Preparation to care for confused older patients in general hospitals: a study of UK health professionals

被引:62
作者
Griffiths, Amanda [1 ]
Knight, Alec [2 ]
Harwood, Rowan [3 ]
Gladman, John R. F. [4 ]
机构
[1] Univ Nottingham, Sch Med, Div Psychiat & Appl Psychol, Nottingham, England
[2] Kings Coll London, Div Hlth & Social Care Res, Sch Med, London WC2R 2LS, England
[3] Nottingham Univ Hosp NHS Trust, Hlth Care Older People, Nottingham, England
[4] Univ Nottingham, Sch Med, Div Rehabil & Ageing, Nottingham, England
关键词
dementia; delirium; workforce; education; general hospitals; older people; LEARNING NEEDS; DELIRIUM; EDUCATION; STAFF;
D O I
10.1093/ageing/aft171
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Methods: using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach. Results: there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction. Conclusion: our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems.
引用
收藏
页码:521 / 527
页数:7
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