Objectives: Dementia causes dramatic changes in everyday-living for spouses. Occured changes in marital relationship, force spouses to perform more both mentally and physically. Leading to a spousal perceived burden. To improve understanding of spouses' needs, spouses lived experiences is needed. The aim was to identify and synthesise qualitative studies on spouses' lived experiences of living with a partner with dementia. Methods: A systematic search was undertaken in January 2017. Six databases (CINAHL, Cochrane Library, Embase, PubMed, PsycINFO and Sociological Abstracts) were searched, using search terms in accordance with PICo. A descriptive synthesis and a thematic synthesis were undertaken. Findings: Fifteen studies met the inclusion criteria. Three themes derived from the analysis 1) Noticing changes in everyday life 2) Transformation to a new marital relation in everyday life, with corresponding sub-themes; changes in marital relationship, management of the transitioned marital relation in everyday life 3) Planning the future. Conclusion: Findings provide an overview of how spouses notice changes and transform their marital relationships in everyday-life. Findings offer a deeper understanding of changes that occurs over time while the partner is living at home. Findings contribute with knowledge on spouses' experiences of changes in early-stages of dementia. Interventions supporting spouses are needed.
Objectives. The aim of this scoping review was to map intervention studies of rehabilitation for people living with dementia regarding processes and outcomes, with a particular focus on whether the intervention is person-centred, home-based, or organised adopting a multidisciplinary approach and measures outcomes relating to everyday functioning and well-being. Methods. A systematic search of electronic databases was conducted in PubMed, CINAHL, PsycINFO, Embase, and Cochrane. Studies from 2005 to November 2018 were collected and screened for relevance and quality. Randomised control trials and prospective cohort trials reporting a statistically significant effect on one or more outcome measures were included. Included studies were mapped according to selected processes and outcome measures. Results. Twenty-six intervention studies were included and mapped. Nineteen of the interventions were person-centred, nine were home-based, and 14 reported a multidisciplinary approach. Twelve of the interventions had activities of daily living as an outcome measure, and 14 had quality of life as an outcome measure. Conclusion. Person-centredness appears in most rehabilitation interventions for people living with dementia. Other processes and outcomes are heterogeneously described in the research literature. Rehabilitation programmes can be home-based or take place at a centre. Although not exclusive, the organisation of rehabilitation can be multidisciplinary. Fewer than half of the intervention studies measure the impact on activities of daily living and quality of life. Future guidelines must take into account the weak evidence regarding these aspects.
BackgroundCardiac rehabilitation (CR) and medical treatment are integrated parts of the intervention for cardiac patients and are a class 1A recommendation. However, CR dropout is reported to be relatively high and little is known about the reasons for CR dropout in primary health settings.AimThis study investigates causes for CR dropout through a qualitative audit of medical charts among patients with ischaemic heart disease.MethodsThis was a qualitative retrospective audit of patient's medical charts. Patients who dropped out from CR between 1 January and 31 December 2018 in five primary health settings were included. Local patient charts provided information related to causes and formed the basis of the analysis. Data were analyzed using thematic analysis.ResultsA total of 690 patients were referred for and commenced CR and 199 (29%) dropped out. Twenty-five (12.6%) patients finished CR but were excluded due to standards of ≥180 days between CR meetings, leaving 118 patients included. Four themes as causes for patient's dropout were identified: (1) CR-programmes, (2) logistical, (3) intrapersonal and (4) clinical factors.ConclusionThis study identified new focus areas to which health professionals may attend in reducing drop-out from CR. Organisation of CR, challenges with combining labor market attachment and CR, focus on patient education and comorbidities. The results underline the importance of health professionals emphasizing the benefits of CR and explains that CR enhances long-term labor market attachment. Furthermore, health professionals should encourage participation in patient education and adapt exercise to the individual patient's potential.
