Experiences Of Caring For People Research Articles

Optimising the health-care experiences of babies, children, and young people

The views of children and young people are too often missing from discussions about their care. The 2021 National Institute for Health and Care Excellence (NICE) guideline on babies, children, and young people's experience of health care aims to optimise the health-care experiences of these populations and ultimately improve their health outcomes and wellbeing. 1 National Institute for Health and Care ExcellenceBabies, children and young people's experience of healthcare NICE guideline (NG204). https://www.nice.org.uk/guidance/ng204Date: Aug 25, 2021 Date accessed: August 31, 2021 Google Scholar Given that almost 10 years have passed since parallel guidelines were published on adults' experiences of health care, 2 National Institute for Health and Care ExcellencePatient experience in adult NHS services: improving the experience of care for people using adult NHS services: clinical guideline. https://www.nice.org.uk/guidance/cg138Date: February, 2012 Date accessed: August 31, 2021 Google Scholar this new guideline for babies, children, and young people in the UK who access the National Health Service (NHS) or local authority commissioned health-care services is welcome, if overdue. The guidance is particularly important because children and young people report less positively about their experiences of inpatient care than their parents, including feeling safe, pain relief, privacy, and involvement in decisions. 3 Hargreaves DS Sizmur S Pitchforth J et al. Children and young people's versus parents' responses in an English national inpatient survey. Arch Dis Childhood. 2018; 103: 486-491 Crossref PubMed Scopus (18) Google Scholar

Qualitative Meta-synthesis of Nurses' Caring Experience for People with Dementia

Purpose: The purpose of this study was to synthesize and integrate the results of qualitative studies on nurses' experience caring for people with dementia.Methods: We followed Noblit and Hare’s seven step of meta-ethnography to synthesize qualitative studies. Six databases (PubMed, Web of Science, EMBASE, RISS, National Assembly Library, KCI) were used to search for literatures that explored the nurses’ experience of caring for people with dementia. Based on the criteria, nine studies were included for the synthesis.Results: Five themes and ten sub-themes were identified: “Knowing the diversity of dementia”, “Building a relationship of trust”, “Finding the value in life”, “Willingness to overcome external obstacles”, “Establishment of nursing strategy to maintain routine of people with dementia”. The nurses considered their own life through the life of the people with dementia, and tried to establish a nursing strategy to maintain daily life for these people.Conclusion: This study provides a deeper understanding of nurses' caring experiences for people with dementia, and can be helpful in establishing various coping strategies so that nurses can provide efficient caring for these patients.

Nurses’ experiences of caring for people with COVID-19 in Hong Kong: a qualitative enquiry

ObjectivesNurses are the largest group of healthcare workers on the front line of efforts to control the COVID-19 pandemic. An understanding of their nursing experiences, the challenges they encountered and...

'It is stressful, almost every hour…': Experiences of caring for people living with dementia in Kenya-An interpretive phenomenological approach.

IntroductionAs chronic conditions such as dementia become increasingly prevalent, the role of caregivers will become ever more critical. In the East African region, little is known about the experiences of caring for people living with dementia. This study aims to describe the views of being a caregiver, including day-to-day responsibilities and duties, determine the impact of caregiving and understand participants’ experiences of supports available or required to facilitate caring for a person living with dementia in Kenya.MethodsThis was a qualitative study that employed an interpretative phenomenological analysis (IPA) approach. We used convenience sampling to identify study participants in three counties in Kenya. Participants were main caregivers for the family and hence included both families and paid caregivers. We recruited 10 caregivers to participate in the study (9 females and 1 male). Data were analysed manually following the IPA approach.ResultsThree main themes emerged from the analysis: the personal experience of caregiving, supports to assist with caregiving and the perceived unmet care needs. The challenges experienced varied based on the support available to the caregiver, the number of years in the caregiving role and knowledge and skills related to providing care.ConclusionOur study shows that caring for a person living with dementia is an arduous experience, requiring significant mental and physical effort. The study highlights a general lack of knowledge and awareness of dementia among families, healthcare professionals and the general public. Training programmes for caregivers, including dementia care skills, educating healthcare practitioners and organising public awareness programmes to understand and accept dementia are urgently needed.

