Crynodeb
Introduction:
Dementia is a global public health challenge now and for future generations. The World Health Organisation (2015) stated that 35.6 million people are affected by dementia with this figure expected to rise to 65.7 million by 2030. Living well with this condition is paramount. Thus, care and treatment to persons living with dementia must be provided in a dignified, respectful and compassionate manner (Francis Report 2013, Andrews Report 2014). In Wales Part 2 of the Mental Health Measure legally requires that all patients in secondary care services has a Care and Treatment Plan (CTP) (WG 2010).
A research study was completed (December 2016) in which 150 CTPs from patients diagnosed with dementia in three local health boards (CTUHB, ABMULHB, ABUHB), were analysed. The focus was to analyse the content of Domain 7 of the CTP - social/cultural/spiritual needs. Spiritual needs are not well addressed in practice. This project was ethically approved by USW Ethics' Committee, and externally by the Wales 6 Ethics’ Committee (IRAS) and approved by all three participating Health Boards.
Aim:
To ascertain how the spiritual needs of patients living with Dementia are addressed within the CTPs
Methodology:
This was a qualitative study conducted in three phrases. Firstly, a literature review was undertaken on dementia and spirituality, secondly CTPs were randomly selected by Research Assistants (RAs) from each of the three participating HBs, and thirdly, focus groups were conducted with staff / care co-ordinators.
Sample
150 CTPs, 50 from each participating health board and a mix of hospital and community CTPs comprised the sample for phase 2. Only CTPs with Domain 7 completed (Social, Cultural and Spiritual) were selected by the RAs. Two focus groups, with a total of 11 staff, all nurses were recruited by their Senior Nurses. Thus, the data was collected from the CTP in written format and staff focus groups i.e. group interviews using open ended questions.
Results:
From the CTPs eight themes emerged. These were: 1. Religion/ Religious beliefs; 2. Social connections with family, friends and neighbours; 3. Social connections with staff/paid workers and volunteers; 4. Meaningful activities (e.g. photos, memory books, watching TV, hobbies, and work-related activities); 5. Support for family and carers; 6. Culture; 7 Person-centred care and 8. Considered but no detail given (e.g. have social, cultural, spiritual needs met).
Spiritual needs were mainly documented in the CTPs with references to the person’s religious affiliation and associated religious practices rather than the broader aspects of spiritual care (compassion, respect, dignity, person centred). The focus in Domain in 7 was on meeting the social needs of the person with dementia i.e. engaging them in meaningful / purposeful activities and helping to maintain social connections with family, friends, neighbours and staff. These can be considered broader aspects of spiritual care. The 8 themes were verified in the focus groups. Staff said that all the domains are important, but that completing Domain 7 was harder.
Conclusion:
Spiritual needs of persons with dementia could be better documented. To help staff with this they would like further training in completing the CTP, especially Domain 7. For example, providing some exemplar questions to ask on spiritual care or some prompts / cues would be helpful. Thus, our findings have implications for practice i.e. how the CTPs are completed - since partly completed CTPs may affect the holistic care that older persons with dementia need and deserve.
Dementia is a global public health challenge now and for future generations. The World Health Organisation (2015) stated that 35.6 million people are affected by dementia with this figure expected to rise to 65.7 million by 2030. Living well with this condition is paramount. Thus, care and treatment to persons living with dementia must be provided in a dignified, respectful and compassionate manner (Francis Report 2013, Andrews Report 2014). In Wales Part 2 of the Mental Health Measure legally requires that all patients in secondary care services has a Care and Treatment Plan (CTP) (WG 2010).
A research study was completed (December 2016) in which 150 CTPs from patients diagnosed with dementia in three local health boards (CTUHB, ABMULHB, ABUHB), were analysed. The focus was to analyse the content of Domain 7 of the CTP - social/cultural/spiritual needs. Spiritual needs are not well addressed in practice. This project was ethically approved by USW Ethics' Committee, and externally by the Wales 6 Ethics’ Committee (IRAS) and approved by all three participating Health Boards.
Aim:
To ascertain how the spiritual needs of patients living with Dementia are addressed within the CTPs
Methodology:
This was a qualitative study conducted in three phrases. Firstly, a literature review was undertaken on dementia and spirituality, secondly CTPs were randomly selected by Research Assistants (RAs) from each of the three participating HBs, and thirdly, focus groups were conducted with staff / care co-ordinators.
Sample
150 CTPs, 50 from each participating health board and a mix of hospital and community CTPs comprised the sample for phase 2. Only CTPs with Domain 7 completed (Social, Cultural and Spiritual) were selected by the RAs. Two focus groups, with a total of 11 staff, all nurses were recruited by their Senior Nurses. Thus, the data was collected from the CTP in written format and staff focus groups i.e. group interviews using open ended questions.
Results:
From the CTPs eight themes emerged. These were: 1. Religion/ Religious beliefs; 2. Social connections with family, friends and neighbours; 3. Social connections with staff/paid workers and volunteers; 4. Meaningful activities (e.g. photos, memory books, watching TV, hobbies, and work-related activities); 5. Support for family and carers; 6. Culture; 7 Person-centred care and 8. Considered but no detail given (e.g. have social, cultural, spiritual needs met).
Spiritual needs were mainly documented in the CTPs with references to the person’s religious affiliation and associated religious practices rather than the broader aspects of spiritual care (compassion, respect, dignity, person centred). The focus in Domain in 7 was on meeting the social needs of the person with dementia i.e. engaging them in meaningful / purposeful activities and helping to maintain social connections with family, friends, neighbours and staff. These can be considered broader aspects of spiritual care. The 8 themes were verified in the focus groups. Staff said that all the domains are important, but that completing Domain 7 was harder.
Conclusion:
Spiritual needs of persons with dementia could be better documented. To help staff with this they would like further training in completing the CTP, especially Domain 7. For example, providing some exemplar questions to ask on spiritual care or some prompts / cues would be helpful. Thus, our findings have implications for practice i.e. how the CTPs are completed - since partly completed CTPs may affect the holistic care that older persons with dementia need and deserve.
| Iaith wreiddiol | Saesneg |
|---|---|
| Statws | Cyhoeddwyd - 29 Tach 2018 |
| Digwyddiad | Cwm Taf University Health Board Annual Research and Development Conference - University of South Wales, Pontypridd, Y Deyrnas Unedig Hyd: 29 Tach 2018 → 29 Tach 2018 |
Cynhadledd
| Cynhadledd | Cwm Taf University Health Board Annual Research and Development Conference |
|---|---|
| Gwlad/Tiriogaeth | Y Deyrnas Unedig |
| Dinas | Pontypridd |
| Cyfnod | 29/11/18 → 29/11/18 |
NDC y CU
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