The barriers and facilitators for recognising distress in people with severe dementia on general hospital wards

Crowther, George; Brennan, Cathy; Bennett, Mike

doi:10.1093/ageing/afx198

Cited by 11 publications

(38 citation statements)

References 25 publications

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“…In review 1, 63 studies were reported in 82 papers. Fourteen studies were represented by more than one paper: nine studies were reported in two papers each; 43,58,59,62,75,76,79,82,89,90,92,95,98,99,102,[109][110][111]113,129 three studies were reported in three papers each; 60,65,66,[72][73][74]84,125 and one study was represented in five papers. [69][70][71]96,114 In review 2, 14 studies were reported in 16 papers: one study was reported in three papers.…”

Section: Study Selectionmentioning

confidence: 99%

“…[69][70][71]96,114 In review 2, 14 studies were reported in 16 papers: one study was reported in three papers. 23,87,142 To signify the singular nature of these studies, although we included all the papers in the syntheses, the journal article first published from each study will be cited when reporting number of studies with a particular finding; 43,58,60,62,66,69,73,76,79,82,90,92,99,110 when quoting an extract or reporting specific findings, the paper of origin will be cited.…”

Section: Study Selectionmentioning

confidence: 99%

“…Appendix 5, Table 4, summarises the characteristics of the studies included in review 1. Studies were conducted in 15 countries; 28 42,44,45,[56][57][58]63,64,69,73,76,79,82,87,88,90,99,106,110,[116][117][118][119][120][121][122]131,132 (44%) studies were conducted in the UK, 12 46,[60][61][62]78,93,97,104,105,[126][127][128] (19%) studies were conducted in Australia, and seven 80,81,83,100,107,108,123 (11%) studies were conducted in Sweden. All included papers were published in peer-reviewed journals, except six dissertations 47,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All included papers were published in peer-reviewed journals, except six dissertations 47,63,75,89,98,117 at PhD level. Three studies 45,46,123 were published before 2000, and 64 44,47,[56][57][58][59][60][61][63][64][65][66][68][69][70][71][73][74][75][76][77][78][79]81,82,84,85,87,88,[90][91][92][93][94][96][97][98][99][100][101][102][103]…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Twenty-four studies 43,[56][57][58][62][63][64]66,67,76,83,85,88,90,97,100,101,104,108,112,116,120,123,128 (38%) reported the experiences of hospital staff, students and/or volunteers only; 14 studies 42,[44][45][46][47]60,61,77,86,93,105,117,124,130 (22%) reported the experiences of carers only; and two studies 78,80 reported the experiences of people living with dementia only. Twenty-two studies 68,69,73,79,81,82,87,91,92,94,…”

Section: Study Characteristicsmentioning

confidence: 99%

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Understanding and improving experiences of care in hospital for people living with dementia, their carers and staff: three systematic reviews

Gwernan‐Jones

Lourida

Abbott

et al. 2020

Health Serv Deliv Res

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Background Being in hospital can be particularly confusing and challenging not only for people living with dementia, but also for their carers and the staff who care for them. Improving the experience of care for people living with dementia in hospital has been recognised as a priority. Objectives To understand the experience of care in hospital for people living with dementia, their carers and the staff who care for them and to assess what we know about improving the experience of care. Review methods We undertook three systematic reviews: (1) the experience of care in hospital, (2) the experience of interventions to improve care in hospital and (3) the effectiveness and cost-effectiveness of interventions to improve the experience of care. Reviews 1 and 2 sought primary qualitative studies and were analysed using meta-ethnography. Review 3 sought comparative studies and economic evaluations of interventions to improve experience of care. An interweaving approach to overarching synthesis was used to integrate the findings across the reviews. Data sources Sixteen electronic databases were searched. Forwards and backwards citation chasing, author contact and grey literature searches were undertaken. Screening of title and abstracts and full texts was performed by two reviewers independently. A quality appraisal of all included studies was undertaken. Results Sixty-three studies (reported in 82 papers) were included in review 1, 14 studies (reported in 16 papers) were included in review 2, and 25 studies (reported in 26 papers) were included in review 3. A synthesis of review 1 studies found that when staff were delivering more person-centred care, people living with dementia, carers and staff all experienced this as better care. The line of argument, which represents the conceptual findings as a whole, was that ‘a change of hospital culture is needed before person-centred care can become routine’. From reviews 2 and 3, there was some evidence of improvements in experience of care from activities, staff training, added capacity and inclusion of carers. In consultation with internal and external stakeholders, the findings from the three reviews and overarching synthesis were developed into 12 DEMENTIA CARE pointers for service change: key institutional and environmental practices and processes that could help improve experience of care for people living with dementia in hospital. Limitations Few of the studies explored experience from the perspectives of people living with dementia. The measurement of experience of care across the studies was not consistent. Methodological variability and the small number of intervention studies limited the ability to draw conclusions on effectiveness. Conclusions The evidence suggests that, to improve the experience of care in hospital for people living with dementia, a transformation of organisational and ward cultures is needed that supports person-centred care and values the status of dementia care. Changes need to cut across hierarchies and training systems to facilitate working patterns and interactions that enable both physical and emotional care of people living with dementia in hospital. Future research needs to identify how such changes can be implemented, and how they can be maintained in the long term. To do this, well-designed controlled studies with improved reporting of methods and intervention details to elevate the quality of available evidence and facilitate comparisons across different interventions are required. Study registration This study is registered as PROSPERO CRD42018086013. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 43. See the NIHR Journals Library website for further project information. Additional funding was provided by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.

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