 2 criteria. RESULTS A total of 82 people with dementia, with a mean age of 80.4 (SD 7.8) years, recorded 147,203 measurements over 958,000 participant-hours. The median percentage of days when any participant took any measurements (ie, any device) was 56.2% (IQR 33.2%-83.7%, range 2.3%-100%). Reassuringly, engagement of people with dementia with the system did not wane with time, reflected in there being no change in the weekly number of measurements with respect to time (1-sample t-test on slopes of linear fit, P=.45). A total of 45% of people with dementia met criteria for hypertension. People with dementia with α-synuclein-related dementia had lower systolic blood pressure; 30% had clinically significant weight loss. Depending on the criteria used, 3.03%-9.46% of measurements generated alerts, at 0.066-0.233 per day per person with dementia. We also report 4 case studies, highlighting the potential benefits and challenges of remote physiological monitoring in people with dementia. These include case studies of people with dementia developing acute infections and one of a person with dementia developing symptomatic bradycardia while taking donepezil. CONCLUSIONS We present findings from a study of the physiology of people with dementia recorded remotely on a large scale. People with dementia and their carers showed acceptable compliance throughout, supporting the feasibility of the system. Our findings inform the development of technologies, care pathways, and policies for IoT-based remote monitoring. We show how IoT-based monitoring could improve the management of acute and chronic comorbidities in this clinically vulnerable group. Future randomized trials are required to establish if a system like this has measurable long-term benefits on health and quality of life outcomes.
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Affiliation(s)
- Michael C B David
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Magdalena Kolanko
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Martina Del Giovane
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Helen Lai
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Jessica True
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Emily Beal
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Lucia M Li
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Ramin Nilforooshan
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Payam Barnaghi
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Paresh A Malhotra
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
- Imperial College London, Brain Sciences, South Kensington, London, United Kingdom
| | - Helen Rostill
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, Surrey, United Kingdom
| | - David Wingfield
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Danielle Wilson
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Sarah Daniels
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - David J Sharp
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Gregory Scott
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
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11
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Knippenberg IAH, Leontjevas R, Stoyanov S, Persoon A, Verboon P, Vermeulen H, van Lankveld JJDM, Gerritsen DL. Informal antidepressant strategies for nursing home residents: two group concept mapping studies. Aging Ment Health 2023; 27:251-262. [PMID: 35369803 DOI: 10.1080/13607863.2022.2057427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To identify and structure potential informal antidepressant strategies that can be used in daily practice for nursing home residents alongside formal treatments. METHODS In a first Group Concept Mapping study, residents, relatives, and professional caregivers (N = 124) brainstormed on strategies residents could use to prevent or alleviate depression. In a second study, the same participants (N = 110) reported strategies for use by others. Furthermore, participants rated the expected effectiveness and feasibility of the suggested strategies. Simultaneously, all strategies were sorted by experts and clustered using multidimensional scaling and hierarchical cluster analysis. RESULTS Six clusters emerged for strategies by residents themselves and five clusters for strategies by others. For residents' strategies, the clusters Being socially connected and Participating in activities were perceived as most effective, as was the cluster Offering personal attention for strategies by others. Participants perceived Creating a healthy living environment as the most feasible cluster executed by residents. Within strategies by others, the clusters Offering personal attention, Using positive treatment/approach, and Using or adapting the physical environment were perceived as the most feasible. CONCLUSION The results indicated the importance of social connectedness, a personalized and positive approach by significant others, and tailored activity programs. The results also suggest that adaptations to the physical environment within nursing homes may be an easy applicable strategy to prevent or alleviate depression in residents. Although more research is needed, these findings may guide daily practice and the development of interventions that include informal strategies. UNLABELLED Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2022.2057427 .
