Acute care delivery to persons with cognitive impairment: a mixed method study of health professionals' care provision and associated challenges. (2nd October 2020)

• Record Type: Journal Article
• Authors: Ernst, Jutta; Petry, Heidi; Luethi, Nadja; Naef, Rahel
• Is Part Of: Aging & mental health. Volume 24:Number 10(2020)
• Page Start: 1726
• Page End: 1735
• Publication Date: 2020-10-02
• Subjects: Dementia -- mild cognitive impairment -- person-centred care -- health professionals -- acute care; Older people -- Mental health -- Periodicals; Geriatric psychiatry -- Periodicals; Older people -- Psychology -- Periodicals; Aging -- Psychological aspects -- Periodicals; Aged -- psychology -- periodicals; Mental Health -- periodicals; Mental Health Services -- periodicals; Aging -- psychology -- periodicals; Aged, 80 and over -- psychology -- periodicals; 618.97689
• DOI: 10.1080/13607863.2019.1616162
• Languages: English
• ISSNs: 1360-7863

Abstract

Abstract: Objectives: Cognitive impairment is common among older persons admitted to hospital and associated with adverse outcomes. Inadequate care has been widely reported, with health professionals tending to be ill-equipped to meet the specific needs of this patient group. This study aimed to investigate health professionals' care provision to persons with cognitive impairment and associated challenges. Design and Setting: A concurrent, cross-sectional mixed method study was conducted at two university-affiliated hospitals. Participants: A total of 339 health professionals participated in the study. Measurements: An online survey (n = 312) determined the extent to which health professionals perceived their care provision to be person-centered and evidence-based (POPAC-R), and experience distress in looking after this patient group (NPI-D). Four focus group interviews (n = 27) explored health professionals' experience of care provision. Results: More than half of the health professionals reported to act always or very frequently in person-centered and evidence-based ways, and two third experienced challenging behaviors as moderately to very distressing. Health professionals working in acute geriatric wards demonstrated statistically significant higher levels of person-centered and evidence-based care provision, and lower distress. Their caring practices pertained to building a relationship, addressing specific needs, involving family members, and working collaboratively. Conclusions: Findings suggest that geriatric models of care delivery support staff in meeting the needs of persons with cognitive impairment. Health professionals require an acute care culture that values relational, collaborative and coordinated care as essential to patient safety and quality of care, and supports the consistent implementation of evidence-based practices for this patient group.