痴呆症护理中的生命故事模板:模糊的方向和目的。

Dementia (London, England) Pub Date : 2024-07-01 Epub Date: 2024-01-04 DOI:10.1177/14713012231224545
Glenn Möllergren, Tove Harnett
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摘要

背景:在痴呆症护理中使用 "生命故事 "被描述为一种将每个人视为独立个体、超越痴呆症的方式。生命故事已成为高质量护理的代名词,而在瑞典,只要在痴呆症护理环境中出现生命故事,就会被认为是国家比较中质量的标志。这些生活故事通常是标准化的,由家庭成员回答模板中预先设定的问题而生成:本研究采用建构主义方法,将(1)描绘出模板所产生的个人生命故事的版本,以及(2)确定模板所传达的此类生命故事的预期目的。本研究将从 "生命故事模板传达了痴呆症患者的某些观念 "这一假设出发。专题分析使用的数据包括 30 个空白模板,共计约 1,700 个问题:研究发现,生活故事模板产生了两种截然不同的个人形象:(1) 一个没有痴呆症状的人或 (2) 一个痴呆症患者。我们还发现,在应包含哪些信息、谁的生命故事以及预期用途等问题上存在矛盾:讨论:尽管痴呆症护理机构面临着向居民收集生活故事的巨大压力,但他们使用的生活故事模板却没有明确的方向、意识形态或目的。鉴于生命故事可被视为塑造痴呆症患者假设和构建痴呆症护理环境现实的行为主体,因此缺乏方向是关键所在。我们强调有必要为生命故事模板的设计制定伦理准则,并为其预期用途提供指导。
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Life story templates in dementia care: Ambiguous direction and purpose.

Background: The use of life stories in dementia care has been described as a way of seeing every person as an individual, looking beyond their dementia. Life stories have become synonymous with high-quality care, while in Sweden their mere existence in dementia care settings is taken to indicate quality in national comparisons. Such life stories are often standardised, generated by a family member answering predetermined questions in a template.

Aim and methods: Using a constructionist approach, this study will (1) chart what versions of a person's life story the templates produce, and (2) establish the intended purpose of such life stories, as communicated by the templates. This study departs from the assumption that life story templates communicate something about the conceptions of people living with dementia. The thematic analysis used data comprising 30 blank templates, totalling about 1,700 questions.

Findings: The life story templates were found to generate two very different versions of the individual: (1) a person before symptoms of dementia or (2) a patient with dementia. We also found contradictions about what information should be included, whose life story it was, and the intended use.

Discussion: Despite strong pressure on dementia care providers to collect life stories from residents, the life story templates they use are without clear direction, ideology, or purpose. The lack of direction is key given that life stories can be considered actants that shape assumptions about people with dementia and construct realities in dementia care settings. We highlight the need to develop ethical guidelines for life story template design, matched with guidelines for their intended use.

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