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Möllergren G, Harnett T. Life story templates in dementia care: Ambiguous direction and purpose. DEMENTIA 2024; 23:741-756. [PMID: 38174545 PMCID: PMC11163841 DOI: 10.1177/14713012231224545] [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] [Indexed: 01/05/2024]
Abstract
BACKGROUND The use of life stories in dementia care has been described as a way of seeing every person as an individual, looking beyond their dementia. Life stories have become synonymous with high-quality care, while in Sweden their mere existence in dementia care settings is taken to indicate quality in national comparisons. Such life stories are often standardised, generated by a family member answering predetermined questions in a template. AIM AND METHODS Using a constructionist approach, this study will (1) chart what versions of a person's life story the templates produce, and (2) establish the intended purpose of such life stories, as communicated by the templates. This study departs from the assumption that life story templates communicate something about the conceptions of people living with dementia. The thematic analysis used data comprising 30 blank templates, totalling about 1,700 questions. FINDINGS The life story templates were found to generate two very different versions of the individual: (1) a person before symptoms of dementia or (2) a patient with dementia. We also found contradictions about what information should be included, whose life story it was, and the intended use. DISCUSSION Despite strong pressure on dementia care providers to collect life stories from residents, the life story templates they use are without clear direction, ideology, or purpose. The lack of direction is key given that life stories can be considered actants that shape assumptions about people with dementia and construct realities in dementia care settings. We highlight the need to develop ethical guidelines for life story template design, matched with guidelines for their intended use.
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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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Dellkvist H, Dallora AL, Christiansen L, Skär L. The use of a digital life story to support person-centred care of older adults with dementia: A scoping review. Digit Health 2024; 10:20552076241241231. [PMID: 38510573 PMCID: PMC10953038 DOI: 10.1177/20552076241241231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction A life story (LS) is a tool healthcare professionals (HCPs) use to help older adults with dementia preserve their identities by sharing their stories. Applied health technology can be considered a niche within welfare technology. Combining technology and nursing, such as using life stories in digital form, may support person-centred care and allow HCPs to see the person behind the disease. Objective The study's objective was to summarise and describe the use of life stories in digital form in the daily care of older adults with dementia. Methods A scoping review was conducted in five stages. Database searches were conducted in Cinahl, PubMed, Scopus, Web of Science, and Google Scholar; 31 articles were included. A conventional qualitative content analysis of the collected data was conducted. Results The qualitative analysis resulted in three categories: (1) benefits for older adults, (2) influence on HCPs' work, and (3) obstacles to implementing a digital LS in daily care. Conclusion Older adults with dementia can receive person-centred care through a digital LS based on their wishes. A digital LS can enable symmetric communication and serve as an intergenerational communication tool. It can be used to handle behavioural symptoms. Using a digital LS in the later stages of dementia may differ from using it earlier in dementia. However, it may compensate for weakening abilities in older adults by enhancing social interaction.
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Affiliation(s)
- Helén Dellkvist
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Ana Luiza Dallora
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Line Christiansen
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Lisa Skär
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Rapaport P, Kidd G, Jeraldo RE, Mason A, Knapp M, Manthorpe J, Shulman C, Livingston G. A qualitative exploration of older people's lived experiences of homelessness and memory problems - stakeholder perspectives. BMC Geriatr 2023; 23:556. [PMID: 37700235 PMCID: PMC10498566 DOI: 10.1186/s12877-023-04250-0] [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: 05/12/2023] [Accepted: 08/23/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND The numbers of older people experiencing both homelessness and memory problems are growing, yet their complex health, housing and care needs remain undelineated and unmet. There is a critical gap in understanding what can improve the care, support and experiences of this group. In this qualitative study we explore how stakeholders understand memory problems among older people in the context of homelessness and consider what they judge gets in the way of achieving positive outcomes. METHOD We conducted reflexive thematic analysis of qualitative interviews (n = 49) using a semi-structured topic guide, with 17 older people (aged ≥ 50 years) experiencing memory problems and homelessness, 15 hostel staff and managers, and 17 health, housing and social care practitioners. We recruited participants from six homelessness hostels, one specialist care home and National Health and Local Authority Services in England. RESULTS We identified four overarching themes. The population is not taken seriously; multiple causes are hard to disentangle; risk of exploitation and vulnerability; and (dis)connection and social isolation. The transience and lack of stability associated with homelessness intensified the disorienting nature of memory and cognitive impairment, and those providing direct and indirect support required flexibility and persistence, with staff moving beyond traditional roles to advocate, provide care and safeguard individuals. Memory problems were perceived by frontline staff and older people to be overlooked, misinterpreted, and misattributed as being caused by alcohol use, resulting in pervasive barriers to achieving positive and desired outcomes. CONCLUSIONS Efforts to meet the needs of older people living with memory problems and experiencing homelessness and future interventions must reflect the complexity of their lives, often in the context of long-term alcohol use and current service provision and we make suggestions as to what could be done to improve the situation.
