Abstract:
Introduction: Stigmatising language concerning people living with dementia can cause potentially harmful and dehumanising consequences. Language used about people living with dementia in mental health wards may focus on medical perspectives and suggest custodial relationships with patients rather than person-centred accounts of individuals. This language could have a devastating impact on the provision of person-centred care. This study investigated the relationship between accounts of people living with dementia written in healthcare case notes and clinical practice at three dementia specialist wards in Wales, UK. Language guidance was provided to ward staff to assess whether stigmatising language could be reduced and whether this influenced the provision of person-centred care.Methodology: Dementia Care Mapping was adapted to analyse case note entries for enhancing and detracting accounts of people living with dementia at three data collection points. These were compared to the results of routine DCM observations of care across the three wards. The healthcare case notes of 117 people living with dementia, encompassing 4, 522 entries over ten months were analysed. DCM observations of 38 people living with dementia within the three wards were compared against the case note results. Person-centred language guidance was shared with care staff following each data collection point.Results: Following the provision of person-centered language guidance, the use of personally enhancing language was observed to increase across all three wards. Non-person-centred case note entries predominantly focussed on Labelling language, whilst language concerning Invalidation and Objectification also occurred frequently compared to other DCM domains. Person centred language typically concerned Acknowledgement. A relationship between case note entries and practice was evident in some domains although findings were inconsistent.Discussion and Implications: The findings highlight the importance of addressing stigmatising language in healthcare and suggest that further studies to support the anti-stigma agenda in dementia care are required.
摘要:
简介:关于痴呆症患者的污名化语言可能会导致潜在的有害和不人道的后果。在精神卫生病房中使用的有关痴呆症患者的语言可能会侧重于医学观点,并建议与患者的监护关系,而不是以人为中心的个人帐户。这种语言可能对提供以人为本的护理产生毁灭性影响。这项研究调查了威尔士三个痴呆症专科病房的医疗保健案例笔记中记载的痴呆症患者与临床实践之间的关系,英国。向病房工作人员提供了语言指导,以评估是否可以减少污名化的语言,以及这是否影响了以人为本的护理。方法:对痴呆症护理图进行了调整,以分析病例记录条目,以在三个数据收集点提高和降低痴呆症患者的账目。将这些与三个病房的常规DCM护理观察结果进行比较。医疗保健案例记录了117名痴呆症患者,分析了超过10个月的4,522个条目。将三个病房内38名痴呆症患者的DCM观察结果与病例记录结果进行了比较。在每个数据收集点之后,与护理人员共享以人为本的语言指导。结果:在提供以人为本的语言指导之后,观察到在所有三个病房中,个人增强语言的使用都有所增加。非以人为中心的案例记录条目主要侧重于标签语言,与其他DCM领域相比,有关无效和对象化的语言也经常发生。以人为中心的语言通常涉及承认。尽管调查结果不一致,但在某些领域,案例说明条目与实践之间的关系很明显。讨论和启示:研究结果强调了在医疗保健中解决污名化语言的重要性,并建议需要进一步的研究来支持痴呆症护理中的反污名化议程。