Caring for people with dementia is a major challenge for relatives and society worldwide. Understanding the family caregivers' needs is crucial to promote their care-giving role during the disease trajectory. The aim of this mixed-method systematic review was to identify and synthetise the existing literature on the needs of family caregivers of people with dementia at home. PubMed, CINAHL, Cochrane Database of Systematic Reviews and PsycINFO databases were systematically explored to find quantitative, qualitative and mixed-method studies published between 2009 and 2019. A total of 1,196 citations were retrieved and 34 studies were included in the review. The variety of interrelated needs emerged from studies has been summarised in four themes: (a) Being supported, (b) Receiving accessible and personalised information, (c) Being trained and educated to care for their beloved with dementia and (d) Finding a balance. Care-giving for individuals with dementia is an ever-changing process characterised by continuous adjustments to their needs. The majority of a family caregivers' needs are oriented towards receiving support, help in offering daily care and finding a balance between the care-giving role and their own personal needs. For family caregivers, receiving information is a priority to improve their knowledge and to develop coping abilities, care skills and strategies aimed at promoting a balance between care assistance duties and their own needs. They also need social, psychological and emotional support and access to flexible, tailored and timely formal care. Further studies are recommended to detect changes in family caregivers' needs throughout the disease progression in order to tailor formal care offered by social and healthcare services.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/hsc.13048

What do family caregivers of people with dementia need? A mixed-method systematic review.

Objective To explore how nurses in hospitals enact person-centred fundamental care delivery. Background Effective person-centred care is at the heart of fundamental nursing care, but it is deemed to be challenging in acute health care as there is a strong biomedical focus and most nurses are not trained in person-centred fundamental care delivery. We therefore need to know if and how nurses currently incorporate a person-centred approach during fundamental care. Design Focused ethnography approach. Methods Observations of 30 nurses on three different wards in two Dutch hospitals during their morning shift. Data were collected through passive observations and analysed using framework analysis based on the fundamentals of care framework. The COREQ guideline was used for reporting. Results Some nurses successfully integrate physical, psychosocial and relational elements of care in patient interactions. However, most nurses were observed to be mainly focused on physical care and did not take the time at their patients' bedside to care for their psychosocial and relational needs. Many had a task-focused way of working and communicating, seldom incorporating patients' needs and experiences or discussing care planning, and often disturbing each other. Conclusions This study demonstrates that although some nurses manage to do so, person-centred fundamental care delivery remains a challenge in hospitals, as most nurses have a task-focused approach and therefore do not manage to integrate the physical, relational and physical elements of care. For further improvement, attention needs to be paid to integrated fundamental care and clinical reasoning skills. Relevance to clinical practice Although most nurses have a compassionate approach, this study shows that nurses do not incorporate psychosocial care or encourage patient participation when helping patients with their physical fundamental care needs, even though there seems to be sufficient opportunity for them to do so.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocn.15024

Exploring person-centred fundamental nursing care in hospital wards: A multi-site ethnography.

Background Healthcare professionals may have certain psychological characteristics which contribute to increasing the quality of their professional performance. Objective Study the effect that humanization of care and communication have on the burnout syndrome in nursing personal. Methods The sample included a total of 330 Spanish nurses. Analytical instruments used were the Health Professional's Humanization Scale (HUMAS), Communication Styles Inventory Revised (CSI-R) and Brief Burnout Questionnaire Revised (CBB-R). Results Two broad nursing profiles could be differentiated by their level of humanization (those with scores over the mean and those with scores below it in optimistic disposition, openness to sociability, emotional understanding, self-efficacy, and affection), where the largest group had the high scores. A communication repertoire based on verbal aggressiveness impacted indirectly on the effect of humanization on burnout, mainly in the personal impact component. We observed the relation of humanization profiles in nursing staff with the job dissatisfaction and burnout components. Besides that, some communication styles, verbal aggressiveness and questioningness, have an indirect effect on the relationship between humanization profiles and job dissatisfaction. Conclusions The results on the relationship between communication styles and burnout, and the mediator effect of communication styles on the relationship between humanization of care and burnout in nursing personnel are discussed.

/pdf/communication-and-humanization-of-care-effects-over-burnout-4o72tbzkg9.pdf

Communication and humanization of care: Effects over burnout on nurses.

Aim The aim of the present research was to investigate the obstacles, which prevent nurses being present with patients. Background It is vital for nurses to be able to spend time with patients for an accurate assessment of patients' needs to take place and to allow patients to express their concerns. The factors, which prevent nurses spending time with patients, are still unclear. Method Data were collected using semi-structured interviews with thirty-five participants, including the nurses and physicians from educational hospitals of Tehran. The analysis was performed through the conventional content analysis. To achieve accuracy and trustworthiness of the data, the Lincoln and Guba criteria were used. Result The results of the study can be summarized as: "conflict between human considerations and bureaucratic structure," "failure to meet basic needs," "the personal and interpersonal aspects of caring" and "safety in caring context." Conclusion To ensure high-quality care, it is important to understand more fully the factors that prevent nurses spending time with patients. Interventions are needed to allow nurses to spend more time with the patients. Implication for nursing management Health service managers should consider that the intrinsic motivation of nurses is to care for patients. They can increase the presence of nurses at patients' bedside and improve care quality by creating an attractive working environment, appreciating nurses' values, paying attention to their opinions and establishing professional communication based on mutual respect.

The obstacles to nurses being present with patients

The rapid increase in the ageing population and health conditions are imposing a higher challenge to the health care system that requires multidisciplinary teamwork utilizing coordinated care approach. This study examined the effects of integrated care model on quality of care received by older hospitalized patients in West Bank. A quantitative interrupted time series design (pretest and posttest multiple time series, quasi-experiment design) was used. The study examined the effects of integrated care model on admitted older patients (n=32) in the West Bank measuring ten dimensions of quality of care and four health indicators. There was a significant improvement in the dimensions of quality of care: dimensions: nurses’ communications with patients, physicians’ communications with patients, staff response to patients’ needs, pain management, explanations on medications, amount of information given on discharge plan, patients' area cleanliness, patients' area quietness, rating of the hospital, and willingness to recommend the hospital. Incidence of falls and incidence of pressure ulcer improved after implementing the model, while readmission rate and average length of stay did not improve. This study contributed to the limited body of knowledge related to the effect of integrated care model on hospitalized older patients’ quality of care in Palestine/ West Bank. Integrated care has the potential to improve care outcomes among hospitalized older patients.

/pdf/testing-the-effectiveness-of-integrated-elderly-care-model-1jrkb88e6t.pdf

Testing the effectiveness of integrated elderly care model on quality of care and health outcomes among hospitalized elderlies in west bank

Core elements of the interpersonal care relationship between nurses and older patients without cognitive impairment during their stay at the hospital: A mixed-methods systematic review.

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Core elements of the interpersonal care relationship between nurses and older patients without cognitive impairment during their stay at the hospital: A mixed-methods systematic review.