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Affiliation(s)
- Penny Rapaport
- UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK.
| | - Garrett Kidd
- UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
| | - Rosario Espinoza Jeraldo
- UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
| | - Ava Mason
- UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, King's College London, London, UK
- NIHR Applied Research Collaboration (ARC) South London, London, UK
| | - Caroline Shulman
- Pathway, London, UK
- Healthy London Partnership, London, UK
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, London, UK
| | - Gill Livingston
- UCL Department of Mental Health of Older People, Division of Psychiatry, Wing B, Floor 6 Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Al-Omari M, Abu Khait A. Feasibility, Acceptability, and Preliminary Effectiveness of Cognitive-Reminiscence Therapy among Jordanian People with Major Depressive Disorders: A Mixed Methods Study. Issues Ment Health Nurs 2023:1-13. [PMID: 37229657 DOI: 10.1080/01612840.2023.2205511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Depression is a major public health problem around the world. Negative automatic thoughts are cognitive errors that build in the mind, leading to depression. Cognitive-reminiscence therapy is one of the most effective psychosocial methods for managing cognitive errors. This study aimed to evaluate cognitive reminiscence therapy's feasibility, acceptability, and preliminary effectiveness among Jordanian patients with major depressive disorder. A convergent-parallel design was employed. A convenience sampling method was used to recruit 36 participants (Site 1: n = 16, Site 2: n = 20). A total of 31 participants were included in the analysis, divided into six groups, with 5-6 participants in each group. Cognitive-reminiscence therapy included eight supported sessions of up to 2 h each, delivered over 4 wk. Recruitment, adherence, retention, and attrition rates of 80%, 86.1%, and 13.9%, respectively, indicated the feasibility of the therapy. The acceptability of therapy was reflected in the following four themes: Positive Cognitive Reminiscence Therapy Perspectives and Outcomes; Cognitive Reminiscence Therapy Sessions Challenge; Suggestions for Improving Cognitive Reminiscence Therapy Sessions; and Motivational Home Activities. A significant reduction in the mean of depressive symptoms and negative automatic thoughts and a significant increase in the self-transcendence mean demonstrated the effectiveness of the intervention. The study's results suggest that cognitive reminiscence therapy is feasible and acceptable among patients with major depressive disorder. This therapy is a promising nursing intervention to reduce depressive symptoms and negative automatic thoughts and increase self-transcendence for those patients.
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Affiliation(s)
| | - Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Mentzou A, Sixsmith J, Ellis MP, Ross J. Change in the psychological self in people living with dementia: A scoping review. Clin Psychol Rev 2023; 101:102268. [PMID: 36898295 DOI: 10.1016/j.cpr.2023.102268] [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: 10/17/2022] [Revised: 02/02/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Alterations in one's sense of self are often considered a significant psychological symptom of dementia. However, the self is not a unified construct; it consists of a set of closely connected, yet substantive, manifestations which might not be equally impacted by dementia. Recognising the multidimensional nature of the self, the current scoping review aimed to explore the nature and scope of the evidence demonstrating change in the psychological self in people living with dementia. Adopting a cognitive psychological framework, a hundred and five (105) quantitative and qualitative studies were reviewed, and findings were organised into three main types of self-manifestations: high-order manifestations, functional aspects of the self, and foundational manifestations. Overall, the results show that although there are alterations in some of these different manifestations of the self, these do not imply a global loss of selfhood. Despite notable cognitive changes during dementia, it seems that preserved aspects of self may be enough to compensate for potential weakening of some self-processes such as autobiographical recall. Better understanding alterations in selfhood is key to addressing psychological symptoms of people living with dementia, such as feelings of disconnection and reduced agency, and may inform new pathways for dementia care interventions.
