Experience of Nurses and Care Workers with Challenging Behaviour of Dementia Patients
Added on 2023-06-14
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Dissertation & Ph.D.
Thesis
Thesis
Table of Contents
TITLE..............................................................................................................................................4
CHAPTER 1: INTRODUCTION AND BACKGROUND (1500).................................................5
Introduction............................................................................................................................5
Experience of nurse and care worker with dementia people..................................................5
Prevalence and projection.......................................................................................................6
Impact on nurse and care worker experience due to challenging behaviour of dementia people
................................................................................................................................................6
Strategies to prevent challenge faced by nurses and care worker while dealing with dementia
people.....................................................................................................................................7
Rationale of the research........................................................................................................7
PICO framework....................................................................................................................8
CHAPTER 2: LITERATURE REVIEW (4000).............................................................................8
Overview of dementia............................................................................................................8
Role of nurses and care workers while dealing with people with dementia........................10
Challenges of the nurses and care workers dealing with challenging behaviour of people with
dementia...............................................................................................................................13
Ways and strategies to minimize the nurses and care worker experience while dealing with the
challenging behaviour of people with dementia...................................................................15
CHAPTER 3: METHODOLOGY (1000).....................................................................................18
CHAPTER 4: METHODS (3000).................................................................................................21
Research aim........................................................................................................................21
Research objective................................................................................................................21
Research questions...............................................................................................................22
Research hypothesis.............................................................................................................22
Eligibility criteria..................................................................................................................22
Search strategy......................................................................................................................24
Study selection process.........................................................................................................25
Quality appraisal of included studies...................................................................................25
Risk of bias assessment........................................................................................................26
TITLE..............................................................................................................................................4
CHAPTER 1: INTRODUCTION AND BACKGROUND (1500).................................................5
Introduction............................................................................................................................5
Experience of nurse and care worker with dementia people..................................................5
Prevalence and projection.......................................................................................................6
Impact on nurse and care worker experience due to challenging behaviour of dementia people
................................................................................................................................................6
Strategies to prevent challenge faced by nurses and care worker while dealing with dementia
people.....................................................................................................................................7
Rationale of the research........................................................................................................7
PICO framework....................................................................................................................8
CHAPTER 2: LITERATURE REVIEW (4000).............................................................................8
Overview of dementia............................................................................................................8
Role of nurses and care workers while dealing with people with dementia........................10
Challenges of the nurses and care workers dealing with challenging behaviour of people with
dementia...............................................................................................................................13
Ways and strategies to minimize the nurses and care worker experience while dealing with the
challenging behaviour of people with dementia...................................................................15
CHAPTER 3: METHODOLOGY (1000).....................................................................................18
CHAPTER 4: METHODS (3000).................................................................................................21
Research aim........................................................................................................................21
Research objective................................................................................................................21
Research questions...............................................................................................................22
Research hypothesis.............................................................................................................22
Eligibility criteria..................................................................................................................22
Search strategy......................................................................................................................24
Study selection process.........................................................................................................25
Quality appraisal of included studies...................................................................................25
Risk of bias assessment........................................................................................................26
Data extraction and synthesis...............................................................................................26
CHAPTER 5: RESULTS (2000)...................................................................................................28
Description of the studies.....................................................................................................28
Risk of bias in included studies............................................................................................29
Risk of bias in review process..............................................................................................30
Effect of intervention............................................................................................................31
CHAPTER 6: DISCUSSION (2500).............................................................................................32
Summary of main results......................................................................................................32