The aim of this study was to identify and synthesize person-centred principles and components as described in rehabilitation intervention studies which target home dwelling people with mild to moderate dementia. Materials and methods:A narrative synthesis was carried out which included 19 rehabilitation intervention studies targeting people with mild to moderate dementia. The analysis was guided by an initial program theory about personcentredness in rehabilitation, which was developed for this purpose.Results: Person-centred principles and components were identified and synthesised. Person-centred rehabilitation practice in dementia includes: 1) a focus on the needs, preferences and cultural values of the individual and consideration of his/her life history and biography ; 2) the cooperation of professionals and people with dementia, including specific tools and methods such as goal-setting, holistic assessment and methods to activate and empower the individual, and building relationships; 3) organisation and structure. Conclusion:Compared to the principles of Kitwood, person-centredness in rehabilitation for people living with dementia also includes goal-setting and empowering principles. There is a need for developing the theoretical and philosophical foundation for person-centredness in rehabilitation in relation to people with dementia.
ObjectivesHigh socioeconomic status (SES) has been linked to high referral for cardiac rehabilitation (CR). However, the impact of SES on CR utilisation from enrolment to completion is unclear. The objective of this study was to examine whether indicators of SES are associated with not taking up and dropout from CR.DesignA population-based, follow-up study.SettingHospitals and primary healthcare centres in the Central Denmark Region.ParticipantPatients diagnosed with ischaemic heart disease (IHD) in the hospital and referred for rehabilitation in the primary healthcare setting from 1 September 2017 to 31 August 2018 (n=2018).VariablesFour SES indicators (education, disposable family income, occupation and cohabitant status) were selected because of their established association with cardiovascular health and CR utilisation. Patients were followed up regarding no uptake of or dropout from CR in the primary healthcare setting.Statistical methodsThe associations between the four SES indicators and either no uptake or dropout from CR were analysed using logistic regression with adjustment for age, sex, nationality and comorbidity.ResultsOverall, 25% (n=507) of the referred patients did not take up CR and 24% (n=377) of the participators dropped out the CR. All adjusted ORs, except one (education/dropout) demonstrated that low SES compared with high are statistically significantly associated with higher odds of not taking up CR and dropout from CR. The ORs ranged from 1.52, 95% CI 1.13 to 2.04 (education/no uptake) to 2.36, 95% CI 1.60 to 3.46 (occupation/dropout).ConclusionsThis study highlights that indicators of SES are important markers of CR utilisation following hospitalisation for IHD.
BackgroundCardiac rehabilitation (CR) is a class 1A recommendation and an integrated part of standard treatment for patients with cardiac disease. In Denmark, CR adheres to European guidelines, it is group-based and partly conducted in primary health settings. Despite high evidence for the benefits of CR, it remains underutilized. How to facilitate CR adherence in primary health settings is poorly understood.AimThis study explores health professional's perspectives on how to facilitate CR adherence for patients with ischaemic heart disease in primary health settings.MethodsData were collected through focus group discussions. Respondents were health professionals specialized in and working with CR in primary health settings. Data were analyzed using thematic analysis.ResultsEleven health professionals participated in two focus group discussions. Five themes emerged as facilitators of CR; (1) placing the person at the center, (2) coherent programme, (3) flow of information, (4) contextual factors, and (5) feeling of belonging.ConclusionThis study illuminates the complexity of facilitating adherence to CR in primary health settings and provides ways in which health professionals may facilitate adherence. Placing the person at the center is pivotal and may be done by adapting CR offers to patients' social context, culture and life circumstances and ensuring a feeling of belonging. The rhetoric related to CR should be positive and throughout the entire course of treatment health professionals should possess a generic and collective approach to and view of CR. Perceiving these elements as potential facilitators is of vital importance and addressing them may facilitate adherence.
Introduction The background of this study is the pilot testing of the Adolescent /Adult Sensory Profile (A/ASP) in dementia units at municipal nursing homes. Based on the results from therapists' A/ASP assessment, recommendations are made according to individual needs and forwarded to the health care providers. This study looks into the health care providers' perspective on the usability of these recommendations. Aim The aim of this qualitative study is to explore the health care providers' perspective on the usability of recommendations derived from the A/ASP during a pilot testing of the profile in dementia units for people living with severe dementia. Methods Participant observations and informal and formal interviews with health care providers at five municipal dementia units during the pilot testing of the A/ASP. Results In the health care provider perspective, the A/ASP is a relevant and useful tool to use when behavioural challenges among residents living with dementia occur. However, in their opinion, it requires time, adjustment, and further education if recommendations are to be fully implemented in everyday practice at the dementia units.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.