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Affiliation(s)
- Aikaterini Mentzou
- School of Humanities, Social Sciences and Law, Division of Psychology, University of Dundee, Scotland, UK.
| | - Judith Sixsmith
- School of Health Sciences, University of Dundee, Scotland, UK
| | - Maggie P Ellis
- School of Psychology and Neuroscience, University of St Andrews, Scotland, UK
| | - Josephine Ross
- School of Humanities, Social Sciences and Law, Division of Psychology, University of Dundee, Scotland, UK
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"Sometimes Life Throws You a Curve Ball": The Lived Experiences of an Individual With Early-Onset Alzheimer's Disease and His Family. CLIN NURSE SPEC 2021; 35:318-326. [PMID: 34606212 DOI: 10.1097/nur.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Individuals with early-onset Alzheimer's disease face many challenges and barriers older adults with late-onset Alzheimer's do not. Unfortunately, information about early-onset Alzheimer's disease is in its infancy stage in comparison with late-onset Alzheimer's. PURPOSE/AIMS The purpose of this study was to examine the lived experiences of a 54-year-old man with early-onset Alzheimer's disease and his family (wife, sister, and mother) to understand the effects on the family unit. DESIGN Interpretive phenomenology was used to guide this study. METHODS All participants completed 2 in-person one-on-one interviews, and a final interview was completed online. Field notes, member checks, and triangulation were used to enhance the study's credibility. RESULTS This article focuses on the theme "'A big curve ball': Disruption of the life cycle." Participants indicated the major financial and social challenges experienced by Joe and his wife. Furthermore, participants emphasized the importance of acceptance and maintaining a positive attitude to help cope with Joe's diagnosis. CONCLUSIONS The accounts of Joe and his family shed light on an area relatively void in the literature. In addition, Joe's experiences may provide comfort for other families facing early-onset Alzheimer's disease. The implications for community health nurses in assisting individuals with early-onset Alzheimer's disease and their families are discussed.
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Abu Khait A, Reagan L, Shellman J. Uses of reminiscence intervention to address the behavioral and psychosocial problems associated with dementia: An integrative review. Geriatr Nurs 2021; 42:756-766. [PMID: 33895497 DOI: 10.1016/j.gerinurse.2021.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Reminiscence is a non-pharmacological technique used to manage the behavioral and psychological symptoms of dementia. This integrative review aims to synthesize the research on the health benefits of reminiscence intervention for people with dementia. METHODS Whittemore and Knafl's five-step method provided the framework for this review. A comprehensive search of PubMed, CINAHL Plus, SCOPUS, and PsycINFO was conducted. The articles were reviewed for eligibility, critically appraised, and extracted the data. RESULTS Twenty-seven studies met the inclusion criteria. Four themes emerged: (a) Recovery from the Darkness of Depressive Symptoms, (B) Enhancement of Cognitive Functions and Filling the Memory Gap, (C) Living a Fulfilling Life in Late Adulthood, and (D) Fulfilling Reminiscence Functions. DISCUSSION This review provides a better understanding of the potential benefits of using reminiscence intervention for addressing the behavioral and psychological symptoms of dementia. However, improving the methodological rigor of future studies is necessary to attain conclusive evidence.
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Affiliation(s)
- Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan.
| | - Louise Reagan
- School of Nursing, University of Connecticut, Storrs, CT 06269, USA.
| | - Juliette Shellman
- School of Nursing, University of Connecticut, Storrs, CT 06269, USA.
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Psychometric Testing of the Arabic Version of the Reminiscence Functions Scale. J Nurs Meas 2021; 30:388-406. [PMID: 33731360 DOI: 10.1891/jnm-d-20-00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The Reminiscence Functions Scale (RFS), a reliable and valid 43-item scale, measures eight specific reasons as to why people reminisce. The current literature lacks an Arabic version of empirically-validated tools that measure reminiscence functions. This study aimed to test the psychometric properties of the translated version of the RFS in a sample of Arabic speakers from Jordan. METHODS The scale was first translated into Arabic and then was translated back into English. A committee of experts reviewed the Arabic scale and then confirmed its content validity. A convenience, snowball sample of 422 subjects completed the Arabic RFS. Exploratory factor analysis (EFA) and the internal consistency method were used to evaluate the factorial structure and reliability of the Arab RFS, respectively. RESULTS The Arabic RFS reported excellent content validity. EFA yielded a six-factor, 39-item structure that accounted for 52% of the variance. Cronbach's alphas for the six factors ranged from 0.82 to 0.91, indicating good to excellent internal consistency. CONCLUSIONS The Arabic RFS is a valid and reliable measure of reminiscence functions for Jordanian adults.
