Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Assessing BPSD with the support of the NPI-NH: a discourse analysis of clinical reasoning
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.ORCID-id: 0000-0003-0313-6002
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.ORCID-id: 0000-0001-7830-8791
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
2018 (engelsk)Inngår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 30, nr 4, s. 581-589Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

The ability of nursing staff to assess and evaluate behavioral and psychological symptoms of dementia (BPSD) to determine when intervention is needed is essential. In order to assist with the assessment process, the current use of the Neuropsychiatric Inventory Nursing Home version (NPI-NH) is internationally accepted. Even though the NPI-NH is thoroughly validated and has several advantages, there are also various challenges when implementing this system in practice. Thus, the aim of this study was to explore clinical reasoning employed by assistant nurses when utilizing the NPI-NH as a tool to assess frequency and severity of BPSD in individuals with advanced dementia.

Twenty structured assessment sessions in which assistant nurses used the NPI-NH were audio recorded and analyzed with a discourse analysis focusing on the activities in the communication.

Four categories were identified to convey assistant nurses' clinical reasoning when assessing and evaluating BPSD using the NPI-NH: considering deteriorations in ability and awareness, incorporating individual and contextual factors, overcoming variations in behaviors and ambiguous formulations in the instrument, and sense-making interactions with colleagues.

The NPI-NH served as a supportive frame and structure for the clinical reasoning performed during the assessment. The clinical reasoning employed by assistant nurses became a way to reach a consensual and broader understanding of the individual with dementia, with the support of NPI-NH as an important framework.

sted, utgiver, år, opplag, sider
Cambridge University Press, 2018. Vol. 30, nr 4, s. 581-589
HSV kategori
Forskningsprogram
Omvårdnad
Identifikatorer
URN: urn:nbn:se:ltu:diva-65964DOI: 10.1017/S1041610217002009ISI: 000431404300014PubMedID: 28965503OAI: oai:DiVA.org:ltu-65964DiVA, id: diva2:1146870
Merknad

Validerad;2018;Nivå 2;2018-05-17 (andbra)

Tilgjengelig fra: 2017-10-04 Laget: 2017-10-04 Sist oppdatert: 2018-09-12bibliografisk kontrollert
Inngår i avhandling
1. Piecing together a fragmented world: Structures to promote the understanding of people with advanced dementia
Åpne denne publikasjonen i ny fane eller vindu >>Piecing together a fragmented world: Structures to promote the understanding of people with advanced dementia
2018 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Alternativ tittel[sv]
Föra samman fragment till en helhet : Strukturer för att öka förståelsen för personer med avancerad demens
Abstract [en]

Understanding people with dementia whose verbal ability has been impaired is a complex and challenging task, even for professional nursing staff. The aim of this PhD thesis was to explore structures that may promote the understanding of people with advanced dementia living in nursing homes. It focusses specifically on (I) the clinical reasoning employed by assistant nurses when utilizing the NPI-NH (Neuropsychiatric Inventory Nursing Home version) as a tool to assess frequency and severity of BPSD (behavioural and psychological symptoms in dementia, i.e. problematic behaviours) in people with advanced dementia, (II) whether a sensor measuring electrodermal activity (EDA) can improve the identification of agitation in individuals with dementia, (III) how an EDA sensor impacts assistant nurses’ structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions, and (IV) how Martha Nussbaum’s approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes. Study I used a method of discourse analysis that focussed on clinical reasoning utilized by assistant nurses when assessing problematic behaviours. In study II, a nonexperimental and correlational observation of the relationship between a sensor measuring EDA and assistant nurses’ structured observations of agitation in people with advanced dementia was applied. Study III used both quantitative and qualitative approaches; data were collected during structured assessments of problematic behaviours conducted by assistant nurses, as well as by focus group interviews with assistant nurses. Study IV took an ethnographic approach with participatory observations that were analyzed with a recursive analysis using a theoretical framework for the conditions necessary for a dignified human life. The structure of the NPI-NH provided a supportive framework that encouraged assistant nurses to discuss and broaden their understanding of the person with dementia (I). The EDA sensor provided continuous information regardless of staff presence and the potential to identify EDA prior to observing these behaviours (II, III), which supported the understanding of the person and when to introduce timely interventions to prevent the onset of problematic behaviours (III). The structure of Nussbaum’s approach to human capabilities illuminated that people with advanced dementia were at risk of living a life in which their opportunities for human capabilities were limited, and hence, the possibility to live a dignified life (IV). An overview of the findings in this thesis indicates that the studied structures were used to piece together fragments of information to create a comprehensive understanding of the needs of the person with dementia. For the structures to support the understanding of the person with dementia, it was crucial that nursing staff were present, attentive and engaged in each person’s situation in order for them to figure out how to piece together and integrate the structures into the overall understanding of the person and, based on that, formulate caring actions in daily life that are meaningful from the perspective of the person with advanced dementia.

sted, utgiver, år, opplag, sider
Luleå: Luleå University of Technology, 2018
Serie
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Emneord
dementia, nursing home, electrodermal activity, capability approach, clinical reasoning, assessment, behaviour
HSV kategori
Forskningsprogram
Omvårdnad
Identifikatorer
urn:nbn:se:ltu:diva-70847 (URN)978-91-7790-199-0 (ISBN)978-91-7790-200-3 (ISBN)
Disputas
2018-10-26, Deltasalen, D770, Luleå, 10:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2018-09-13 Laget: 2018-09-12 Sist oppdatert: 2018-09-27bibliografisk kontrollert

Open Access i DiVA

Fulltekst mangler i DiVA

Andre lenker

Forlagets fulltekstPubMed

Personposter BETA

Melander, CatharinaSävenstedt, StefanOlsson, MalinVälivaara, Britt-Marie

Søk i DiVA

Av forfatter/redaktør
Melander, CatharinaSävenstedt, StefanOlsson, MalinVälivaara, Britt-Marie
Av organisasjonen
I samme tidsskrift
International psychogeriatrics

Søk utenfor DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 159 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf