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- Hedman, Ragnhild, 1962-, et al.
(författare)
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Enacting person-centred care in home care services for people with dementia
- 2022
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 31:11-12, s. 1519-1530
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To develop the theoretical understanding of the process of providing person-centred home care for people with dementia.Background: People with dementia are increasingly cared for at home by family members and home care staff. Care of people with dementia should be person-centred; however, little is known about how home care staff understand and enact person-centred care in their daily work.Design: Grounded theory.Methods: Home care staff (n = 29) were recruited from home care services specialised in providing care for people with dementia. Group interviews were conducted, and a tentative theoretical model for providing person-centred home care to people with dementia was outlined. Nine of the participants were then individually interviewed to further develop the model. The analysis was conducted parallel to the data collection, and hypotheses concerning the evolving theoretical model were continuously tested in the following interviews. The COREQ checklist for qualitative studies was used in reporting the study.Results: Person-centred home care of people with dementia was conceptualised as a series of processes: Getting ready, getting in, giving care, getting out and finalising the story, each with subprocesses. Theatre metaphors were used to describe how the care was provided. A core process, Enacting and re-enacting familiarity, was at centre in all processes.Conclusions: In the person-centred care of people with dementia, familiarity had to be established and continuously fostered. When familiarity was in place, the care recipient and the home care staff acted as a team to perform the care. The theoretical works of Goffman were used to interpret the results.Relevance to clinical practice: The study provides a model for person-centred care of people with dementia at home that deepens the understanding of its processes, prerequisites and outcomes. The model can inform education and administration of home care for people with dementia.
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| 2. |
- Hellzén, Ove, et al.
(författare)
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From optimism to pessimism : A case study of a psychiatric patient
- 1998
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 7:4, s. 360-370
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses on the results of a single case study which illuminates an understanding of phases in nursing care for a patient in a psychiatric setting in Sweden. The focus of this study is a fifty year old man who showed progressive deterioration from increased motor activity to oral, sexual, destructive and aggressive actions. The data collection using five methods occurred during a 21 months period. Results of the content analyses processes identified four distinct but indiscreet phases of the patient’s complex condition. The medical and nursing care was categorised in three approaches: optimistic, strategic and resigned. The results raise the question whether there is action that is without any meaning as an expression of the patient´s wishes, thoughts and feelings. It seems clear that the patient in this study felt really angry and in despair. However, during moments of lucidity, he also indicated that he felt this was not an authentic expression of his "real" self. His experience was that of a splintered world.
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| 4. |
- Normann, Hans Ketil, et al.
(författare)
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People with severe dementia exhibit episodes of lucidity : A population-based study
- 2006
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:11, s. 1413-1417
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe frequency and characteristics of people with severe dementia who according to care providers, exhibit ELs in a population of those with dementia in institutional care.Background. There are reports in the literature concerning episodes when the resident unexpectedly says or acts in a way that surprises the care provider because the resident seems to be much more aware of her/his situation than usual. This is labelled ‘episodes of lucidity’ (ELs).Design. The study is based on data from a point prevalence study from institutions for the older people in northern Sweden in May 2000.Methods. Out of 3804 residents, assessed by key care providers, by means of the Multi-Dimensional Dementia Assessment Scale (MDDAS) with questions about ELs added, 92 residents were found to have severe dementia and difficulties with verbal communication. The key care providers’ competence in assessing severe dementia was not evaluated. An ethics committee approved the study.Results. Fifty-two residents (57%) were assessed as exhibiting ELs. Residents who showed ELs had higher orientation scores and expressed more emotions than residents who did not show ELs. More residents who exhibited ELs took outdoor walks with their care providers exhibited ELs than those who did not (P = 0·001).Conclusions. Every second resident with severe dementia and difficulties with verbal communication showed ELs.Relevance for clinical practice. The fact that every second resident with severe dementia and difficulties with verbal communication showed ELs and that this was noticed especially when care providers took outdoor walks with the residents imply that closer contact between care providers and residents with severe dementia could change the care providers’ expectations and enhance communication between the parties.
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