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Abstract
OBJECTIVES There are a number of conceptual models of dementia, capturing a range of biopsychosocial factors. Few integrate the lived experience of dementia. The aim of this study was to develop a conceptualisation grounded in the first-hand accounts of living with the condition and reflecting its complexity. METHOD The study was conducted within an explanatory, critical realist paradigm. An overarching narrative approach, informed by a previously completed systematic review and metasynthesis of research on the lived experience of dementia and the assumptions of complexity theory, was used to guide data collection and analysis. Data were contributed by 31 adults, including 12 people living with dementia and 19 family caregivers. RESULTS The experience of living with dementia was conceptualised as a process of adaptation through participation, emerging from ongoing, dynamic and nonlinear interactions between the adaptive capacity of a person with dementia and the adaptive capacity within the environment. The proposed conceptual model describes contexts and mechanisms which shape this capacity. It identifies a range of potential outcomes in dementia. These outcomes reflect interactions and the degree of match between the adaptive capacity of a person and the adaptive capacity within the environment. CONCLUSION By recognising and exploring the potential for adaptation and enduring participation in dementia, findings of this research can support practitioners in facilitating positive outcomes for people affected by the condition.
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Affiliation(s)
- Sylwia M Górska
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
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Renjith V, Yesodharan R, Noronha JA, Ladd E, George A. Qualitative Methods in Health Care Research. Int J Prev Med 2021; 12:20. [PMID: 34084317 PMCID: PMC8106287 DOI: 10.4103/ijpvm.ijpvm_321_19] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/23/2019] [Indexed: 12/05/2022] Open
Abstract
Healthcare research is a systematic inquiry intended to generate robust evidence about important issues in the fields of medicine and healthcare. Qualitative research has ample possibilities within the arena of healthcare research. This article aims to inform healthcare professionals regarding qualitative research, its significance, and applicability in the field of healthcare. A wide variety of phenomena that cannot be explained using the quantitative approach can be explored and conveyed using a qualitative method. The major types of qualitative research designs are narrative research, phenomenological research, grounded theory research, ethnographic research, historical research, and case study research. The greatest strength of the qualitative research approach lies in the richness and depth of the healthcare exploration and description it makes. In health research, these methods are considered as the most humanistic and person-centered way of discovering and uncovering thoughts and actions of human beings.
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Affiliation(s)
- Vishnu Renjith
- School of Nursing and Midwifery, Royal College of Surgeons Ireland - Bahrain (RCSI Bahrain), Al Sayh Muharraq Governorate, Bahrain
| | - Renjulal Yesodharan
- Department of Mental Health Nursing, Manipal College of Nursing Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Judith A Noronha
- Department of OBG Nursing, Manipal College of Nursing Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Elissa Ladd
- School of Nursing, MGH Institute of Health Professions, Boston, USA
| | - Anice George
- Department of Child Health Nursing, Manipal College of Nursing Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Thoft DS, Møller AK, Møller AKK. Evaluating a digital life story app in a nursing home context - A qualitative study. J Clin Nurs 2021; 31:1884-1895. [PMID: 33590641 DOI: 10.1111/jocn.15714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/08/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate how digital life stories can be used to support person-centred care focusing on benefits and challenges experienced by the staff and the management team in a nursing home context. BACKGROUND Life story work can be used to support person-centred care and help people with dementia maintain their identity. The use of digital life stories provides opportunities to easily share the content between staff and relatives and combine different types of multimedia, for example pictures, videos, text and sound. DESIGN Six healthcare professionals and two members of the management team at a nursing home were recruited. Participant observations with informal interviews of the formal health career were conducted in two day shifts and two night shifts. Field notes were taken during the observations. Also, individual semi-structured interviews were held with four of the recruited participants. This article adheres to the Standards for Reporting Qualitative Research (SRQR). RESULTS Themes revealed were (1) person-centred care and life story work as interrelated approaches; (2) Pros and cons related to the My Life Story app; and how (3) Time and information and communication technology (ICT) can restrict life story work. CONCLUSION Digital life stories can be used to support a person-centred care approach. However, a number of challenges exist related to digital life story work. When using digital life stories, it is important to ensure the staff time and competences needed to work with, for example an app and that visible support and encouragement are provided by the management team. RELEVANCE TO CLINICAL PRACTICE Challenges are revealed when life story work is embedded in the culture and everyday work of a nursing home. It is of great importance to clinical practice to be aware of and address these challenges in order to succeed with digital life story work.