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Affiliation(s)
- Inge A H Knippenberg
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.,Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.,Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Slavi Stoyanov
- Faculty of Educational Sciences, Department of Technology Enhanced Learning and Innovation, Open University of the Netherlands, Heerlen, The Netherlands
| | - Anke Persoon
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Hester Vermeulen
- IQ healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
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12
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Abstract
In health care, well-being is considered to be composed of multiple interacting dimensions and to regard the subjective (affective and cognitive) evaluation of these dimensions. These dimensions are often referred to as physical, psychological, and social domains of life. Although there are various disease-specific and group-specific conceptual approaches, starting from a universal perspective provides a more inclusive approach to well-being. Indeed, universal approaches to well-being have striking overlaps with dementia-specific approaches. Although many initiatives have been launched to promote person-centered care and attention for well-being in recent decades, the current COVID pandemic showed that the primary focus in (Dutch) long-term care was still on physical health. However, a well-being perspective can be a central base of care: it is a means to include positive aspects, and it can be applied when addressing problems such as challenging behavior in the sense that both are about needs. Furthermore, providing care from this perspective is not only about the well-being of frail people and their loved ones but also about the well-being and needs of the involved professionals. Increasingly, research shows the importance of the quality of the resident-carer relationship, the carer's behavior, and their well-being for improving the well-being of residents. Applying the care approaches 'attentiveness in care' and relationship-centered care can contribute to the well-being of all involved stakeholders as these uphold the reciprocity of care relationships and take the values and attitudes, but also the vulnerability of those involved, into account.
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Affiliation(s)
- Debby L Gerritsen
- Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Department of Primary and Community care, Radboud University Medical Center, Nijmegen, The Netherlands
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13
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Yang Y, Dolega L, Darlington-Pollock F. Ageing in Place Classification: Creating a geodemographic classification for the ageing population in England. APPLIED SPATIAL ANALYSIS AND POLICY 2022; 16:583-623. [PMID: 36532714 PMCID: PMC9742038 DOI: 10.1007/s12061-022-09490-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/24/2022] [Indexed: 05/21/2023]
Abstract
Population ageing is one of the most significant demographic changes underway in many countries. Far from being a homogenous group, older people and their experiences of ageing are diverse. A better understanding of the characteristics and geography of the older population, including the older workforce, is important. It allows policymakers and stakeholders to better adapt to the opportunities and challenges that the ageing population brings. This paper describes the implementation of the Ageing in Place Classification (AiPC) in England. AiPC is a multidimensional geodemographic classification, and it employs a wide range of spatially representative attributes of older people's sociodemographic characteristics and their living environment at the small area level. The openly available product provides valuable insights that can be implemented in both local and national contexts, in particular to improve service delivery and inform targeted policy interventions. AiPC is readily updateable with the arrival of new Census data; the concept and framework are also transferable to other countries.
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Affiliation(s)
- Yuanxuan Yang
- University of Liverpool, Liverpool, UK
- University of Leeds, Leeds, UK
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14
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van Corven CTM, Bielderman A, Diaz Ponce A, Gove D, Georges J, Graff MJL, Gerritsen DL. Empowering interventions for people living with dementia: A European survey. J Adv Nurs 2022; 78:4104-4112. [PMID: 35867338 PMCID: PMC9796734 DOI: 10.1111/jan.15385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/31/2022] [Accepted: 07/05/2022] [Indexed: 01/07/2023]
Abstract
AIMS We aim to identify existing empowerment interventions for people living with dementia and to explore which used interventions and projects are considered empowering and why. DESIGN This was an online survey. METHODS We conducted an online survey between May 2018 and July 2018 amongst professionals interested in dementia care in Europe. Interventions were clustered within the ecological model for health promotion. Reasons from respondents as to why they considered interventions to be empowering were analysed and structured according to a recently developed conceptual framework of empowerment for people living with dementia. RESULTS Seventy-three respondents from 23 countries together mentioned 98 interventions or projects, of which 90 were unique. Interventions focused on the (inter)personal (n = 54), organizational (n = 15), communal (n = 6) and societal (n = 15) levels. A broad range of interventions were considered empowering, but no interventions were specifically developed for, nor aimed at, empowerment. Reasons as to why respondents considered these interventions as empowering fitted the framework's domains. CONCLUSION This European survey provides insights into interventions considered empowering for people living with dementia. An important step that needs to be taken is to develop and test interventions that specifically aim to promote empowerment for people living with dementia. IMPACT Empowerment may encourage people with dementia to live the life they choose, and focus on what is possible, instead of what is no longer possible. Many interventions are considered as empowering for people living with dementia, however no interventions could be identified that were specifically developed for or aimed at empowerment. This study shows that for promoting empowerment, it is necessary to develop and test interventions that specifically aim for empowerment, do this in collaboration with relevant stakeholders, and in this way support people living with dementia to live according to their competencies, talents and wishes.