Certainty of evidence............................................................................................................33
Potential bias in the review process......................................................................................34
Agreement and disagreement with other studies..................................................................35
Generalisability.....................................................................................................................36
CHAPTER 7: CONCLUSION AND RECOMMENDATION (1000)..........................................36
Implication of practice..........................................................................................................36
Implication for research........................................................................................................37
REFERENCES..............................................................................................................................39
APPENDICES...............................................................................................................................49
Appendix A: Ethical approval..............................................................................................49
Appendix B: Missing data....................................................................................................51
Appendix C: CASP table......................................................................................................52
Appendix D: PRISMA chart................................................................................................53
CHAPTER 5: RESULTS (2000)...................................................................................................28
Description of the studies.....................................................................................................28
Risk of bias in included studies............................................................................................29
Risk of bias in review process..............................................................................................30
Effect of intervention............................................................................................................31
CHAPTER 6: DISCUSSION (2500).............................................................................................32
Summary of main results......................................................................................................32
Certainty of evidence............................................................................................................33
Potential bias in the review process......................................................................................34
Agreement and disagreement with other studies..................................................................35
Generalisability.....................................................................................................................36
CHAPTER 7: CONCLUSION AND RECOMMENDATION (1000)..........................................36
Implication of practice..........................................................................................................36
Implication for research........................................................................................................37
REFERENCES..............................................................................................................................39
APPENDICES...............................................................................................................................49
Appendix A: Ethical approval..............................................................................................49
Appendix B: Missing data....................................................................................................51
Appendix C: CASP table......................................................................................................52
Appendix D: PRISMA chart................................................................................................53
TITLE
"Nurses' and care workers' experience while dealing with challenging behaviour of people with
dementia."
"Nurses' and care workers' experience while dealing with challenging behaviour of people with
dementia."
CHAPTER 1: INTRODUCTION AND BACKGROUND (1500)
Introduction
Dementia is defined as the loss of function related to the cognitive aspect that includes
thinking, remembering, and reasoning. Moreover, it helps to show the interference with the
person related to the person's daily activity. In addition, some people with dementia usually do
not control their emotions and the personalities that may change. The range of dementia is based
on the severity from the mildest stage when they are started to affect the person, which may
affect the person's functioning based on various severe stages. Most of the people 850,000 in the
United Kingdom face the issue of dementia and live at home with their families (Amador et al.,
2018). More often, they are facing various difficulties which are related to dementia means
nurses are usually laid a vital role in supporting and providing care. They also face multiple
challenges due to the behaviour of dementia people. At the same time, the nurses used to focus
on all settings, which is relatively managing the patient who is usually coexisting health issue
and used to assist with the personal care. In addition to this, most people live with dementia
independently and require minimum support and maintenance. Whereas, the nurse and care
worker experience various challenges when dealing with dementia people in some regions while
performing them regular activities and many more related to basic life things (Bolt et. al., 2019).
Experience of nurse and care worker with dementia people
In addition, the care worker also shares their experience when dealing with people facing the
issue of dementia. Moreover, caring for the person dealing with the advanced stage of dementia
can evoke various emotions. While taking the context of example for the clear understanding, it
can usually feel unrewarding and upsetting to look after the people who appear and live in
another world for all intent and purpose. It is a duty to provide support and care to people with
dementia. The need and requirements are used to undertake, and also care workers assist them in
eating, washing, and dressing to support the person with such activity. In addition to this, the role
is challenging, which can often help lead both family and professional care workers to become in
the position of burnout (Bourbonnais et. al., 2020).
The nurse and the care worker experience may be worst sometime due the improper
behaviour form the patient with dementia. In addition, the patient used to create challenge for the
nurse and care worker when they are providing support and care. It may have related with the
Introduction
Dementia is defined as the loss of function related to the cognitive aspect that includes
thinking, remembering, and reasoning. Moreover, it helps to show the interference with the
person related to the person's daily activity. In addition, some people with dementia usually do
not control their emotions and the personalities that may change. The range of dementia is based
on the severity from the mildest stage when they are started to affect the person, which may
affect the person's functioning based on various severe stages. Most of the people 850,000 in the
United Kingdom face the issue of dementia and live at home with their families (Amador et al.,
2018). More often, they are facing various difficulties which are related to dementia means
nurses are usually laid a vital role in supporting and providing care. They also face multiple
challenges due to the behaviour of dementia people. At the same time, the nurses used to focus
on all settings, which is relatively managing the patient who is usually coexisting health issue
and used to assist with the personal care. In addition to this, most people live with dementia
independently and require minimum support and maintenance. Whereas, the nurse and care
worker experience various challenges when dealing with dementia people in some regions while
performing them regular activities and many more related to basic life things (Bolt et. al., 2019).
