Exploring how the spiritual needs of dementia patients are addressed within the Care and Treatment Plans (CTPs) in three health boards in Wales

Anne Fothergill

Allbwn ymchwil: Cyfraniad at gynhadleddPosteradolygiad gan gymheiriaid

Crynodeb

Background

In Wales the Mental Health Measure outlines the care that Mental Health Service Users (MHSU) are legally entitled to; Part 2 requires MHSU’s in secondary care to have a Care and Treatment Plan (CTP) (WG 2010). The CTP sets out 8 domains that the nurse/assessor should complete. Domain 7 refers to social/cultural/spiritual needs. A small local audit suggested that Domain 7 may not be regularly completed for dementia patients thus, their spiritual needs may potentially go unmet. This is of concern given the Francis (2013) and Andrews (2014) reports’ findings that older people with dementia were not receiving respectful, compassionate, and dignified care. These NHS values are closely aligned to the notion of spiritual care which is at the heart of healthcare guidance (e.g. DH 2009, WG 2015).

Method/Description

Objectives:
1. To analyse dementia patients’ CTPs, from community mental health teams (CMHT) and in-patient wards.
2. To compare Domain 7 with the other domains of the CTP.
3. To conduct focus groups with staff to explore their views on completing Domain 7; this will be compared with the written CTP.

Methods
Phase 1. Literature review of spiritual care in dementia.
Phase 2. Thematic analysis of Domain 7 of a purposive sample of 150 CTPs (with Domain 7 completed) collected from older persons CMHTs and wards in 3 Health Boards to identify how spiritual needs are addressed, how often CTPs are updated (if they are) and by whom. The content of Domain 7 will be compared with the other domains (for content, volume and frequency/method of evaluation).
Phase 3. Focus groups with health care professionals to explore emerging themes identified in Phase 2.

Result/outcome
There is a dearth of literature on spiritual care in dementia. Analysis conducted was primarily for domain 7 of the CTP, which revealed that social aspects of care were well documented in particular staff encouraged patients to engage in meaningful activities and helped patients maintain social connections. Spiritual needs were mainly documented with reference to patients’ religious affiliation and associated religious rituals/practices. Person centred was also well documented throughout the whole CTP rather than being specific to one of the domains.
Focus groups with staff further supported the findings from the analysis of the written CTP. Completing the spiritual aspects of domain 7 was challenging and thus in the main staff documented the person’s religious affiliation and/or beliefs.

Conclusion
Staff recognised that spirituality was broader than a person’s religious affiliation, but capturing this on the CTP was difficult. Staff agreed that training in completing the CTP would be welcome, but especially to complete domain 7 as this was the least completed of all the 8 domains.

A final study report will be compiled later this year and will be disseminated to the three participating Health Boards: ABUHB, CTUHB and ABMUHB.
Iaith wreiddiolSaesneg
StatwsCyhoeddwyd - 30 Tach 2017
DigwyddiadCwm Taf University Health Board Research & Development Conference - University of South Wales, Pontypridd, Y Deyrnas Unedig
Hyd: 30 Nov 201730 Nov 2017

Cynhadledd

CynhadleddCwm Taf University Health Board Research & Development Conference
Gwlad/TiriogaethY Deyrnas Unedig
DinasPontypridd
Cyfnod30/11/1730/11/17

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