Person-Centred Dementia Care in an Acute Hospital: Experiences from Nurses Working in a Specialized Dementia Unit.

BACKGROUND: Person-centred care (PCC) is synonymous with best practice in the care of persons with dementia. However, the research focus has been in long-term care settings with less attention in acute hospitals. We aimed to study the perspectives and experiences of nurses implementing PCC in an acute hospital dementia unit (Care for Acute Mentally Infirm Elders [CAMIE]). METHOD: This was an exploratory qualitative study involving individual, face-to-face, semi-structured in-depth interviews. A purposive sample of 10 nurses participated in the interview. We employed an inductive thematic analysis approach to analyse the qualitative data. RESULTS: The findings highlighted the positive experiences, for example, meaningful connection with patients and the challenges, for example, managing challenging behaviour in providing PCC. The initial challenges were due to a lack of prior knowledge and experience. Through formal and informal learning, the nurses built confidence and competence, and also provided support to one other. They emphasized the importance of teamwork and camaraderie in the CAMIE team but raised concerns about the negative perceptions of non-CAMIE nurses on the value of their work. CONCLUSION: Despite the challenges, adequate knowledge and robust organizational level support are the key support for nurses to embrace PCC as their care ethos in the acute care setting.

A new music therapy engagement scale for persons with dementia.

ABSTRACTObjectives:To develop and validate a new scale to assess music therapy engagement in persons with dementia (PWDs). DESIGN: A draft scale was derived from literature review and >2 years of qualitative recording of PWDs during music therapy. Content validity was attained through iterative consultations, trial sessions, and revisions. The final five-item Music Therapy Engagement scale for Dementia (MTED) assessed music and non-music related elements. Internal consistency and inter-rater reliability were assessed over 120 music therapy sessions. MTED was validated with the Greater Cincinnati Chapter Well-being Observation Tool, Holden Communication Scale, and Participant Engagement Observation Checklist - Music Sessions. SETTING AND PARTICIPANTS: A total of 62 PWDs (83.2 ± 7.7 years, modified version of the mini-mental state examination = 13.2/30 ± 4.1) in an acute hospital dementia unit were involved. RESULTS: The mean MTED score was 13.02/30 ± 4.27; internal consistency (Cronbach's α = 0.87) and inter-rater reliability (intra-class correlation = 0.96) were good. Principal component analysis revealed a one-factor structure with Eigen value > 1 (3.27), which explained 65.4% of the variance. MTED demonstrated good construct validity. The MTED total score correlated strongly with the combined items comprising Pleasure, Interest, Sadness, and Sustained attention of the Greater Cincinnati Chapter Well-being Observation Tool (rs = 0.88, p < 0.001). CONCLUSIONS: MTED is a clinically appropriate and psychometrically valid scale to evaluate music therapy engagement in PWDs.