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Affiliation(s)
- Diana S Thoft
- University College Northern Denmark, Aalborg, Denmark
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Eriksen S, Bartlett RL, Grov EK, Ibsen TL, Telenius EW, Mork Rokstad AM. The Experience of Lived Time in People with Dementia: A Systematic Meta-Synthesis. Dement Geriatr Cogn Disord 2020; 49:435-455. [PMID: 33176312 PMCID: PMC7949212 DOI: 10.1159/000511225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/27/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION For people with dementia, lived time is important to understand, as the condition affects memory, perceptions of time, and life expectancy. The aim of this study was to locate, interpret, and synthesize the experience of lived time for people with dementia. METHOD This article presents a qualitative systematic meta-synthesis. The theoretical framework of lifeworlds by van Manen provided the context for the study. The Critical Appraisal Skills Programme criteria for qualitative studies were used to appraise the studies. Sixty-one qualitative research studies based on interviews with people with dementia were included in the review. The analysis followed the principles of interpretive synthesis. RESULTS Four categories were revealed: (1) rooted in the past - "I am the same as before"; (2) focussing on the present - "Nobody has tomorrow"; (3) thinking about the future - "What is going to happen to me?"; and (4) changes in the experience of self over time - "I used to…." The latent overall meaning was expressed as "being engaged with the dimensions of time." DISCUSSION/CONCLUSION The experience of lived time is an active and important one, enabling people to manage the dementia journey. Future work involving people with dementia should foreground the experience of lived time.
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Affiliation(s)
- Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Ruth Louise Bartlett
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway,
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Abu Khait A, Shellman J. Reminiscence in the Care of People with Mild Dementia: A Concept Analysis. Nurs Forum 2020; 55:282-293. [PMID: 31919849 DOI: 10.1111/nuf.12427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM To clarify the concept of reminiscence in the care of people with mild dementia, highlight its uses as a nursing intervention in dementia care, and propose an operational definition of the concept. BACKGROUND Reminiscence is one of the leading nonpharmacological interventions in dementia care. The existing literature lacks a unified definition of reminiscence as it applies to the care of patients with mild dementia and a precise understanding of the concept's applications in nursing care. DATA SOURCES We derived data from literature searches in CINAHL, PsycINFO, PubMed, Google Scholar, Scopus, and Cochrane Library databases. DESIGN Concept Analysis. REVIEW METHODS The review method used was the Walker and Avant's (2019) eight-step method. RESULTS Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies reminiscence in the care of patients with mild dementia as a cognitive, functional process of recalling and reconstructing distant memories using memory stimuli through mutual interaction with a trained facilitator. CONCLUSION Clarifying the concept will add validity to the current and future literature, help to develop new research instruments that accurately measure this concept, and function as a framework for holistic nursing interventions.
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Abu Khait A, Shellman J, Sabo K. Metasynthesis of Patients' Perspectives about Reminiscence in Dementia Care. West J Nurs Res 2020; 42:852-866. [PMID: 31959082 DOI: 10.1177/0193945919897927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dementia is a serious condition that has become a public health priority worldwide. Reminiscence is the process of recollecting personal memories from the distant past. This metasynthesis aims to present a thorough analysis of available qualitative literature concerning patients' perspectives about reminiscence in dementia care. A search of CINAHL, PubMed, PsycINFO, Scopus, and ProQuest for qualitative studies published in English between 2005 and 2019 generated 110 studies. Eleven studies were retrieved, assessed for quality using the Critical Appraisal Skills Programme tool, and then synthesized according to Noblit and Hare's seven-step approach. Metaphors were arranged in a list and translated into one another. Five reciprocal themes emerged: Promoting a Comfort Zone, Keeping the Conversation Going, Creating a Dynamic Life, Reliving Painful Memories and Emotional Turmoil, and Strengthening Inner Forces. Increased awareness of patients' perspectives about reminiscence can help design a better framework for interventions that will serve this vulnerable population.
