Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24
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Item Sexual expression in persons living with dementia(All Ireland Gerontological Nurses Association, 2017-03) Rennie, Karen; Dewing, Jan; Banks, DavidBackground: Due to disinhibition and disorientation, individuals living with dementia may express sexual desires leading to negative experiences for persons living with dementia and nurses. However, the need for sexual expression does not diminish with age or loss of capacity and continues to provide psychological and physical benefits in later life.Item Strategies to prevent dehydration in older people with dementia: A literature review(2019-11-26) Wilson, Kirsty; Dewing, JanDehydration is prevalent in hospitalised older people and residents in care homes, and older people with dementia are particularly at risk. A literature review was conducted to determine the evidence-based interventions used to prevent and manage dehydration in older people with dementia. Three databases were searched for relevant literature: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, and MEDLINE, alongside hand-searching. In-depth reading of the 12 studies included in this literature review was undertaken. Five themes were identified in relation to the hydration of older people: physical and social environment; staff communication strategies; access to drinks; drinking vessels; and individual preferences. The evidence suggests that dehydration in older people with dementia is an ongoing concern that needs to be addressed. There is evidence supporting the use of essential nursing interventions to improve hydration, such as coloured cups and verbal prompts, but less is known about the barriers preventing nurses from implementing these evidence-based interventions.Item Facilitation of a workplace learning intervention in a fluctuating context: An ethnographic, participatory research project in a nursing home in Norway(Foundation of Nursing Studies (FoNS), 2018-10-14) Dahl, Hellen; Dewing, Jan; Mekki, Tone Elin; Håland, Astrid; Øye, ChristineBackground: This single-site nursing home study is part of a larger cluster-randomised controlled trial that aimed to reduce staff use of restraint. The cluster-RCT study involved 24 nursing homes, and investigated the effect of a standardised education intervention to reduce restraint in dementia care with a person-centred care approach. This article draws on empirical data from one of the nursing homes in the control group of the trial, at which the education intervention was tailored to better account for contextual circumstances. Aim: To explore how a tailored education intervention can reduce the use of restraint in a nursing home. The study aims to investigate what local contextual circumstances influenced the process of facilitation of the intervention. Methods: The study was theoretically informed by the Promoting Action Research Implementation in Health Services (PARiHS) framework, with practice development principles to address local learning needs and contextual issues. External facilitators tailored the education intervention in collaboration with the nursing home leader and staff. A participatory design with data collection based on principles of critical ethnography was used to evaluate the intervention. Results: Fluctuation emerged as the core theme from the evaluation: fluctuating enthusiasm among staff, fluctuating nursing home culture and fluctuating responses by care home residents. Conclusion: The study offers insights into the interplay between a tailored facilitation intervention and fluctuating contextual circumstances in a nursing home. Implications for practice: A successful education intervention requires facilitators who can take into consideration and adapt to fluctuations in the context Facilitation skills must include the ability to value team experiences, recognise learning needs, provide feedback and participate in finding solutions in the moment Flexibility is important in terms of how new knowledge can be used in person-centred ways, notably in attempts to reduce the use of restraint in dementia careItem Developing facilitation skills amongst undergraduate nursing students to promote dementia awareness with children in a higher education institution (innovative practice)(Sage, 2018-11-17) Gibson, Caroline; Rennie, Karen; Dewing, Jan; McKinlay, LesleyFinal year students on a BSc Hons Nursing programme in Scotland were supported to become Dementia Friends facilitators and develop interactive dementia awareness sessions for children from local schools. The children were invited to indicate phrases and images they associated with ‘dementia’ at the outset and end of the session. Analysis of the responses suggested that there were positive changes in the children’s values and beliefs when thinking about a person living with dementia during the sessions. We suggest that peer learning is a valuable strategy to increase public and professional awareness about dementia and supports the development of graduate attributes.Item Haven: Sharing receptive music listening to foster connections and wellbeing for people with dementia who are nearing the end of life, and those who care for them(Sage, 2018-10-11) Garabedian, Claire E.; Kelly, FionaThis paper reports on research exploring the effects of music played for 12 dyads: a care home resident (‘resident’) with dementia and someone closely connected to him/her (‘carer’). Six individualised music interventions (3 live and 3 pre-recorded) were played by the first author on solo cello within five Scottish non-NHS care homes. All interventions were video-recorded. Semi-structured interviews with carer participants, key staff, and managers explored their responses to interventions. Thick descriptions of video recordings and interview transcripts were thematically coded using Nvivo. A key finding was that structural elements of the interventions combined with characteristics of the music played facilitated an internalised experience of ‘haven’; sonically transporting