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Affiliation(s)
- Charlotte T. M. van Corven
- Department of Primary and Community CareRadboud University Medical Centre, Radboud Institute for Health Sciences, Radboud Alzheimer CentreNijmegenThe Netherlands
| | - Annemiek Bielderman
- Department of Primary and Community CareRadboud University Medical Centre, Radboud Institute for Health Sciences, Radboud Alzheimer CentreNijmegenThe Netherlands
| | | | | | | | - Maud J. L. Graff
- Scientific Institute for Quality of Healthcare and Department of RehabilitationRadboud University Medical Centre, Radboud Institute for Health Sciences, Radboud Alzheimer CentreNijmegenThe Netherlands
| | - Debby L. Gerritsen
- Department of Primary and Community CareRadboud University Medical Centre, Radboud Institute for Health Sciences, Radboud Alzheimer CentreNijmegenThe Netherlands
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15
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van Corven C, Bielderman A, Wijnen M, Leontjevas R, Lucassen PL, Graff MJ, Gerritsen DL. Promoting empowerment for people living with dementia in nursing homes: Development and feasibility evaluation of an empowerment program. DEMENTIA 2022; 21:2517-2535. [PMID: 36063815 PMCID: PMC9583290 DOI: 10.1177/14713012221124985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives This article describes the development and feasibility evaluation of an
empowerment program for people living with dementia in nursing homes. Methods Development and feasibility evaluation of the empowerment program was guided
by the British Medical Research Council’s (MRC) framework. In the
developmental phase, we used intervention mapping to develop the theory- and
evidence-based intervention. During the feasibility phase, two care teams
utilised the program from September to December 2020. We evaluated the
feasibility in terms of demand, acceptability, implementation, practicality,
integration and limited efficacy. Findings This study showed that, according to healthcare professionals, the program
was feasible for promoting empowerment for people living with dementia in a
nursing home. Healthcare professionals mentioned an increased awareness
regarding the four themes of empowerment (sense of identity, usefulness,
control and self-worth), and greater focus on the small things that matter
to residents. Healthcare professionals experienced challenges in involving
family caregivers. Conclusion An important step is to take into account the implementation prerequisites
that follow from our findings, and to further investigate feasibility, as
the use of the program and data collection was hindered by the COVID-19
pandemic. Subsequent research could investigate the effects of the
empowerment program.
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Affiliation(s)
- Charlotte van Corven
- Department of Primary and Community Care, 6034Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Annemiek Bielderman
- Department of Primary and Community Care, 6034Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Mandy Wijnen
- Department of Primary and Community Care, 6034Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ruslan Leontjevas
- Faculty of Psychology, 10198Open University of The Netherlands, Heerlen, The Netherlands.,Department of Primary and Community Care, 6034Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Peter Lbj Lucassen
- Department of Primary and Community Care, 6034Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Maud Jl Graff
- Scientific Institute for Quality of Healthcare and Department of Rehabilitation, 6034Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, 6034Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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16
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Moermans VRA, Bleijlevens MHC, Verbeek H, Passos VL, Milisen K, Hamers JPH. District nurses' attitudes towards involuntary treatment in dementia care at home: A cross-sectional study. Geriatr Nurs 2022; 47:107-115. [PMID: 35905633 DOI: 10.1016/j.gerinurse.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/18/2022]
Abstract
One in two persons living with dementia (PLWD) at home receive care which they resist to and/or have not given consent to, defined as involuntary treatment. District nurses play a key role in the use of involuntary treatment. However, little is known how their attitudes and opinions influence the use of involuntary treatment. This cross-sectional study aims to investigate the attitudes of district nurses towards the use of involuntary treatment in dementia care at home, determinants and their opinion about its restrictiveness and discomfort. Results show that district nurses perceive involuntary treatment as regular part of nursing care, having neither positive nor negative attitude towards its appropriateness. They consider involuntary treatment usage as moderately restrictive to PLWD and feel moderately uncomfortable when using it. These findings underscore the need to increase the awareness of district nurses regarding the negative consequences of involuntary treatment use to PLWD at home.