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Affiliation(s)
| | | | - Katherine Sabo
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, CT, USA
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16
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Bjørkløf GH, Helvik AS, Ibsen TL, Telenius EW, Grov EK, Eriksen S. Balancing the struggle to live with dementia: a systematic meta-synthesis of coping. BMC Geriatr 2019; 19:295. [PMID: 31666020 PMCID: PMC6822397 DOI: 10.1186/s12877-019-1306-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/07/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND People with dementia describe experiences of loss that threaten their autonomy and ability to contribute to society. They often have difficulties with orientation, loss of roll function, and fear about the future, and need help from others. An increasing body of literature also focuses on how people with dementia search for meaning and maintaining of quality to life, and how they find strategies to live with dementia. A review of the scientific literature on coping and dementia is warranted and can help to advice and inform healthcare personnel and decision makers on how they can support and plan for appropriate healthcare services for people with dementia. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding people with dementia's experience of coping. METHODS We conducted a systematic, computerised search of Medline, Embase, Cinahl Complete, PsycINFO and Age Line combining MeSH terms and text words for different types of dementia with different descriptions of experience. Studies comprised 1) a sample of people with dementia, 2) a qualitative interview as a research method and 3) a description of experiences of coping were included. The search resulted in 7129 articles, of which 163 were read in full text, 80 were excluded due to the exclusion criteria or low quality according. The analysis was conducted in line with qualitative content analyses. RESULTS This interpretative qualitative meta-synthesis included 74 articles of good quality encompassing interviews with 955 persons with dementia. The material revealed two main resources of coping: (1) Humour and (2) Practical and emotional support, and four overall strategies in which people with dementia cope with the challenges they experience: (1) Keep going and holding on to life as usual; (2) Adapting and adjusting to the demands from the situation; (3) Accepting the situation; and (4) Avoiding the situation A comprehensive understanding of the categories led to the latent theme: Balancing the struggle of living with dementia. CONCLUSION This meta-synthesis indicates that people with dementia cope in different ways and using several parallel strategies. This insight is essential in dementia care to facilitate a supportive environment.
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Affiliation(s)
- Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
- VID Spesialized University, Faculty of Health Studies, Oslo, Norway
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17
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Andersson EK, Dellkvist H, Bernow Johansson U, Skär L. Relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care: An interview study. Nurs Open 2019; 6:276-282. [PMID: 30918679 PMCID: PMC6419116 DOI: 10.1002/nop2.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/30/2018] [Accepted: 09/03/2018] [Indexed: 11/10/2022] Open
Abstract
AIM The aim of this study was to describe relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care. DESIGN An explorative descriptive qualitative design was used. METHODS The data were collected using semi-structured interviews with a purposeful sample of eight relatives and analyzed using a qualitative content analysis. RESULTS Results show that creating and sharing the life story of a close family member could help relatives handle grief and stress. It was perceived as an important, yet difficult, task to ensure that the close family member got good quality care. The creation of a meaningful life story takes time and requires cooperation with family members and other significant people.