Nurses' experience of caring for people living with HIV: a focused ethnography.

Healthcare providers have been found to have limited knowledge and skills in interacting with people living with HIV. These factors can adversely affect providers' practice, jeopardize their safety and compromise the care of the patients. This study aimed to explore the experiences of Iranian nurses who were caring for patients with HIV. A focused ethnography approach was used. Participants consisted of 12 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences and recruited by purposeful sampling. Semi-structured interviews, field observations and field notes were used for data collection. Data were analysed employing content analysis. Three main themes emerged from the analysis of the participants' experiences of providing care to patients with HIV: 'excessive fear of being infected', 'concerns about the possible consequences' and 'lack of self-confidence in care provision'. Nurses have experienced a great deal of fear of self and cross-contamination when providing care to people living with HIV. Social stigma and discrimination against people living with HIV amplified the nurses' experience of fear. Providing appropriate education and training for nurses can improve their attitudes, emotions and self-confidence while providing care to such people and increasing the quality of care provided. Planning more educational programmes focusing on improving their misunderstandings about HIV could result in positive outcomes: for nurses to provide high-quality care and for people living with HIV who receive this care. The healthcare system should consider the culture of care provided by nurses to these people.

The experience of caring for people with eating disorders: a qualitative study of nurses' perspectives

Eating disorders (ED) are an increasingly prevalent problem with serious consequences for different spheres of life. This study aims to analyze nurses' perspectives and experiences of the care provided to people diagnosed with an ED. Hermeneutical phenomenological qualitative study. Nineteen nurses from Alcalá de Henares (Madrid) collab-orated in the research sharing their experience through interviews and stories, which were recorded, transcribed and analyzed thematically. Three issues were obtained: a fight between the heart and mind, conscious reflection: the body says what the head keeps silent and learning how to care holistically. Nurses experience a struggle with their feelings of transference / countertransference when caring for patients. They set out to combine skills acquired from their experience with new research, without losing sight of the individual and the factors involved (family, society and work), which are key to understand the patient's experience and recovery. Nurses need more specialization, ongoing training, coordination and teamwork with other professionals to provide people with holistic care. Gender perspectives should be taken into account to enable care to be adapted to the needs of men and women. This study takes an in-depth look at the care relationship between nurse and patient, to obtain a hitherto unknown perspective of care, which makes it possible to expand knowledge and individualize the care provided.

Understanding and improving the experience of care for people with dementia in hospital: Developing the dementia care pointers for service change

AbstractBackgroundBeing in hospital can be particularly confusing and challenging not only for people living with dementia, but also for their carers and the staff that care for them.MethodWe undertook three systematic reviews of quantitative and qualitative evidence according to best practice guidelines. The reviews explored: 1) experience of care in hospital; 2) experience of interventions to improve care in hospital; and 3) effectiveness and cost ‐effectiveness of interventions to improve the experience of care in hospital for people living with dementia, their carers and staff. Links between the findings from the three reviews were explicitly identified through the creation of a conceptual map. The overarching messages and their implications were discussed with key stakeholders. An advisory group of dementia specialists, hospital staff, commissioners and family carers advised us throughout the project. PROSPERO registration CRD42018086013ResultOur reviews show that the experience of care in hospital for people living with dementia is a dynamic process, being impacted by a complex range of personal, institutional and environmental factors. Despite the intent to deliver person centred care, and armed with the knowledge of how important this is, person centred care is still not happening consistently within hospitals. The effect of this is not only a poorer experience of care for people living with dementia and their carers, but also has a detrimental effect on staff emotional well‐being as a result of not being able to give the care they strive to provide. We highlight 12 institutional and environment practices and processes (Pointers for Service Change) that warrant consideration for those aiming to improve the experience of care in hospital for people living with dementia, their carers and staff.ConclusionEvidence suggests that although people living with dementia can have a good experience of care in hospital, this is still not happening for many. When staff cannot provide the care they would like to give, this has a negative effect on people living with dementia, their carers and the staff themselves. Further research needs to identify how best to change ward cultures, and how to maintain these changes in the long‐term.

