老年学と老年医学の研究

概要

Experiences and Needs of Nursing Staff Caring for Double Care Demanding Patients: A Qualitative Study

Collet J, De-Vugt ME, Ackermans DFG, Verhey FRJ, Engelen NJJA and Schols JMGA

Nursing staff has a key role in the multidisciplinary care for patients with combined mental (psychiatric and/or psychogeriatric) and physical problems (DCD-patients). This study explores the experiences and needs of DCD-nursing staff in Dutch mental healthcare (MH) and nursing home (NH) settings, to identify factors to provide optimal care for DCD-patients. A qualitative approach was used, consisting of five semi-structured focus group interviews with DCD-staff (n=28) from MH- and NH-settings in the Netherlands. Five levels of factors were identified: (1) Patient-related factors (complexity of combined care needs, and complexity of behavioral problems); (2) Informal care-related factors (misapprehension of DCD-complexity, and involvement of volunteers); (3) Professional care-related factors (competences and attitudes, well-matched multidisciplinary team, and collaborative care between MH- and NH-settings); (4) Living and work environment-related factors (staff availability and continuity, and facility requirements); and (5) Organization-related factors (clear DCD-care policy, and provision of specific training and coaching). DCD-staff stressed the importance of team-efficacy, depending on commitment, mutual trust, and good communication- and collaboration skills; of experiencing a psychologically and physically safe work-environment; and of empowerment through the acknowledgment of the specificity of DCD-care and the teams’ specific qualities regarding DCD-care. These findings can be used to optimize DCD-care.