학술논문
Risk assessment for people living with dementia: a systematic review.
Document Type
Academic Journal
Author
Hoe J; Geller Institute of Ageing and Memory, University of West London, London, UK.; School of Health Sciences, University of London, London, UK.; Profyri E; School of Health Sciences, University of London, London, UK.; Kemp C; School of Health Sciences, University of London, London, UK.; Manela M; UCL Division of Psychiatry, University College London, Maple House, London, UK.; Webster L; UCL Division of Psychiatry, University College London, Maple House, London, UK.; Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK.; Anthony J; School of Health Sciences, University of London, London, UK.; School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.; Costafreda S; UCL Division of Psychiatry, University College London, Maple House, London, UK.; Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK.; Arrojo F; Alzheimer's Society Research Network, Alzheimer's Society, London, UK.; Souris H; Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK.; Dementia Clinical Network, NHS England and NHS Improvement (London Region, London, UK.; Livingston G; UCL Division of Psychiatry, University College London, Maple House, London, UK.; Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK.
Source
Publisher: Cambridge University Press Country of Publication: England NLM ID: 9007918 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1741-203X (Electronic) Linking ISSN: 10416102 NLM ISO Abbreviation: Int Psychogeriatr Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: This systematic review identified key components of risk assessment for people with dementia, examined attitudes toward risk identification and risk assessment, and appraised existing risk assessment tools.
Methods: Systematic searches of five databases on two platforms (EBSCO, OVID) and gray literature databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesized using thematic synthesis.
Results: Our review found people with dementia, their family carers, and healthcare professionals differed in how risk is conceptualized, with views being shaped by media perceptions, personal experiences, socio-cultural influences, dementia knowledge, and dementia severity. We found that mobilization (causing falls inside and getting lost outside) is the most frequently identified risk factor. Our findings show people with dementia are generally risk-tolerant, while healthcare professionals may adopt risk-averse approaches because of organizational requirements. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute toward adverse risk events. We discovered that most studies about risk and risk assessment scales did not consider insight of the person with dementia into risks although this is important for the impact of a risk. No risk instrument identified had sufficient evidence that it was useful.
Conclusion: Accurate risk assessment and effective communication strategies that include the perspectives of people with dementia are needed to enable risk-tolerant practice. No risk instrument to date was shown to be widely acceptable and useful in practice.
Methods: Systematic searches of five databases on two platforms (EBSCO, OVID) and gray literature databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesized using thematic synthesis.
Results: Our review found people with dementia, their family carers, and healthcare professionals differed in how risk is conceptualized, with views being shaped by media perceptions, personal experiences, socio-cultural influences, dementia knowledge, and dementia severity. We found that mobilization (causing falls inside and getting lost outside) is the most frequently identified risk factor. Our findings show people with dementia are generally risk-tolerant, while healthcare professionals may adopt risk-averse approaches because of organizational requirements. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute toward adverse risk events. We discovered that most studies about risk and risk assessment scales did not consider insight of the person with dementia into risks although this is important for the impact of a risk. No risk instrument identified had sufficient evidence that it was useful.
Conclusion: Accurate risk assessment and effective communication strategies that include the perspectives of people with dementia are needed to enable risk-tolerant practice. No risk instrument to date was shown to be widely acceptable and useful in practice.