Abstract：
BACKGROUND: Dementia encompasses neurodegenerative disorders that account for a global estimated healthcare expenditure of 1.3 trillion US dollars. In Australia, one in 12 people aged ≥65 has a diagnosis of dementia and it is the second leading cause of death. Paramedics play a crucial role in person-centred dementia care, particularly in the community. While consensus has been established on paramedicine\'s integration into interdisciplinary care teams, there remains a lack of clarity regarding the paramedic role in dementia care.
OBJECTIVE: This study aimed to examine and report paramedic interactions with people living with dementia in the out-of-hospital setting.
METHODS: This was a scoping review study of paramedics and people living with dementia within the out-of-hospital setting.
METHODS: This study was guided by the Joanna Briggs Institute (JBI) scoping review framework. Databases were searched without date limits, up to 4 April 2023. These encompassed OVID Medline, CINAHL, Scopus, APA PsycInfo and OVID Embase. Articles were included if they were primary, peer-reviewed studies in English and reporting on paramedic-specific interactions with people living with dementia in the out-of-hospital setting. Data extraction was performed based on study setting, design, population and key findings.
RESULTS: Twenty-nine articles were included in the thematic analysis. Four themes emerged: need for training, patterns of attendances, patterns of documentation and the integrative potential of paramedicine. Paramedics reported feeling ill-equipped and unprepared in caring for patients living with dementia due to challenges in assessment and management of caregiver tensions. They were often called as a last resort due to poor service integration and a lack of alternative care pathways. Despite high conveyance rates, there was low incidence of paramedic interventions initiated. Underdocumentation of dementia and pain was found.
CONCLUSIONS: Emergency ambulance conveyance of people living with dementia is a surface reaction compounded by a lack of direction for paramedics in the provision of out-of-hospital care. There is a pressing need for establishment of research and educational priorities to improve paramedic training in dementia-specific skillsets.
OBJECTIVE: This study aimed to examine and report paramedic interactions with people living with dementia in the out-of-hospital setting.
METHODS: This was a scoping review study of paramedics and people living with dementia within the out-of-hospital setting.
METHODS: This study was guided by the Joanna Briggs Institute (JBI) scoping review framework. Databases were searched without date limits, up to 4 April 2023. These encompassed OVID Medline, CINAHL, Scopus, APA PsycInfo and OVID Embase. Articles were included if they were primary, peer-reviewed studies in English and reporting on paramedic-specific interactions with people living with dementia in the out-of-hospital setting. Data extraction was performed based on study setting, design, population and key findings.
RESULTS: Twenty-nine articles were included in the thematic analysis. Four themes emerged: need for training, patterns of attendances, patterns of documentation and the integrative potential of paramedicine. Paramedics reported feeling ill-equipped and unprepared in caring for patients living with dementia due to challenges in assessment and management of caregiver tensions. They were often called as a last resort due to poor service integration and a lack of alternative care pathways. Despite high conveyance rates, there was low incidence of paramedic interventions initiated. Underdocumentation of dementia and pain was found.
CONCLUSIONS: Emergency ambulance conveyance of people living with dementia is a surface reaction compounded by a lack of direction for paramedics in the provision of out-of-hospital care. There is a pressing need for establishment of research and educational priorities to improve paramedic training in dementia-specific skillsets.
摘要：
背景：痴呆症包括神经退行性疾病，其全球医疗支出估计为1.3万亿美元。在澳大利亚,每12名年龄≥65岁的人中就有一人被诊断为痴呆症，这是第二大死亡原因。护理人员在以人为中心的痴呆症护理中起着至关重要的作用，特别是在社区。虽然在将辅助医疗纳入跨学科护理团队方面已经建立了共识，关于护理人员在痴呆症护理中的作用仍然缺乏明确性.
目的：本研究旨在检查和报告在院外环境中护理人员与痴呆症患者的互动。
方法：这是一项对护理人员和痴呆症患者在院外环境中的范围审查研究。
方法：本研究由JoannaBriggs研究所（JBI）范围审查框架指导。数据库搜索没有日期限制，2023年4月4日这些包含OVIDMedline，CINAHL,Scopus,APAPsycInfo和OVIDEmbase。如果文章是主要的，同行评审的英语研究，并报告护理人员与痴呆症患者在院外环境中的特定互动。数据提取是根据研究设置进行的，设计,人口和主要发现。
结果：主题分析包括29篇文章。出现了四个主题:需要培训，出席方式,文献模式和辅助医学的综合潜力。护理人员报告说，由于在评估和管理护理人员紧张关系方面的挑战，护理人员在照顾痴呆症患者方面感到设备不足和准备不足。由于服务整合不良和缺乏替代护理途径，它们通常被称为最后的手段。尽管运输率高，开始的护理人员干预的发生率较低.发现痴呆症和疼痛的文献不足。
结论：痴呆症患者的紧急救护车运送是一种表面反应，由于护理人员在提供院外护理时缺乏指导而加剧。迫切需要建立研究和教育优先事项，以改善痴呆症特定技能的护理人员培训。
目的：本研究旨在检查和报告在院外环境中护理人员与痴呆症患者的互动。
方法：这是一项对护理人员和痴呆症患者在院外环境中的范围审查研究。
方法：本研究由JoannaBriggs研究所（JBI）范围审查框架指导。数据库搜索没有日期限制，2023年4月4日这些包含OVIDMedline，CINAHL,Scopus,APAPsycInfo和OVIDEmbase。如果文章是主要的，同行评审的英语研究，并报告护理人员与痴呆症患者在院外环境中的特定互动。数据提取是根据研究设置进行的，设计,人口和主要发现。
结果：主题分析包括29篇文章。出现了四个主题:需要培训，出席方式,文献模式和辅助医学的综合潜力。护理人员报告说，由于在评估和管理护理人员紧张关系方面的挑战，护理人员在照顾痴呆症患者方面感到设备不足和准备不足。由于服务整合不良和缺乏替代护理途径，它们通常被称为最后的手段。尽管运输率高，开始的护理人员干预的发生率较低.发现痴呆症和疼痛的文献不足。
结论：痴呆症患者的紧急救护车运送是一种表面反应，由于护理人员在提供院外护理时缺乏指导而加剧。迫切需要建立研究和教育优先事项，以改善痴呆症特定技能的护理人员培训。