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

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.

A mind of care

This article approaches issues arising out of being in the middle of the first wave of the COVID-19 pandemic in Finland in March 2020, both from the point of view of the lived experience of caring for people in our conference setting, and through analysing the statements and actions of the Finnish government from the point of view of an ethics of care. It argues that an ethics of care approach is better equipped at dealing with thinking about and understanding complex life situations such as the spread of the pandemic than what the standardised taxonomy approaches offer. It further states that an ethics of care not only provides concepts and frameworks that help people grapple with challenging situations in an ethical manner, it also enables us to imagine how hospitality and solidarity can be envisioned anew.

Perceptions of hospital-based Registered Nurses of care and discharge planning for people who are homeless: A qualitative study

ABSTRACT Background Links among homelessness, poor health and frequent hospitalisation are familiar to health services worldwide. Despite this, limited research has explored hospital-based Registered Nurses’ perspectives of homelessness healthcare. Aim This study explored the perspectives of hospital-based Registered Nurses, regarding provision of person-centred care for people who are homeless. Methods Interviews were conducted with twelve Registered Nurses working in a tertiary metropolitan hospital. Interview transcripts were analysed using a deductive thematic approach guided by Deci and Ryan’s self-determination theory (SDT). Findings Five themes emerged regarding provision of person-centred care for people who are homeless. First, people who are homeless frequently access the hospital as a safe place. Second, nurses often perceive homeless health problems as multifaceted and difficult to manage. Third, stigma creates a barrier to the delivery of hospital-based homelessness healthcare. Fourth, it is important to provide people who are homeless with a sense of choice. Fifth, there is a lack of suitable discharge options and connection between the hospital and community services. Discussion If care pathways within a hospital are not designed to adequately address the complex needs of people who are homeless, they are vulnerable to frequent re-admissions and extended lengths of stay. A non-judgmental attitude and providing a sense of choice are important approaches for hospital-based Registered Nurses when working with people who are homeless. Conclusion Hospital-based homelessness healthcare presents many challenges. The perceptions of Registered Nurses provide insight into the daily experience of caring for people experiencing homelessness within a hospital setting.

Help, I can’t help: A qualitative study of psychiatric nurse’s perspectives on their care for people who hear voices

WHAT IS KNOWN ABOUT THE SUBJECT?: There are no studies on the perceptions of psychiatric nurses on interventions they provided to people hearing voices while in an acute psychiatric unit in Ireland. There are three studies focussed on psychiatric nurses' experiences of caring for people that hear voices, two based in England and one based in Australia. Only two of these studies is focussed on nurses working in an acute psychiatric unit. WHAT IS THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study used semi-structured interviews to explore perceptions of psychiatric nurses in the Republic of Ireland on interventions they provided people hearing voices while in an acute psychiatric unit. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further quantitative and qualitative research into the nursing practice for people experiencing auditory hallucinations, in both in-patient and community settings. Follow up supports and supervision after the completion training programmes should be implemented, to ensure the transition of skills and knowledge to the clinical environment. Further investigation into whether or not psychiatric nurses are well prepared for the developments outlined in national polices. ABSTRACT: Aims and Objectives To explore the perspectives and experiences of Irish psychiatric nurses working in acute care in regard to their role in addressing hearing voices in the people in their care, with a view to gain insight in the nurses' personal experiences, interventions they provide, attitudes, knowledge, facilitating factors and challenges. Background Treatment of auditory hallucinations often takes place in acute psychiatric care. Traditionally treatment was focused on medication, but this is no longer the sole approach, with psychosocial interventions gaining ground. Psychiatric nurses have the potential to provide these interventions. As part of the changing emphasis of mental health care in Ireland towards more responsibilities for psychiatric nurses, there is a need to establish whether psychiatric nurses are prepared to take up these added responsibilities. Design A qualitative study, comprising of semi-structured interviews (n=16). Results Four themes emerged through thematic analysis. These included (a) the importance of therapeutic relationships; (b) reservations about the emphasis on medication; (c) limitations to interventions; and (d) the lack of focus/structure of interventions. Conclusions The use of systematic psychosocial interventions for people who hear voices is not well supported in the acute psychiatric settings the psychiatric nurses in the study worked in.

