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Abstract：
OBJECTIVE: As part of a larger study, and in collaboration with rural primary health care teams, RaDAR (Rural Dementia Action Research) primary care memory clinics have evolved and continue to spread in communities across southeast Saskatchewan, Canada. This study focuses on the geographical areas of the four communities where RaDAR memory clinics were first developed and implemented and describes the services and supports available to older adults including memory clinic patients and families living in these areas. Our goal was to identify and describe existing programs and gaps, create inventories and maps, and explore the service experiences of family caregivers of people living with dementia in these rural areas.
METHODS: Using a qualitative descriptive design, an environmental scan of services was conducted from December 2020 to April 2021 using focus groups (n = 4) with health care providers/managers (n = 12), a secondary source (e.g., program brochures) review, and a systematic internet search targeting four RaDAR memory clinic communities and surrounding areas via community websites, online resources, and the 211 Saskatchewan service database. Data were analyzed using content analysis; findings informed semi-structured interviews with caregivers (n = 5) conducted from March to July 2022, which were analyzed thematically. Geographic areas explored in this study covered an area of approximately 5666 km2.
RESULTS: From the scan, 43 services were identified, categorized into 7 service types, and mapped by location. Seventeen services were dementia-related. Services included social/leisure activities (n = 14), general support/referrals (n = 13), transportation (n = 7), information/education (n = 4), respite (n = 2), in-home care (n = 2), and safety (n = 1). Service levels included local (n = 24), provincial (n = 17), and national (n = 2), and were offered in-person, remotely (or both) with 20 services across 4 service types offered remotely. In general, most services had no fees, involved self-referral, and providers had a range of education/training. Key interview themes reflected the need for locally available, accessible services that offer (i) individualized, flexible, needs-based approaches, (ii) in-home care and continuity of care, and (iii) both formal and informal supports. Key gaps were identified, including (i) locally accessible, available services and resources in general, (ii) dementia-related training and education for service providers, and (iii) awareness of available services. Benefits of services, consequences of gaps, and recommendations to address gaps were reported. In general, service providers and program participants were an even mix of females and males, and program content was gender neutral.
CONCLUSIONS: Findings highlight a range of available services, and a number of varied service-user experiences and perspectives, in these rural areas. Key service gaps were identified, and caregivers made some specific recommendations to address these gaps. Findings underscore multiple opportunities to inform service delivery and program participation for rural and remote people living with dementia and their families.
METHODS: Using a qualitative descriptive design, an environmental scan of services was conducted from December 2020 to April 2021 using focus groups (n = 4) with health care providers/managers (n = 12), a secondary source (e.g., program brochures) review, and a systematic internet search targeting four RaDAR memory clinic communities and surrounding areas via community websites, online resources, and the 211 Saskatchewan service database. Data were analyzed using content analysis; findings informed semi-structured interviews with caregivers (n = 5) conducted from March to July 2022, which were analyzed thematically. Geographic areas explored in this study covered an area of approximately 5666 km2.
RESULTS: From the scan, 43 services were identified, categorized into 7 service types, and mapped by location. Seventeen services were dementia-related. Services included social/leisure activities (n = 14), general support/referrals (n = 13), transportation (n = 7), information/education (n = 4), respite (n = 2), in-home care (n = 2), and safety (n = 1). Service levels included local (n = 24), provincial (n = 17), and national (n = 2), and were offered in-person, remotely (or both) with 20 services across 4 service types offered remotely. In general, most services had no fees, involved self-referral, and providers had a range of education/training. Key interview themes reflected the need for locally available, accessible services that offer (i) individualized, flexible, needs-based approaches, (ii) in-home care and continuity of care, and (iii) both formal and informal supports. Key gaps were identified, including (i) locally accessible, available services and resources in general, (ii) dementia-related training and education for service providers, and (iii) awareness of available services. Benefits of services, consequences of gaps, and recommendations to address gaps were reported. In general, service providers and program participants were an even mix of females and males, and program content was gender neutral.
CONCLUSIONS: Findings highlight a range of available services, and a number of varied service-user experiences and perspectives, in these rural areas. Key service gaps were identified, and caregivers made some specific recommendations to address these gaps. Findings underscore multiple opportunities to inform service delivery and program participation for rural and remote people living with dementia and their families.
