The staff's view on dementia and the care in three cultures: A qualitative study in France, Portugal and Sweden

Abstract

This article discusses the staff's view on dementia and its impact on the care delivered arising out of a qualitative comparative study focusing on long-term care of older people in France, Portugal and Sweden. The aim was to explore the staff's view on the illness dementia; on older people suffering from dementia; the care provided and the impact of various views on the care. The care was studied through observations at 22 care settings in the three countries and the staff's attitudes were explored by means of interviews with 79 people. A relation-oriented phenomenological approach was used. Great differences appeared regarding the various staff groups’ views. The findings also indicated that the staff's view; the cultural context and the organizational environment might have an impact on the care provided. However the impact of professional affiliation and the way of collaborating seemed to be of greater significance than other similarities or differences. An interdisciplinary based starting point, with close collaboration between medical based health care and social care of older people suffering from dementia in integrative care models, is therefore of vital importance.

The intersection of culture in the provision of dementia care: A systematic review

“…; Nichols et al., ; Yong & Manthorpe, ), one study included care workers only (Xiao et al., ). Two studies included other healthcare professions, of which one study included qualified nurses, a care worker and a physiotherapist (Egede‐Nissen et al., ), and one study included doctors, therapists, dieticians, social workers, qualified nurses and care workers (Emilsson, ). The majority of studies ( n = 6) applied semi‐structured interviews (Antelius & Kiwi, ; Boughtwood et al., ; Egede‐Nissen et al., ; Emilsson, ; Xiao et al., ; Yong & Manthorpe, ).…”

“…() included semi‐structured questionnaires and a workshop. All studies reported an underlying philosophy that guided their methodological approach, which ranged from ethnography (Antelius & Kiwi, ), modified framework analysis (Boughtwood et al., ), hermeneutic phenomenology (Egede‐Nissen et al., ), content analysis (Emilsson, ), interpretative phenomenology (Yong & Manthorpe, ) and Gadamer's hermeneutics (Xiao et al., ).…”

“…Differences in cultural perceptions of old age rather than dementia also emerged, Emilsson () found staff working in care homes with residents with dementia in France, Portugal, and Sweden, viewed residents as requiring support due to their age and not due to their dementia. In France, staff viewed the residents as “old and ill,” in Portugal as “old and in need of help,” and in Sweden as “old” and not in relation to their cognitive abilities.…”

“…The review identified qualitative studies exploring experiences and opinions of culturally diverse healthcare professionals. The studies were completed in a number of countries which included: Australia (Boughtwood et al, 2011;Nichols et al, 2015;Xiao, Habel, & De Bellis, 2015), Sweden (Antelius & Kiwi, 2015;Emilsson, 2011), Norway (Egede-Nissen, Sellevold, Jakobsen, & Sørlie, 2016) and England (Yong & Manthorpe, 2016). Several studies (n = 4) included both qualified nurses and care workers (Antelius & Kiwi, 2015;Boughtwood et al 2011;Nichols et al, 2015;Yong & Manthorpe, 2016), one study included care workers only (Xiao et al, 2015).…”

“…Each paper was assessed against the Critical Appraisal Skills Programme (CASP) for qualitative studies, which considers the appropriateness of methodology, design, recruitment strategy, data collection, data analysis, findings and the value of the research (CASP 2014). The only element highlighted across many of the papers (n = 5) was the lack of clear reporting and consideration of the relationship between the researcher and participants (Antelius & Kiwi, 2015;Boughtwood et al, 2011;Emilsson, 2011;Nichols et al, 2015;Yong & Manthorpe, 2016).…”