The experience of care coordination for people living with multimorbidity at risk of hospitalisation: an interpretative phenomenological analysis

Objective: There is growing interest in improving the care of people living with multimorbidity who require care coordination to help manage their health and reduce risk of hospitalisation. There has been limited past research exploring experiences of care for people living with multimorbidity. This qualitative study sought to explore the care experience of people enrolled in a care coordination intervention.Design: We interviewed 23 people living with multimorbidity enrolled in a care coordination intervention to examine their perceptions of the care experience. We used interpretative phenomenological analysis to identify themes from participants’ perspectives of involvement in their care, using information to make decisions, and the meanings they made of their care experiences.Results: We identified three master themes of the participants’ experience of care: Needing expert guidance, Circle of care, and I want to be spoken to like a person. We discuss these findings in the context of the recent literature on person-centred care.Conclusion: Understanding participants’ experience of care reinforces the need for person-centred approaches. These findings suggest care coordination offered to people living with multimorbidity can be implemented through practical support and information alongside establishing a relationship of trust.

A state-of-the-art review of the experience of care coordination interventions for people living with multimorbidity.

To explore recent research on care coordination interventions for people living with multimorbidity, from the perspective of the person receiving care. Care coordination interventions for people living with multimorbidity show some effectiveness in improving management of their health and reducing potentially preventable hospitalisations. The experience of people enrolled in care coordination interventions requires further exploration. State-of-the-art review. A review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist where five databases (The Cochrane Library, PsycINFO, Scopus, CINAHL and MEDLINE) were searched for qualitative sources published from January 2008-March 2019. Two additional databases focused on multimorbidity and integrated care were included in the search. Titles, abstracts and full texts were screened using inclusion criteria. Reference lists of the included articles were hand-searched. Summary tables were developed for data extraction, and the data were mapped to the research question. Eighteen primary research articles were included. Three themes of participant experience were identified: (a) relationships built on trust, (b), a sense of safety and security and (c) feeling cared for and respected. The contribution of qualitative approaches to evaluating the experiences of care for people living with multimorbidity is growing. Participants' describe afocus on relationships formed with healthcare professionals during care coordination. Further research incorporating lived experiences of participants could illuminate these concepts further. People living with multimorbidity who require assistance via care coordination value trusting relationships with healthcare professionals, who respect their needs and provide a sense of security. Understanding participant experiences is important to shape care coordination interventions that incorporate person-centred approaches.

Advanced care planning: an exploratory study of community-based mental health practitioners’ views and experiences of ACP in practice with people with dementia