摘要：
目标：作为一项更大研究的一部分，并与农村初级卫生保健团队合作，农村痴呆症行动研究（RaDAR）初级保健记忆诊所已经发展并继续在萨斯喀彻温省东南部的社区中传播，加拿大。这项研究的重点是首先开发和实施RADAR记忆诊所的四个社区的地理区域，并描述了老年人可获得的服务和支持，包括记忆诊所患者和居住在这些地区的家庭。我们的目标是识别和描述现有的计划和差距，创建库存和地图，并探索这些农村地区痴呆症患者家庭照顾者的服务体验。
方法：使用定性的描述性设计，从2020年12月到2021年4月，使用焦点小组(n=4)和医疗保健提供者/管理者(n=12)对服务进行了环境扫描，次要来源(例如，计划手册)审查，以及通过社区网站针对四个Radar记忆诊所社区和周边地区的系统互联网搜索，在线资源，和211萨斯喀彻温省服务数据库。使用内容分析对数据进行分析;研究结果为2022年3月至7月对护理人员进行的半结构化访谈(n=5)提供了信息，并进行了主题分析。本研究中探索的地理区域面积约为5666km2。
结果：从扫描，确定了43个服务，分为7种服务类型，并按位置绘制。17项服务与痴呆症有关。服务包括社交/休闲活动（n=14），一般支持/推荐(n=13)，交通运输（n=7），信息/教育（n=4），喘息时间(n=2)，家庭护理(n=2)，和安全性（n=1）。服务级别包括本地（n=24），省（n=17），和国家(n=2)，并亲自提供，远程（或两者），在远程提供的4种服务类型中提供20种服务。总的来说,大多数服务没有收费，涉及自我推荐，和提供者有一系列的教育/培训。关键的采访主题反映了当地可用的需求，提供(I)个性化的无障碍服务，灵活,基于需求的方法，(ii)家庭护理和护理的连续性，以及(iii)正式和非正式支持。确定了关键差距，包括（i）本地可访问的，一般可用的服务和资源，(二)对服务提供者进行与痴呆症有关的培训和教育，和(iii)对现有服务的认识。服务的好处,差距的后果，并报告了弥补差距的建议。总的来说,服务提供者和项目参与者是女性和男性的平均混合体，节目内容性别中立。
结论：调查结果强调了一系列可用的服务，以及许多不同的服务用户体验和观点，在这些农村地区。确定了关键的服务差距，和护理人员提出了一些具体建议来解决这些差距。研究结果强调了为农村和偏远痴呆症患者及其家人提供服务和参与计划的多种机会。
方法：使用定性的描述性设计，从2020年12月到2021年4月，使用焦点小组(n=4)和医疗保健提供者/管理者(n=12)对服务进行了环境扫描，次要来源(例如，计划手册)审查，以及通过社区网站针对四个Radar记忆诊所社区和周边地区的系统互联网搜索，在线资源，和211萨斯喀彻温省服务数据库。使用内容分析对数据进行分析;研究结果为2022年3月至7月对护理人员进行的半结构化访谈(n=5)提供了信息，并进行了主题分析。本研究中探索的地理区域面积约为5666km2。
结果：从扫描，确定了43个服务，分为7种服务类型，并按位置绘制。17项服务与痴呆症有关。服务包括社交/休闲活动（n=14），一般支持/推荐(n=13)，交通运输（n=7），信息/教育（n=4），喘息时间(n=2)，家庭护理(n=2)，和安全性（n=1）。服务级别包括本地（n=24），省（n=17），和国家(n=2)，并亲自提供，远程（或两者），在远程提供的4种服务类型中提供20种服务。总的来说,大多数服务没有收费，涉及自我推荐，和提供者有一系列的教育/培训。关键的采访主题反映了当地可用的需求，提供(I)个性化的无障碍服务，灵活,基于需求的方法，(ii)家庭护理和护理的连续性，以及(iii)正式和非正式支持。确定了关键差距，包括（i）本地可访问的，一般可用的服务和资源，(二)对服务提供者进行与痴呆症有关的培训和教育，和(iii)对现有服务的认识。服务的好处,差距的后果，并报告了弥补差距的建议。总的来说,服务提供者和项目参与者是女性和男性的平均混合体，节目内容性别中立。
结论：调查结果强调了一系列可用的服务，以及许多不同的服务用户体验和观点，在这些农村地区。确定了关键的服务差距，和护理人员提出了一些具体建议来解决这些差距。研究结果强调了为农村和偏远痴呆症患者及其家人提供服务和参与计划的多种机会。