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Affiliation(s)
- Vincent R A Moermans
- PhD - Student, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht 6229 GT, The Netherlands; Regional Manager and Nurse Specialist, Department of Nursing, White and Yellow Cross Limburg, Genk, Belgium; Voluntary Scientific Assistant, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
| | - Michel H C Bleijlevens
- Assistant Professor, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Hilde Verbeek
- Professor, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Valéria Lima Passos
- Associate Professor, Department Methodology and Statistics, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Koen Milisen
- Professor, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Jan P H Hamers
- Professor, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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17
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van Corven CTM, Bielderman A, Lucassen PLBJ, Verbeek H, Lesman-Leegte I, Depla MFIA, Stoop A, Graff MJL, Gerritsen DL. Family caregivers' perspectives on their interaction and relationship with people living with dementia in a nursing home: a qualitative study. BMC Geriatr 2022; 22:212. [PMID: 35296246 PMCID: PMC8924349 DOI: 10.1186/s12877-022-02922-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/04/2022] [Indexed: 11/19/2022] Open
Abstract
Background Social interactions are important for people living with dementia in a nursing home. However, not much is known about interactions and relationships between residents and family caregivers and related experiences of family caregivers. We aim to advance the knowledge on how family caregivers interact with people living with dementia in a nursing home and how they maintain or redesign a meaningful connection. Methods Qualitative research using interviews with family caregivers (n = 31) to explore perspectives on their interaction and relationship with the person living with dementia. Interviews were held during the reopening of nursing homes after the first COVID-19 lockdown in the Netherlands. In this situation, family caregivers became more aware of their interaction and relationship with the resident, which provided a unique opportunity to reflect on this. The interviews explored the interaction and relationship in a broad sense, not specifically for the COVID-19 situation. Thematic analysis was performed to analyze the data. Results We were able to identify three key themes reflecting the experiences of family caregivers: (1) changes in the interaction and relationship, (2) strategies to promote connection, and (3) appreciation of the interaction and relationship. From the viewpoint of family caregivers, the interaction and relationship are important for both the resident living with dementia and for themselves, and family caregivers have different strategies for establishing a meaningful connection. Nevertheless, some appear to experience difficulties with constructing such a connection with the resident. Conclusions Our results provide a basis for supporting family caregivers in perceiving and establishing mutuality and reciprocity so that they can experience togetherness. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02922-x.
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Affiliation(s)
- Charlotte T M van Corven
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Annemiek Bielderman
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter L B J Lucassen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Living Lab in Ageing and Long-Term Care, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Ivonne Lesman-Leegte
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marja F I A Depla
- Department of Medicine for Older People, Amsterdam Public Health Research Institute (APH), Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - Annerieke Stoop
- Department Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Maud J L Graff
- Scientific Institute for Quality of Healthcare and Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
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18
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Lynn JD, Ryan A, McCormack B, Martin S. A Qualitative Exploration of Living with Dementia in Supported Living Environments using a Peer Researcher Approach. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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van Corven CTM, Bielderman A, Wijnen M, Leontjevas R, Lucassen PLBJ, Graff MJL, Gerritsen DL. Empowerment for people living with dementia: An integrative literature review. Int J Nurs Stud 2021; 124:104098. [PMID: 34706313 DOI: 10.1016/j.ijnurstu.2021.104098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Although the concept of empowerment seems useful for good care and support for people living with dementia, there is a lack of understanding of the process of empowerment. Therefore, more insight is needed into the concept of empowerment, and the environment's role in the empowerment process. RESEARCH DESIGN AND METHODS We performed an integrative literature review (PubMed, CINAHL, PsychINFO), including studies that addressed empowerment for people living with dementia in their title or abstract. Using qualitative data analysis software ATLAS.ti, we applied open codes to describe all relevant aspects of included articles. Common themes and categories were identified using inductive reasoning and constant comparison. RESULTS Sixty-nine articles were included. We identified four themes: (1) description of the state of being empowered, (2) the process of empowerment, (3) contribution of the environment to the empowerment process, and (4) effects on other variables. We combined these results with the conceptual framework of our previous qualitative study on the definition of empowerment for people living with dementia based on stakeholders' perspectives. Subsequently, the combined information of both studies was visualized in a revised conceptual framework. DISCUSSION AND IMPLICATIONS This literature review provides more details as to the role of the environment for empowerment of people living with dementia and suggests that empowerment can be considered a dynamic process, taking place through interaction between the person living with dementia and their environment. Our revised conceptual framework of empowerment can serve as a basis for future studies on empowerment for people living with dementia, and to support (in)formal caregivers in the empowerment process.