Purpose Advanced care planning (ACP) involves the discussion of preferences relevant to a possible future time when one’s ability to make decisions may be compromised. ACP is considered as having potential to enhance choice and control and thereby to improve the experience of care for people with dementia and their carers. Care coordinators have been highlighted as possibly playing a central role in facilitating these discussions among people with long-term care needs. However, there is limited evidence of how ACP is facilitated by community mental health professionals who may be supporting people with dementia and carers. The paper aims to discuss this issue. Design/methodology/approach This exploratory study took the form of qualitative semi-structured interviews to explore the views and experiences of community mental health professionals when discussing ACP with people with dementia and/or their carers. A convenience sample of 14 participants working in community mental health services in one NHS Mental Health Trust in London, England, was recruited and interview data were analysed using a framework approach. Findings Five themes emerged from the interviews – knowledge and experience, use of ACP, inhibitors of discussion, service influences and the future. The depth of ACP facilitation appeared dependent on the knowledge, confidence and skills of the individual professional. Limited resources leading to service rationing were cited as a major barrier to ACP engagement. Helping people with dementia and their carers with ACP was not viewed as a priority in the face of competing and increasing demands. A further organisational barrier was whether ACP was viewed by service managers as “core business”. Findings indicate that practice was generally to refer people with dementia to other agencies for ACP discussions. However, pockets of ACP practice were reported, such as explaining proxy decision making options for finances. Research limitations/implications This exploratory study took place in the community mental health services in one NHS Mental Health Trust that may not be representative of other such teams. Case records were not scrutinised or clinical conversations with people with dementia or carers. Practical implications Barriers to initiating ACP discussions were cited, such as limited resources, lack of time and knowledge; unclear role remit, uncertain service direction and poor documentation sharing processes. However, participants held a common belief that ACP for people with dementia is potentially important and were interested in training, a greater team focus on ACP and pathway development. This indicates the potential for staff development and continuing professional development. Originality/value Few studies have asked a wide range of members of community mental health services about their knowledge, skills and confidence in ACP and this study suggests the value of taking a team-wide approach rather than uni-professional initiatives.

Nurses' experiences of delivering acute orthopaedic care to patients with dementia.

Nurses who care for acute patients with dementia in a hospital setting report a variety of challenges in regard to meeting the complex needs of their patients. In particular, known barriers to optimal care include a lack of knowledge about dementia, lack of dementia-friendly acute clinical environments, lack of time to care for the individual patient and a prioritised focus on the medical issues that triggered the hospitalisation. Research to date has not specifically focused on nurses' experiences of caring for people with dementia in orthopaedic wards. This study investigates nurses' experiences of caring for people with dementia, in an acute orthopaedic hospital ward setting. Qualitative interviews. This qualitative study employs hermeneutic phenomenological research methods. Eight Danish nurses were interviewed in an orthopaedic ward about their experiences in caring for orthopaedic patients with dementia. Nurses with various levels of expertise were selected for interview so that a full range of nursing experiences could inform the research study. The results of the study revealed two major themes: "Nurse communication and patient information" and "Care compromise", with three and four sub-themes, respectively. These findings are used to illustrate how, and why, nurses' experiences of caring for patients with dementia contribute a discontentment and negative preconceived perception by some nurses towards their acute care of patients with chronic dementia. The results are discussed in the context of Interactional Nursing Practice theory and describe the challenges experienced by acute care orthopaedic nurses who care for patients with dementia. Orthopaedic nurses find it challenging and professionally difficult to provide person-centred care for patients with dementia during an acute orthopaedic hospital admission. Orthopaedic nurses should work to adopt a positive attitude, and person-centred approach, towards dementia care. It is also recommended that the electronic patient record should be supplemented by oral dissemination to some extent, as information, plans of action and knowledge about the care situation for patients with dementia has a tendency to drown in chronological data presentation.

What is the cultural value of dying in an era of assisted dying?

Assisted dying is now a lawful and integral component of many societies ‘death system’, orienting individual and collective encounters with death and dying. While only a very small number of...

Working with consumers who hear voices: The experience of early career nurses in mental health services in Australia.