Experience of nurse and care worker with dementia people
In addition, the care worker also shares their experience when dealing with people facing the
issue of dementia. Moreover, caring for the person dealing with the advanced stage of dementia
can evoke various emotions. While taking the context of example for the clear understanding, it
can usually feel unrewarding and upsetting to look after the people who appear and live in
another world for all intent and purpose. It is a duty to provide support and care to people with
dementia. The need and requirements are used to undertake, and also care workers assist them in
eating, washing, and dressing to support the person with such activity. In addition to this, the role
is challenging, which can often help lead both family and professional care workers to become in
the position of burnout (Bourbonnais et. al., 2020).
The nurse and the care worker experience may be worst sometime due the improper
behaviour form the patient with dementia. In addition, the patient used to create challenge for the
nurse and care worker when they are providing support and care. It may have related with the
diagnosis, treatment or the intake of medication as per the schedule time that associated with the
dementia patient. They mostly refuse to take the treatment and diagnosis for the longer period. It
is act as a task for the nurses and care worker to deal and manage the patient and get them ready
for the diagnosis and treatment. The patient become aggressive and used to perform such
activities that harm the nurse or care worker on the physical level is also a challenge. These all
are experience which is related with the nurses and care worker (Jensen et. al., 2019).
Prevalence and projection
The study is based on the care worker and nurse experience which is usually focus on the
aspect that focus on the number of delivery of care that provided to dementia people. With this
contrast, the study is usually focus on the aspect that provide the data and information which is
relevant to challenge that faced by care worker while dealing with dementia people. The total
population is usually help to provide the prevalence which is among the 65s is approx. 7.1
percent which is based on the year of population data 2013 in the UK. Therefore, it is usually
equal one in the every 79 of 1.3 percent of the entire population in the UK, moreover, the entire
UK population and the 1 in every 14 of the population ages in the 65 years and over. The
projection of the arising cases is more than 20 percent with the above age group of 50 to 65
years. In addition, the dementia people have wider range of concept which provide diversity of
challenge with the patient with dementia (Brazil et. al., 2018).
Impact on nurse and care worker experience due to challenging behaviour of dementia people
Major challenges: In this, the major challenge which is faced by nurse and care worker on
the separate way are, the dementia people usually refuse to take proper medication and diagnosis
that render the delivery of services. In addition, due to the poor communication and interaction
with dementia patient, they used to create issue while convince them for the activities and
interventional care plan. the other major challenge of the nurses and care worker usually face
issue when the same diagnosis or therapy used to provide with the person with dementia on the
repetitive way that they are agitated and angry which may create major challenge with nurses to
deal with such circumstance. The other associated issue is problematic behaviour that include
angry, abusive tendency of the patient and lack of focus that also act as a barrier in the delivery
of support and care to the dementia patient (Haugland, & Reime, 2018).
Impact on nurses: The nurses usually face issue due to the behaviour which is problematic
as per the vision of people with dementia. They suffer violence and continuous stress due to
dementia patient. They mostly refuse to take the treatment and diagnosis for the longer period. It
is act as a task for the nurses and care worker to deal and manage the patient and get them ready
for the diagnosis and treatment. The patient become aggressive and used to perform such
activities that harm the nurse or care worker on the physical level is also a challenge. These all
are experience which is related with the nurses and care worker (Jensen et. al., 2019).
