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BackgroundPerson-centered care is a holistic and integrative approach designed to maintain well-being and quality of life for people with dementia, and it includes the elements of care, the individual, the carers, and the family.AimA systematic literature review and meta-analysis were undertaken to investigate the effectiveness of person-centered care for people with dementia.MethodsLiterature searches were undertaken using six databases including Medline, EMBASE, CINAHL, PsycINFO, Cochrane Database, and KoreaMed using the following keywords: cognition disorder, dementia, person-centered care, patient-centered care, client-centered care, relationship-centered care, and dementia care. The searches were limited to interventional studies written in English and Korean and included randomized controlled studies and noncontrolled studies for people with dementia living in any setting.ResultsNineteen interventional studies, including 3,985 participants, were identified. Of these, 17 studies were from long-term care facilities and two studies were from homecare settings. The pooled data from randomized controlled studies favored person-centered care in reducing agitation, neuropsychiatric symptoms, and depression and improving the quality of life. Subgroup analysis identified greater effectiveness of person-centered care when implemented for people with less severe dementia. For agitation, short-term interventions had a greater effect (standardized mean difference [SMD]: −0.434; 95% conference interval [CI]: −0.701 to −0.166) than long-term interventions (SMD: −0.098; 95% CI: −0.190 to 0.007). Individualized activities resulted in a significantly greater beneficial effect than standard care (SMD: 0.513; 95% CI: −0.994 to −0.032). However, long-term, staff education, and cultural change interventions had a greater effect on improving the quality of life for people with dementia (SMD: 0.191; 95% CI: 0.079 to 0.302).ConclusionThis systematic review and meta-analysis provided evidence for person-centered care in clinical practice for people with dementia. Person-centered care interventions were shown to reduce agitation, neuropsychiatric symptoms, and depression and to improve the quality of life. Person-centered care interventions can effectively reduce agitation for a short term using intensive and activity-based intervention. However, an educational strategy that promotes learning and skill development of internal care staff is needed to enhance patient’s quality of life and to ensure the sustainability of the effects of behavioral problems. The feasibility and effectiveness of the intervention, the severity of patient disease, and intervention type and duration should be considered as part of an intervention design.

The results of the study indicate that the Family Involvement in Care intervention improves the caregiving experience of family members in nursing homes as well as nursing home staff attitudes toward family members. The intervention did not influence the perceived conflict with staff on the part of family caregivers or the perception of a partnership with family caregivers on the part of staff.

The purpose of this study was to provide an in-depth description of the experience of making the decision to place a family member in a special care unit among a diverse sample of family caregivers. To achieve purposive maximum variation of the sample, the sample of 30 family caregivers was chosen from an original study of 256 family caregivers. The sample was randomly stratified according to ethnicity, gender, and relationship to the care receiver. Three independent researchers used Luborsky's method of thematic analysis to analyze the interviews. After mutual consensus, 1565 themes (descriptive statements) were identified and synthesized into 21 topics. The topics were then synthesized into four patterns describing the decision-making experience: moving toward the unavoidable decision, struggling with the decision, seeking reassurance, and remaining connected.

The purpose of this study was to provide an in-depth description of 19 Korean family caregivers' experiences in making the decision to place a family member with dementia in a Korean long-term care facility. A total of 656 themes (descriptive statements) were identified and synthesized into 17 topics using Luborsky's method for thematic analysis. The topics were synthesized into four patterns: (a) feeling exhausted; (b) deep sorrow; (c) fractured relationships; and (d) apprehension. The findings enhance the capacity of health care professionals and the public to understand more fully, how caregiving experiences differ by cultural context. The findings contribute to understanding family caregiving experiences in a country in transition from a traditional society based on Confucianism to a Westernized society.

Anticipation of increased numbers of older persons throughout the coming decades who will require care and assistance with chronic illnesses and functional deficits has correspondingly increased awareness of the need for nursing research to support best geriatric nursing practices. Although badly needed, research in nursing homes presents challenges. This article discusses issues and challenges of ethically acceptable and rigorous research in nursing homes that are related to the dependency and institutionalization of older persons and to setting, staff, and resident characteristics. Strategies for easing the challenges of nursing research in nursing homes are offered.

Aims:To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.Background: Patient and family engagement is increasingly emerging as a potential approach for improving patient safety.Design: Mixed method multilevel synthesis.Results: Forty-two relevant studies were identified. Common intervention groups included 'direct care' and 'organization' levels with 'consultation' and 'involvement' approaches, while the 'health system' level and 'partnership and shared leadership' approaches were rarely implemented. Findings revealed positive effects of the interventions on patient safety. Most study participants expressed their willingness to engage in or support patient and family engagement. However, existing gaps and barriers in implementing patient and family engagement were identified. Conclusion:Future research should further focus on issuing consensus guidelines for implementing patient and family engagement in patient safety, extending the research scope for all aspects of patient and family engagement and patient safety and identifying priority areas for action that is suitable for each health facility. Impact: Policymakers should issue guidelines for implementing patient and family engagement in healthcare systems which would enable healthcare providers to implement patient and family engagement and improve patient safety appropriately and effectively. K E Y W O R D Sevidence-based practice, family, nursing, patient engagement, patient safety, systematic review | 63 PARK et Al.

It is vital to develop a service and support program with a greater emphasis on the behavioral problems and IADL deficiency of patients with AD as well as on improving the competence ability of caregivers to deal with such difficulties.