Best practice and needs for improvement in the chain of care for persons with dementia in Sweden: a qualitative study based on focus group interviews

BMC Health Services Research

Ann-Christin Janlöv¹  Ingalill Rahm Hallberg²  Staffan Karlsson²  Gerd Ahlström²  Christina Bökberg² 

[1] School of Health and Society, Kristianstad University, Kristianstad, SE–291 88, Sweden;Department of Health Sciences, Faculty of Medicine, Lund University, Lund, SE–221 00, Sweden

关键词: Nursing;    Professional care providers;    Nursing home;    Home care;    Chain of care;    Health care;    Transitions;    Best practice;    Dementia care;   

Others  :  1090390
DOI  :  10.1186/s12913-014-0596-z

 received in 2014-04-24, accepted in 2014-11-10,  发布年份 2014

【 摘 要 】

Background

Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers’ views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden.

Methods

The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life).

Results

The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in thechain of care, Competent staff a prerequisite for high-quality care, Day care facilitatestransition in the chain of care and Next-of-kin participation is a prerequisite forcontinuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care.

Conclusions

The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages.

【 授权许可】

   
2014 Bökberg et al.; licensee BioMed Central Ltd.

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