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Affiliation(s)
| | - Helén Dellkvist
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
- Karlskrona MunicipalityKarlskronaSweden
| | - Ulrika Bernow Johansson
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
- Karlskrona MunicipalityKarlskronaSweden
| | - Lisa Skär
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
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18
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Górska S, Forsyth K, Maciver D. Living With Dementia: A Meta-synthesis of Qualitative Research on the Lived Experience. THE GERONTOLOGIST 2019; 58:e180-e196. [PMID: 28069886 PMCID: PMC5946830 DOI: 10.1093/geront/gnw195] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/21/2016] [Indexed: 11/14/2022] Open
Abstract
Purpose of the Study To identify and examine the published qualitative research evidence relative to the experience of living with dementia. Design and Methods Metasynthesis was used as the methodological framework to guide data collection and analysis. Results Three themes were identified. The first theme considered the main condition-related changes experienced by people with dementia (PWD) and showed how these are interlinked and impact upon various areas of people’s lives. The second theme indicated that amidst these changes, PWD strive to maintain continuity in their lives by employing various resources and coping strategies. The third theme underlined the role of contextual factors. The reviewed evidence indicates that, the emerging experience of PWD and their potential to adjust to the continuous changes is influenced by access to and quality of both personal and contextual resources which remain in a constant, transactional relationship to each other. Implications The findings were interpreted and discussed in the context of relevant theoretical frameworks and research evidence. It was considered that current evidence and findings presented in this review can be further explored and expanded upon in a more systematic way through research conducted within the theoretical framework of dynamic systems theory. Further research would be also beneficial to explore the subjective experience of dementia from a participatory perspective. Exploring the application of these theoretical standpoints would contribute to the current state of knowledge and offer both PWD and carers fresh perspective on the nature of change and potential for adaptability in dementia.
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Affiliation(s)
- Sylwia Górska
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
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19
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Doran C, Noonan M, Doody O. Life-story work in long-term care facilities for older people: An integrative review. J Clin Nurs 2018; 28:1070-1084. [PMID: 30431682 DOI: 10.1111/jocn.14718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/15/2018] [Accepted: 11/03/2018] [Indexed: 01/14/2023]
Abstract
AIM To systematically review the literature regarding the experience of older people, families and staff using life-story work in residential care facilities for older people. BACKGROUND Life-story work has been promoted as an approach to enhance care provided and involves collecting memories and moments that are important to the person assisting them to regain their sense of self. DESIGN An integrative review utilising the PRISMA reporting guidelines where seven databases, Scopus, EMBASE, CINAHL, MEDLINE, PsychInfo, PsychARTICLES, and Cochrane, were searched within the timeframe; 1 January 2006 to 14 March 2016. Data were reviewed using Whittemore and Knalf's (Journal of Advanced Nursing, 2005, 52:546) methodological approach for integrative reviews. Analysis was conducted utilising Braun and Clarke's (Qualitative Research in Psychology, 2006, 3:77) six phases to identify, analyse and record themes within the data. RESULTS Thirteen articles were reviewed, and the review found that life-story work has been introduced using a range of different approaches, with no common approach. Thematic analysis identified two: maintaining identity and building and maintaining relationships. CONCLUSION The review extends the current evidence on the experience of using life-story work in long-term aged care facilities for older people. Life-story work has the potential to enhance person-centred care in long-term care. However, improving the process of implementation of life-story work will require education, time and resources and a commitment from service providers and managers. RELEVANCE TO CLINICAL PRACTICE Staff who undertake life-story work with residents need to be equipped with the skills to recognise and manage the challenges and issues that may potentially arise. Further research into the successful implementation of life-story work and how it can be resourced is required.
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Affiliation(s)
| | - Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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20
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Laird EA, Ryan A, McCauley C, Bond RB, Mulvenna MD, Curran KJ, Bunting B, Ferry F, Gibson A. Using Mobile Technology to Provide Personalized Reminiscence for People Living With Dementia and Their Carers: Appraisal of Outcomes From a Quasi-Experimental Study. JMIR Ment Health 2018; 5:e57. [PMID: 30206053 PMCID: PMC6231741 DOI: 10.2196/mental.9684] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/10/2018] [Accepted: 06/18/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Dementia is an international research priority. Reminiscence is an intervention that prompts memories and has been widely used as a therapeutic approach for people living with dementia. We developed a novel iPad app to support home-based personalized reminiscence. It is crucial that technology-enabled reminiscence interventions are appraised. OBJECTIVE We sought to measure the effect of technology-enabled reminiscence on mutuality (defined as the level of "closeness" between an adult living with dementia and their carer), quality of carer and patient relationship, and subjective well-being. METHODS A 19-week personalized reminiscence intervention facilitated by a program of training and a bespoke iPad app was delivered to people living with dementia and their family carers at their own homes. Participants (N=60) were recruited in dyads from a cognitive rehabilitation team affiliated with a large UK health care organization. Each dyad comprised a person living with early to moderate dementia and his or her family carer. Outcome measurement data were collected at baseline, midpoint, and intervention closure. RESULTS Participants living with dementia attained statistically significant increases in mutuality, quality of carer and patient relationship, and subjective well-being (P<.001 for all 3) from baseline to endpoint. Carers attained nonsignificant increases in mutuality and quality of carer and patient relationship and a nonsignificant decrease in subjective well-being. CONCLUSIONS Our results indicate that individual-specific reminiscence supported by an iPad app may be efficient in the context of early to moderate dementia. A robust randomized controlled trial of technology-enabled personalized reminiscence is warranted.