Mental health consumers who hear voices frequently experience distress and express a desire to discuss their voice-hearing experience. Nurses do not regularly demonstrate a willingness to engage in such discussions. With the introduction of educational strategies that develop empathy and an understanding of voice-hearing experiences, it is anticipated that early career nurses will be able to translate such understanding into their professional nursing practice. To explore early career nurses' understanding of providing care to mental health consumers who hear voices, a qualitative exploratory descriptive study was conducted in which nine early career Registered Nurses were interviewed regarding their experiences of caring for people who hear voices. Thematic analysis was employed to analyse the data and generate themes. Participants reported difficulty in developing relationships with consumers who hear voices, due to a workplace culture that was focussed on risk and lacking professional support. Nurses need specific education to develop the skills necessary to respond to consumers who hear voices and engage in dialogue that assists consumers to relate to the voices in a meaningful way. However, for this to succeed in practice, changes need to be supported by addressing the cultural barriers, such as risk-focussed environments, that prevent nurses implementing best practice.

"A tool doesn't add anything". The importance of added value: Use of observational pain tools with patients with advanced dementia approaching the end of life-a qualitative study of physician and nurse experiences and perspectives.

Observational pain tools (OPTs) are widely recommended in health care policies, clinical guidelines, and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life. To explore hospice, secondary, and primary care physicians' and nurses' use of OPTs with patients dying with advanced dementia and their perspectives on practice development and training needs. Twenty-three physicians and 24 nurses with experience of caring for people dying with advanced dementia were recruited from primary care surgeries (n=5), hospitals (n=6), hospices (n=4), and nursing homes (n=10). Semistructured, face-to-face interviews were conducted. Interviews were digitally recorded, transcribed verbatim, and thematic analysis applied to identify core themes. Three key themes emerged: (1) use of OPTs in this vulnerable patient population, (2) barriers to the use of OPTs and lack of perceived "added value", and (3) perspectives on practice development and training in pain assessment in advanced dementia at end of life. Just over one-quarter of participants (n=13) routinely used OPTs. Reasons for nonuse included perceived limitations of such tools, difficulties with their use and integration with existing practice, and lack of perceived added value. Most participants strongly emphasised a need for ongoing training and development which facilitated transfer of knowledge and multidisciplinary skills across professions and specialties. Health professionals require ongoing support in developing and integrating change to existing pain assessment protocols and approaches. These findings have important implications for health education, practice, and policy.

Community health professionals\u2019 dementia knowledge, attitudes and care approach: a cross-sectional survey in Changsha, China

BackgroundCommunity health professionals play a significant role in dementia care. However, little is known about community health professionals’ capacity in dementia care, especially in low and middle-income countries. The aim of the present study was to assess community health professionals’ dementia knowledge, attitudes and care approach in China, a country with the largest population of people with dementia in the world and where community based dementia care services are much needed.MethodsA cross-sectional survey was conducted. 450 health professionals were recruited into the study using random sampling from community health service centres in Changsha, China. Their knowledge, attitudes and care approach were assessed utilising the Chinese version of the Alzheimer’s Disease Knowledge Scale, Dementia Care Attitude Scale and Approach to Advanced Dementia Care Questionnaire respectively.ResultsA total of 390 participants returned the questionnaire (response rate 87%). Age, education, professional group and care experience were associated with knowledge scores, and overall dementia knowledge was poor. Attitudes were generally positive and influenced by age, professional group, gender and care experience. The experience of caring for people with dementia was positively associated with a person-centred care approach, although the participants tended not to use a person-centred care approach. A statistically significant association was found between knowledge and attitudes (r = 0.379, P < 0.001), and between attitudes and care approach (r = 0.143, P < 0.001). However, dementia knowledge has no relationship with a person-centred approach.ConclusionsCommunity health professionals showed generally positive attitudes towards people with dementia. However, they demonstrated poor dementia knowledge and tended not to use a person-centred care approach. The results suggest that a multifaceted approach consisting of educational interventions for community health professionals, and policy and resource development to meet the demand for community dementia care services, is urgently needed in China.

Walking Forward, Looking Back: A District Nurse’s Life Journey

The author is a retired district nurse and midwife and this book is a heart-warming reflection on her experiences of caring for people in their homes as she recalls past events while out walking her dog.