Melanie Bienas1, Irmela Gnass2, Benjamin Mayer3, Lukas Radbruch4,5, Albert Lukas6,7. 1. Malteser Krankenhaus Seliger Gerhard, Bonn/Rhein-Sieg, Zentrum für Altersmedizin, Akademisches Lehrkrankenhaus, Universität Bonn, Von-Hompesch-Straße 1, 53123, Bonn, Deutschland. 2. Institut für Pflegewissenschaft und -praxis, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich. 3. Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland. 4. Malteser Krankenhaus Seliger Gerhard, Bonn/Rhein-Sieg, Zentrum für Palliativmedizin, Akademisches Lehrkrankenhaus, Universität Bonn, Bonn, Deutschland. 5. Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland. 6. Malteser Krankenhaus Seliger Gerhard, Bonn/Rhein-Sieg, Zentrum für Altersmedizin, Akademisches Lehrkrankenhaus, Universität Bonn, Von-Hompesch-Straße 1, 53123, Bonn, Deutschland. albert.lukas@malteser.org. 7. Klinik für Orthopädie und Unfallchirurgie, Uniklinik Bonn, Bonn, Deutschland. albert.lukas@malteser.org.
Abstract
BACKGROUND: People with dementia are receiving treatment in acute care hospitals at increasing rates. Most prominently, patients exhibiting behavioral and psychological symptoms of dementia (BPSD) are perceived as significant burdens for staff members. Non-detected pain is seen as one substantial reason for behavior that is seemingly unexplainable. In order to gather information about dealing with BPSD a survey was performed. The objective of this study was to enable a more cause-oriented treatment. METHODS: The procedure consisted of an anonymous survey of nurses, by semi-structured interviews with open and closed questions about BPSD: type, frequency, perceived burden, therapeutic countermeasures including pain recognition. RESULTS: A total of 46 nurses from 3 wards (internal, geriatric, surgery) were interviewed. 1. Nurses reported being heavily burdened by patients with BPSD. 2. A structured identification of possible causes as part of an established treatment process was not observed. 3. Offering to talk with the patient in order to identify possible causes for BPSD was seen as the first step in the right direction but is inhibited by the limitations of people with severe dementia. 4. Pain as one important cause for BPSD was known by the staff but was often measured by inadequate instruments. 5. Positioning and mobilization were the most commonly used attempts at treatment. CONCLUSION: Nurses are especially affected in their daily work by patients with BPSD. Clarifying the cause may play a crucial role in treating BPSD.
BACKGROUND:People with dementia are receiving treatment in acute care hospitals at increasing rates. Most prominently, patients exhibiting behavioral and psychological symptoms of dementia (BPSD) are perceived as significant burdens for staff members. Non-detected pain is seen as one substantial reason for behavior that is seemingly unexplainable. In order to gather information about dealing with BPSD a survey was performed. The objective of this study was to enable a more cause-oriented treatment. METHODS: The procedure consisted of an anonymous survey of nurses, by semi-structured interviews with open and closed questions about BPSD: type, frequency, perceived burden, therapeutic countermeasures including pain recognition. RESULTS: A total of 46 nurses from 3 wards (internal, geriatric, surgery) were interviewed. 1. Nurses reported being heavily burdened by patients with BPSD. 2. A structured identification of possible causes as part of an established treatment process was not observed. 3. Offering to talk with the patient in order to identify possible causes for BPSD was seen as the first step in the right direction but is inhibited by the limitations of people with severe dementia. 4. Pain as one important cause for BPSD was known by the staff but was often measured by inadequate instruments. 5. Positioning and mobilization were the most commonly used attempts at treatment. CONCLUSION: Nurses are especially affected in their daily work by patients with BPSD. Clarifying the cause may play a crucial role in treating BPSD.
Entities:
Keywords:
Acute care hospital; BPSD; Dementia; Pain; Pain recognition