Aesthetic ways of knowing: exploring mental health nurses' experiences of delirium superimposed on dementia.

Claire Anne Pryor
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Abstract

Background: In the UK, people with delirium superimposed on dementia may be cared for by mental health nurses, however there is little in the literature about the experience of caring for people with the condition from the perspective of mental health nurses.

Aim: To illuminate the experiences of mental health nurses caring for people with delirium superimposed on dementia and to explore how mental health nurses 'know' the people they care for using 'aesthetic ways of knowing'.

Method: A mixed-methods design was used guided by the principles of activity theory. Participants were registered mental health nurses with experience of caring for people with delirium superimposed on dementia within a 24-hour care environment, including an NHS mental health foundation trust and care homes. Data were collected in two ways and at two different time points: first via semi-structured interviews (n=7), second via a questionnaire (n=25). Thematic analysis of the qualitative data was paired with simple descriptive statistics of the quantitative data to describe participants' experience.

Findings: This article discusses one finding from the larger study, which was undertaken as part of the author's PhD, in relation to the way in which mental health nurses 'know' the people they care for. Overall, participants showed a preference for aesthetic ways of knowing, rather than the use of formal assessment tools or scores. Participants experienced caring for people with delirium superimposed on dementia by valuing the person and concentrating on their behaviours, responses and personality, thus enabling them to anticipate and/or recognise potential triggers, precipitating factors and any changes in behaviours.

Conclusion: The ways in which mental health nurses know the people they care for influences their care delivery. Mental health nurses' use of aesthetic ways of knowing should be recognised and valued as a way of better understanding and supporting the person with delirium superimposed on dementia.

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审美认知方式:探索心理健康护士的谵妄与痴呆叠加的经历。
背景:在英国,精神健康护士可能会照顾患有谵妄和痴呆症的人,但文献中很少有关于从精神健康护士的角度照顾患者的经验。目的:阐明心理健康护士照顾痴呆症合并谵妄患者的经验,并探讨心理健康护士如何使用“审美认识方式”来“认识”他们所照顾的人。方法:在活动理论原理的指导下,采用混合方法设计。参与者是注册的心理健康护士,有在24小时护理环境中照顾痴呆症患者的经验,包括NHS心理健康基金会信托和护理院。数据以两种方式在两个不同的时间点收集:第一种是通过半结构化访谈(n=7),第二种是通过问卷调查(n=25)。定性数据的专题分析和定量数据的简单描述性统计相结合,以描述参与者的经历。研究结果:本文讨论了作为作者博士学位的一部分进行的更大规模研究中的一项发现,即心理健康护士“了解”他们所照顾的人的方式。总体而言,参与者表现出更喜欢审美的认知方式,而不是使用正式的评估工具或分数。参与者通过重视精神错乱叠加痴呆症患者并专注于他们的行为、反应和个性,从而能够预测和/或识别潜在的触发因素、诱发因素和任何行为变化,从而体验到对患者的护理。结论:心理健康护士了解他们所照顾的人的方式会影响他们的护理提供。心理健康护士对审美认知方式的使用应该得到认可和重视,作为更好地理解和支持痴呆症患者的一种方式。
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