Aim: To understand how family caregivers of older adults hospitalized for orthopaedic surgery are integrated by nurses in delirium prevention care.
Design: Multiple case study.
Methods: The sample consisted of eight cases. Each case comprised an older adult, a family caregiver, and a nurse. Data were collected from September 2017 - April 2018 through various instruments, including semi-structured interviews and family caregiver logs. Within- and across-case analyses were conducted, based on the model of The Care Partner Engagement developed by Hill, Yevchak, Gilmore-Bykovskyi, & Kolanowski (Geriatric Nursing, 35, 2014, 272).
Results: Two themes emerged: (a) family caregivers were engaged in caring for the older adults during their hospital stay, though they had differences in terms of views and needs; and (b) family caregivers communicated with nurses but nurses did not recognize their role and did not integrate them much in care.
Conclusion: The presence and availability of family caregivers, their sense of responsibility towards the hospitalized older adults, and their positive effects on them suggest that family caregivers could be integrated more systematically in a care partnership with nurses. Poor integration of family caregivers in delirium prevention care shows that nurse delirium prevention competencies and their relational skills for communicating effectively with family caregivers need to be developed further.
Impact: Integrating family caregivers in delirium prevention care for older adults is a challenge for nurses. Family caregivers are engaged during the hospitalization of older adults, though differences and problems exist between the two groups. While there is communication between patients, family caregivers, and nurses, nurses do not recognize the role of family caregivers and hardly integrated them in the delirium prevention care of hospitalized older adults. Nurses must adopt a patient- and family-centred approach. Care and training facilities must make resources available to implement this approach in nursing practice.
目标: 了解住院接受骨科手术的老年患者的家庭照料人员如何被纳入护士的谵妄防治方案中。 设计: 多个病例研究。 方法: 样本包括8个病例。每个病例包括一名老年患者、一名家庭照料人员和一名护士。收集自2017年9月至2018年4月通过各种工具采集到的数据,包括半结构化采访和家庭护理人员日志。根据伊尔、耶夫查克、吉尔莫尔·比科夫斯基和科拉诺夫斯基(老年护理,35,2014,272)开发的护理合作伙伴参与模式进行病例内和跨病例分析。 结果: 发现两个主题:(a)尽管在观点和需求方面存在差异,但家庭照料人员在老年患者住院期间参与照顾;(b)家庭照料人员与护士进行沟通,但护士未认识到他们的作用,也并未将其纳入护理方案中。 结论: 家庭照料人员随侍在旁、家庭照料人员对住院老人的责任感以及家庭照料人员对住院老人的积极影响表明,家庭照料人员可以更系统地融入到护士的护理伙伴关系中。家庭照料人员在谵妄防治护理中的整合效果欠佳,显示护士谵妄防治能力及其与家庭照料人员有效沟通的关系技巧有待进一步发展。 影响: 将家庭照料人员纳入老年人谵妄防治护理是护士面临的一个挑战。在老人住院期间,家庭照料人员会参与其中,尽管两组群体之间存在差异和问题。虽然患者、家庭照料人员和护士之间有交流,但护士未认识到家庭照料人员的作用,而且很难将他们纳入住院老人的谵妄防治护理工作中。护士必须采取以病人和家庭为中心的方法。护理和培训设施必须提供相应资源,以便在护理实践中实施这种方法。.
Keywords: delirium; family caregivers; hospitalization; integration; nurses; older adults; orthopaedic surgery; prevention.
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