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Issues experienced while administering care to patients with dementia in acute care hospitals: a study based on focus group interviews.

Fukuda R, Shimizu Y, Seto N - Int J Qual Stud Health Well-being (2015)

Bottom Line: Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle.This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals.In coping with this cycle, the nurses develop protection plans for themselves and for the hospital.

View Article: PubMed Central - PubMed

Affiliation: Nursing and Health Science, Graduate School of Medicine, Ehime University, Ehime, Japan; r-fukuda@umin.ac.jp.

ABSTRACT

Objective: Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan.

Methods: This was a qualitative study using focus group interviews (FGIs). The setting was six acute hospitals with surgical and medical wards in the western region of Japan. Participants were nurses in surgical and internal medicine wards, excluding intensive care units. Nurses with less than 3 years working experience, those without experience in dementia patient care in their currently assigned ward, and head nurses were excluded from participation. FGIs were used to collect data from February to December 2008. Interviews were scheduled for 1-1.5 h. The qualitative synthesis method was used for data analysis.

Results: In total, 50 nurses with an average experience of 9.8 years participated. Eight focus groups were formed. Issues in administering care to patients with dementia at acute care hospitals were divided into seven groups. Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle. This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals. In coping with this cycle, the nurses develop protection plans for themselves and for the hospital.

Conclusions: The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were as follows: (a) the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle, and (b) nurses do their best to adapt to these conditions despite feeling conflicted.

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Related in: MedlinePlus

Schematic diagram of the issues faced by nurses caring for patients with dementia in acute care hospitals.
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Figure 0002: Schematic diagram of the issues faced by nurses caring for patients with dementia in acute care hospitals.

Mentions: The data acquired from the FGI sessions were structured using seven themes, and the interrelationships between the themes are shown in Figure 2. On the basis of these relationships, we can draw conclusions with regard to the issues faced by nurses caring for patients with dementia in acute care hospitals. Problematic patient behavior affects many individuals, including the families and hospital roommates of patients with dementia. Therefore, families and hospital roommates may also require nursing care for fear, anxiety, and frustration related to the problematic behavior of patients with dementia. Families are, however, also regarded as assistants when patients with dementia are hospitalized in Japan, and they are regarded as essential to prevent the problematic behavior of the patient and to protect the patient's safety. In consequence, problems arise when the problematic behavior of the patient with dementia is repeated when the assistance of the family is impossible to obtain.


Issues experienced while administering care to patients with dementia in acute care hospitals: a study based on focus group interviews.

Fukuda R, Shimizu Y, Seto N - Int J Qual Stud Health Well-being (2015)

Schematic diagram of the issues faced by nurses caring for patients with dementia in acute care hospitals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4340824&req=5

Figure 0002: Schematic diagram of the issues faced by nurses caring for patients with dementia in acute care hospitals.
Mentions: The data acquired from the FGI sessions were structured using seven themes, and the interrelationships between the themes are shown in Figure 2. On the basis of these relationships, we can draw conclusions with regard to the issues faced by nurses caring for patients with dementia in acute care hospitals. Problematic patient behavior affects many individuals, including the families and hospital roommates of patients with dementia. Therefore, families and hospital roommates may also require nursing care for fear, anxiety, and frustration related to the problematic behavior of patients with dementia. Families are, however, also regarded as assistants when patients with dementia are hospitalized in Japan, and they are regarded as essential to prevent the problematic behavior of the patient and to protect the patient's safety. In consequence, problems arise when the problematic behavior of the patient with dementia is repeated when the assistance of the family is impossible to obtain.

Bottom Line: Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle.This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals.In coping with this cycle, the nurses develop protection plans for themselves and for the hospital.

View Article: PubMed Central - PubMed

Affiliation: Nursing and Health Science, Graduate School of Medicine, Ehime University, Ehime, Japan; r-fukuda@umin.ac.jp.

ABSTRACT

Objective: Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan.

Methods: This was a qualitative study using focus group interviews (FGIs). The setting was six acute hospitals with surgical and medical wards in the western region of Japan. Participants were nurses in surgical and internal medicine wards, excluding intensive care units. Nurses with less than 3 years working experience, those without experience in dementia patient care in their currently assigned ward, and head nurses were excluded from participation. FGIs were used to collect data from February to December 2008. Interviews were scheduled for 1-1.5 h. The qualitative synthesis method was used for data analysis.

Results: In total, 50 nurses with an average experience of 9.8 years participated. Eight focus groups were formed. Issues in administering care to patients with dementia at acute care hospitals were divided into seven groups. Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle. This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals. In coping with this cycle, the nurses develop protection plans for themselves and for the hospital.

Conclusions: The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were as follows: (a) the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle, and (b) nurses do their best to adapt to these conditions despite feeling conflicted.

Show MeSH
Related in: MedlinePlus