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Affiliation(s)
- Elizabeth A Laird
- Institute of Nursing and Health Research, Ulster University, Derry, United Kingdom
| | - Assumpta Ryan
- Institute of Nursing and Health Research, Ulster University, Derry, United Kingdom
| | - Claire McCauley
- Institute of Nursing and Health Research, Ulster University, Derry, United Kingdom
| | - Raymond B Bond
- School of Computing, Ulster University, Belfast, United Kingdom
| | | | - Kevin J Curran
- School of Computing, Engineering & Intelligent Systems, Ulster University, Derry, United Kingdom
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Derry, United Kingdom
| | - Finola Ferry
- Psychology Research Institute, Ulster University, Derry, United Kingdom
| | - Aideen Gibson
- School of Computing, Ulster University, Belfast, United Kingdom
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21
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Eriksen S, Helvik AS, Juvet LK, Skovdahl K, Førsund LH, Grov EK. The Experience of Relations in Persons with Dementia: A Systematic Meta-Synthesis. Dement Geriatr Cogn Disord 2018; 42:342-368. [PMID: 27866199 DOI: 10.1159/000452404] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dementia influences a person's experience of social relationships, as described in several studies. In this systematic meta-synthesis of qualitative studies, we aim to interpret and synthesize the experiences of persons with dementias and their relations with others. SUMMARY Living with dementia changes life, leading to new social roles and different social statuses. Persons with dementia experience being disconnected and dependent on others, feeling like being a burden, and being a person who is treated in paternalistic ways. Family, friends and others with dementia might play significant roles in their ability to maintain a meaningful life. Key Messages: Three categories emerged from the data, change in life, change in relations, and maintenance of meaningful aspects in life; these categories are intertwined and essential in sustaining a lifeline for persons with dementia. The comprehensive meaning of the material is understood as the expression: Living a meaningful life in relational changes.
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Affiliation(s)
- Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
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22
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Cotter VT, Gonzalez EW, Fisher K, Richards KC. Influence of hope, social support, and self-esteem in early stage dementia. DEMENTIA 2017; 17:214-224. [PMID: 29164906 DOI: 10.1177/1471301217741744] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background People in the early stages of dementia adjust to the illness through stages of awareness, coping, and evaluation. Studies have found that hope, social support, and self-esteem facilitate coping, adjustment, and adaptation in chronic illness. Objective The purpose of this descriptive study was to examine the relationships between hope, social support, and self-esteem in individuals with early stage dementia. Methods Data were obtained from 53 individuals with early stage dementia. The scores on the Herth Hope Index, Social Support Questionnaire Short-Form, and the State Self-Esteem Scale were analyzed using linear regression. Results Hope was moderately associated with self-esteem ( r = .49, p < .001). Hope accounted for 25% of the variance in self-esteem and was a key component in predicting self-esteem. No significant relationship was found between social support and self-esteem. Conclusion Findings suggest that hope may be an important factor to help individuals manage potential threats to self-esteem in the experience of early stage dementia. Strategies to inspire hope and then enhance self-esteem are promising for individuals living with early stage dementia.
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Affiliation(s)
| | | | - Kathleen Fisher
- 15775 Drexel University College of Nursing and Health Professions , USA
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Shakespeare T, Zeilig H, Mittler P. Rights in Mind: Thinking Differently About Dementia and Disability. DEMENTIA 2017; 18:1075-1088. [DOI: 10.1177/1471301217701506] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Heggestad AKT, Slettebø Å. How individuals with dementia in nursing homes maintain their dignity through life storytelling - a case study. J Clin Nurs 2015; 24:2323-30. [DOI: 10.1111/jocn.12837] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Åshild Slettebø
- Faculty of Health and Sport Sciences; University of Agder; Kristiansand Norway
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