为痴呆症叠加谵妄患者提供护理的精神科护士的体验 | Age & Ageing

Abstract

Introduction

People with severe dementia are frequently cared for by registered mental health nurses due to their often complex cognitive or psychological care needs. This study aimed to explore and describe the experiences of mental health nurses who provide care for people with delirium superimposed on dementia.

Methods

Activity Theory was used to inform, a mixed methods design. Commencing with semi structured interviews, before further quantitative exploration using a questionnaire. Framework analysis was used for qualitative analysis, followed by descriptive statistical analysis of questionnaire data. Robust integration of data was undertaken, and findings presented in an activity system graphic. Participants were registered mental health nurses working in 24-hour care settings for people with dementia.

Results

Five key themes emerged: 1. For RNMHs to use tools (such as scores or guidelines), they need to see them as useful and contextually relevant. Whilst they are aware of tools, they may choose not to use them if they do not see the value in them. 2. Knowing the person for whom they provide care is central and personal. The RNMHs favour aesthetic ways of knowing and use this to guide their care provision. 3. Hierarchy within the multidisciplinary team remains, however this is not seen as a negative. The RNMHs feel supported and secure within their wider MDT. 4. Burdens of care felt by the RNMHs is driven by the care environment and care context. 6. There remains a disconnection of mental and physical health in both care environments and how the RNMHs see their role.

Conclusion

This study is the first to explore the complexities of specifically the mental health nurse context in relation to DSD. The novel application of Activity Theory as a lens offered a unique frame to support exploration of the mental health nurses working environments and experiences.

摘要翻译（仅供参考）

简介

由于严重痴呆症患者通常有复杂的认知或心理护理需求，因此经常由注册精神健康护士进行护理。本研究旨在探索和描述为痴呆症患者提供护理的精神健康护士的体验。

研究方法

活动理论被用来指导混合方法的设计。首先是半结构化的访谈，然后用问卷进行进一步的定量探索。在定性分析中使用了框架分析，然后对问卷数据进行描述性统计分析。对数据进行了有力的整合，并将结果以活动系统图的形式呈现。参与者是在为痴呆症患者提供的24小时护理环境中工作的注册精神健康护士。

结果

出现了五个关键的主题：

1. 1.对于RNMHs使用工具（如分数或指南），他们需要看到它们是有用的和与环境相关的。虽然他们知道这些工具，但如果他们没有看到这些工具的价值，他们可能会选择不使用。

2. 2. 了解他们提供护理的对象是最重要的和个人的。RNMHs赞成以审美的方式来了解，并以此来指导他们的护理工作。

3. 多学科团队中的等级制度仍然存在，但这并不被认为是一种消极现象。在更广泛的多学科团队中，RNMHs 感到被支持和安全。

4. RNMHs所感受到的护理负担是由护理环境和护理背景所决定的。6. 6. 在护理环境和RNMHs如何看待他们的角色方面，仍然存在着心理和身体健康的脱节。

结论

本研究首次探讨了与DSD有关的心理健康护士背景的复杂性。以活动理论为视角的新应用提供了一个独特的框架来支持对心理健康护士工作环境和经验的探索。

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