Prevalence and projection
The study is based on the care worker and nurse experience which is usually focus on the
aspect that focus on the number of delivery of care that provided to dementia people. With this
contrast, the study is usually focus on the aspect that provide the data and information which is
relevant to challenge that faced by care worker while dealing with dementia people. The total
population is usually help to provide the prevalence which is among the 65s is approx. 7.1
percent which is based on the year of population data 2013 in the UK. Therefore, it is usually
equal one in the every 79 of 1.3 percent of the entire population in the UK, moreover, the entire
UK population and the 1 in every 14 of the population ages in the 65 years and over. The
projection of the arising cases is more than 20 percent with the above age group of 50 to 65
years. In addition, the dementia people have wider range of concept which provide diversity of
challenge with the patient with dementia (Brazil et. al., 2018).
Impact on nurse and care worker experience due to challenging behaviour of dementia people
Major challenges: In this, the major challenge which is faced by nurse and care worker on
the separate way are, the dementia people usually refuse to take proper medication and diagnosis
that render the delivery of services. In addition, due to the poor communication and interaction
with dementia patient, they used to create issue while convince them for the activities and
interventional care plan. the other major challenge of the nurses and care worker usually face
issue when the same diagnosis or therapy used to provide with the person with dementia on the
repetitive way that they are agitated and angry which may create major challenge with nurses to
deal with such circumstance. The other associated issue is problematic behaviour that include
angry, abusive tendency of the patient and lack of focus that also act as a barrier in the delivery
of support and care to the dementia patient (Haugland, & Reime, 2018).
Impact on nurses: The nurses usually face issue due to the behaviour which is problematic
as per the vision of people with dementia. They suffer violence and continuous stress due to
behaviour of the dementia people which is abusive and full violence generate stress and
frustration among the nurses and care worker. The wellbeing and resilience are completely
render due to the offensive and non-societal behaviour without any cooperation in the care and
support. Therefore, it creates impact on the health of nurses and care worker with reference to
patient with dementia (Jennings et. al., 2018).
Strategies to prevent challenge faced by nurses and care worker while dealing with dementia
people
There are several of strategies which is followed under as an intervention to reduce the
complication and consequence that associated with the challenging behaviour of dementia
people. The majority of the ways to deal with such challenge which may arise while dealing with
dementia people with the creation of relationship bond with appropriate communication and
interaction with patient. In addition, the nurses and care worker used to follow various aspect in
such a way which create bond with the help to communication and interaction and they lead the
relationship as a friend and so on. Therefore, it reduce the chance of unnecessary problematic
behaviour of dementia towards the nurse and the patient who used to provide support and care all
the time. The other interventional scenario is use of polite manner, take care action plan and
create understanding which is based on emotional and cognitive level (Manthorpe et. al., 2018).
Rationale of the research
The rationale of the research is a valuable aspect that provides some of the signs related to
the topic that includes core aspects for professional and personal development. The issue is
usually associated with studying the experience of nurses and care workers with dementia.
Personal development allows people to gain some of the core knowledge associated with the
term and factor of dementia and people's experience, especially nurses and care workers. The
incident by nurses or the care worker helps build adequate knowledge while practising and
dealing with them as per professional needs. In addition, it helps to provide quality based support
and knowledge for the professional level for the profession. In addition to this, the personal
development is also included when the experience is used to underlying which is related with the
dementia people. therefore, the people with the extended factor about personal development and
growth (McDonald, Lolich, Timonen, & Warters, 2019).
frustration among the nurses and care worker. The wellbeing and resilience are completely
render due to the offensive and non-societal behaviour without any cooperation in the care and
support. Therefore, it creates impact on the health of nurses and care worker with reference to
patient with dementia (Jennings et. al., 2018).
Strategies to prevent challenge faced by nurses and care worker while dealing with dementia
people
There are several of strategies which is followed under as an intervention to reduce the
complication and consequence that associated with the challenging behaviour of dementia
people. The majority of the ways to deal with such challenge which may arise while dealing with
dementia people with the creation of relationship bond with appropriate communication and
interaction with patient. In addition, the nurses and care worker used to follow various aspect in
such a way which create bond with the help to communication and interaction and they lead the
relationship as a friend and so on. Therefore, it reduce the chance of unnecessary problematic
behaviour of dementia towards the nurse and the patient who used to provide support and care all
the time. The other interventional scenario is use of polite manner, take care action plan and
create understanding which is based on emotional and cognitive level (Manthorpe et. al., 2018).