listeners away from their present reality and fulfilling the basic human needs for inclusion, comfort, identity, occupation and attachment.Item Research and education to understand fire risks associated with dementia: A collaborative case study (innovative practice)(SAGE, 2018-08-01) Heward, Michelle; Kelly, FionaThis article reports on outcomes from the evaluation of a collaborative project between a University and a Fire and Rescue Service where research and education were developed to inform understanding of fire risks associated with dementia. Project outcomes were determined using a mixed-methods approach (survey, reports, statistics, case studies, course evaluation forms). Main outputs were a research report that identified dementia-specific fire risks and safety strategies, and an education package for Fire and Rescue Service staff and volunteers. The evaluation demonstrates the value of collaborative partnerships to develop understanding of risks pertinent to particular vulnerable groups and research-informed education.Item The nourishing soil of the soul-: The role of horticultural therapy in promoting well-being in community-dwelling people with dementia(Sage, 2015-12-23) Noone, Sarah; Innes, Anthea; Kelly, Fiona; Mayers, AndyTwo-thirds of people with dementia reside in their own homes; however, support for community dwelling people with dementia to continue to participate in everyday activities is often lacking,resulting in feelings of depression and isolation among people living with the condition. Engagement in outdoor activities such as gardening can potentially counteract these negative experiences by enabling people with dementia to interact with nature, helping to improve their physical and psychological well-being. Additionally, the collaborative nature of community gardening may encourage the development of a sense of community, thereby enhancing social integration. Despite increasing evidence supporting its therapeutic value for people with dementia in residential care, the benefits of horticultural therapy have yet to be transposed into a community setting. This paper will examine the theoretical support for the application of horticultural therapy in dementia care, before exploring the potential of horticultural therapy as a means of facilitating improved physical and psychological well-being and social integration for people living with dementia within the community.Item Living with dementia in hospital wards: a comparative study of staff perceptions of practice and observed patient experience(Wiley, 2016-01-20) Innes, Anthea; Kelly, Fiona; Scerri, Charles; Abela, StephenAims and objectives. To ascertain the experiences, attitudes and knowledge of staff working in two Maltese hospital wards and the observed experiences of people with dementia living there. To examine the impact of recommendations made in October 2011 for improving the psychosocial and physical environments of the wards 1 year later. Background. There is an increasing policy recognition of the need for a better trained and educated dementia care workforce and of ensuring that the environmental design of care settings meets the needs of people with dementia. Design and methods. At both time points, three established and validated data collection methods evaluated (i) staff/patient interaction and patient experience, (ii) the extent to which the wards met dementia friendly principles and (iii) staff views about their work environment and their perceptions about their practice. Sixteen (five male and 11 female) patients with dementia and 69 staff in the two wards participated in the study. Results. We noted small but important changes; however, the physical and psychosocial environments of the wards did not always align to current recommendations for dementia care, with staff perceptions of care delivery not always reflecting the observed experiences of care of those living with dementia. Conclusions. Comparing staff questionnaire data with observational methods offered a unique opportunity to understand multiple perspectives in a complex hospital setting. Incorporating these perspectives into staff and management feedback allowed for recommendations that recognised both patient-centred values and staff constraints.Item Scaffolding and working together: a qualitative exploration of strategies for everyday life with dementia(Oxford University Press, 2017-12-20) McCabe, Louise; Robertson, Jane; Kelly, FionaBackground: Living with dementia has been described as a process of continual change and adjustment, with people with dementia and their families adopting informal strategies to help manage everyday life. As dementia progresses, families increasingly rely on help from the wider community and formal support. Methods: This paper reports on a secondary analysis of qualitative data from focus groups and individual interviews with people with dementia and their carers in the North of England. In total 65 people with dementia and 82 carers took part in the research: 26 in interviews and 121 in focus groups. Focus group and interview audio recordings were transcribed verbatim. A qualitative, inductive, thematic approach was taken for data analysis. Findings: The paper applies the metaphor of scaffolding to deepen understanding of the strategies used by families. Processes of scaffolding were evident across the data where families, communities, professionals and services worked together to support everyday life for people with dementia. Within this broad theme of scaffolding were three sub-themes characterising the experiences of families living with dementia: doing things together; evolving strategies; and fragility and fear of the future. Conclusions: Families with dementia are resourceful but do need increasing support (scaffolding) to continue to live as well as possible as dementia progresses. More integrated, proactive work is required from services that recognises existing scaffolds and provides appropriate support before informal strategies become unsustainable; thus enabling people with dementia to live well for longer.