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Affiliation(s)
- Charlotte T M van Corven
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Annemiek Bielderman
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Mandy Wijnen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands.
| | - Peter L B J Lucassen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Maud J L Graff
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Scientific Institute for Quality of Healthcare and Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
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20
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Sánchez-Martínez I, Vilar R, Irujo J, Ulsamer D, Cano D, Casaca Soares C, Acevedo Á, Jerez-Roig J, Celdrán M. Effectiveness of the Validation Method in Work Satisfaction and Motivation of Nursing Home Care Professionals: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E201. [PMID: 33383940 PMCID: PMC7796077 DOI: 10.3390/ijerph18010201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/24/2020] [Accepted: 12/24/2020] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to carry out a literature review on the effectiveness of the validation method (VM) in job satisfaction and motivation of care professionals working with older people in nursing homes. The review was carried out in specialised databases: Scopus, PsychINFO, PubMed, Web of Science (WOS), Google Scholar, Scielo, and Cochrane Database of Systematic Reviews. 9046 results were obtained, out of which a total of 14 studies met the inclusion criteria: five quantitative, four qualitative, one single case series, two quasi-experimental and two mixed methods studies. The results of the analysed studies report that the VM can be an effective tool that facilitates communication and interaction in care, reducing levels of stress and job dissatisfaction among care professionals. The VM facilitates communication between professionals and older people with dementia, and improves the management of complex situations that may arise in care, directly influencing a reduction in work stress and increasing job satisfaction.
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Affiliation(s)
- Iván Sánchez-Martínez
- Research Group on Methodology, Methods, Models and Health and Social Outcomes (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain;
- Fundació Privada Sant Andreu de Castellcir, Residència la Ginesta, 08183 Barcelona, Spain
| | - Raül Vilar
- Validation Training Institute, Inc., P.O. Box 871, Pleasant Hill, OR 97455, USA; (R.V.); (J.I.); (D.U.); (D.C.)
| | - Javier Irujo
- Validation Training Institute, Inc., P.O. Box 871, Pleasant Hill, OR 97455, USA; (R.V.); (J.I.); (D.U.); (D.C.)
| | - Duna Ulsamer
- Validation Training Institute, Inc., P.O. Box 871, Pleasant Hill, OR 97455, USA; (R.V.); (J.I.); (D.U.); (D.C.)
| | - Dolors Cano
- Validation Training Institute, Inc., P.O. Box 871, Pleasant Hill, OR 97455, USA; (R.V.); (J.I.); (D.U.); (D.C.)
| | - Celia Casaca Soares
- Centre for Interdisciplinary Applied Research in Health (CIIAS/IPS), School of Health, Polytechnic Institute of Setúbal, 2914-503 Setúbal, Portugal;
| | - Ángel Acevedo
- Fundació Vella Terra, Residència, Centre de dia i Casal de Les Corts, 08029 Barcelona, Spain;
| | - Javier Jerez-Roig
- Research Group on Methodology, Methods, Models and Health and Social Outcomes (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain;
| | - Montserrat Celdrán
- Research Group in Gerontology (GIG), Faculty of Psychology, University of Barcelona (UB), 08035 Barcelona, Spain;
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