Rationale of the research
The rationale of the research is a valuable aspect that provides some of the signs related to
the topic that includes core aspects for professional and personal development. The issue is
usually associated with studying the experience of nurses and care workers with dementia.
Personal development allows people to gain some of the core knowledge associated with the
term and factor of dementia and people's experience, especially nurses and care workers. The
incident by nurses or the care worker helps build adequate knowledge while practising and
dealing with them as per professional needs. In addition, it helps to provide quality based support
and knowledge for the professional level for the profession. In addition to this, the personal
development is also included when the experience is used to underlying which is related with the
dementia people. therefore, the people with the extended factor about personal development and
growth (McDonald, Lolich, Timonen, & Warters, 2019).
PICO framework
Population/ problem Nurses and care worker that they face issue with the behaviour of
dementia people. In addition, the issue is problematic behaviour of the
dementia people with the major of time due the short term memory and
enhanced level of illness.
Intervention Use right approach of communication and interaction that develop bond
of friend and many more.
Comparison Polite and effective way to create understanding among the dementia
people based on the emotional level.
Outcome Provide quality of life for the patient with dementia. In addition, the
nurse and care worker feel relaxed and make right care plan to provide
support and care.
CHAPTER 2: LITERATURE REVIEW (4000)
Overview of dementia
Dementia is defined as the loss of cognitive functioning, thinking, remembering and the aspect
of loss of memories which is related with the function. In addition, in such extent that they
critically interfere the person daily routine which is related with the end of life and with this,
such activities are usually restricted due to the dysfunction of brain. Usually, it is defined as the
thinking which is based on the group and social symptoms which usually render the daily
functioning and personalities. Therefore, some people with the core context of dementia that
cannot control their emotions and their personalities which is showing some of the fraction
which is change accordingly (Leocadie, Roy & Rothan-Tondeur, 2018). As per this, some of the
common warning sign which is related with the dementia are:
Memory loss which may affect the day-to-day abilities.
Difficulty in such a way which affect in performing the familiar task.
In addition, they also create the issue which is related with the language.
Therefore, the people with the dementia also facing the issue which is related with the
aspect of disorientation associated with the time and space.
Population/ problem Nurses and care worker that they face issue with the behaviour of
dementia people. In addition, the issue is problematic behaviour of the
dementia people with the major of time due the short term memory and
enhanced level of illness.
Intervention Use right approach of communication and interaction that develop bond
of friend and many more.
Comparison Polite and effective way to create understanding among the dementia
people based on the emotional level.
Outcome Provide quality of life for the patient with dementia. In addition, the
nurse and care worker feel relaxed and make right care plan to provide
support and care.
CHAPTER 2: LITERATURE REVIEW (4000)
Overview of dementia
Dementia is defined as the loss of cognitive functioning, thinking, remembering and the aspect
of loss of memories which is related with the function. In addition, in such extent that they
critically interfere the person daily routine which is related with the end of life and with this,
such activities are usually restricted due to the dysfunction of brain. Usually, it is defined as the
thinking which is based on the group and social symptoms which usually render the daily
functioning and personalities. Therefore, some people with the core context of dementia that
cannot control their emotions and their personalities which is showing some of the fraction
which is change accordingly (Leocadie, Roy & Rothan-Tondeur, 2018). As per this, some of the
common warning sign which is related with the dementia are:
Memory loss which may affect the day-to-day abilities.
Difficulty in such a way which affect in performing the familiar task.
In addition, they also create the issue which is related with the language.
Therefore, the people with the dementia also facing the issue which is related with the
aspect of disorientation associated with the time and space.
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