This article reports results of a study of contributing factors and associated behaviours in specific clinical areas to resistance to care episodes.
Resistance to Care has previously been studied in aged care settings, and previous studies have reported patient behaviours and appropriate responses. Resistance to Care is a defensive response by patients towards healthcare staff and is demonstrated in various non-compliant behaviours.
A cross-sectional survey of a representative sample of nurses (n = 5044), who were members of the New South Wales Nurses' Association in Australia, was conducted in 2008–2009.
Resistance to Care episodes occur in various clinical settings and may be precipitated by a range of clinical diagnoses and symptoms. They may also be triggered during various nursing activities that nurses recognize as high-risk for these episodes.
The reported Resistance to Care behaviours are similar to those reported in studies of aggression and violence; however, they require a substantially different response by nurses in various clinical contexts.
[Show abstract][Hide abstract] ABSTRACT: AimTo conduct a best-evidence review of non-pharmacological interventions for resistance-to-care behaviours of nursing home residents with dementia in a personal-care context.Background
Resistance to care is a major source of staff burnout in nursing homes and it is also a safety issue for the staff.DesignBest-evidence review.Data SourcesWe searched for non-pharmacological intervention studies published from 1990–2012, written in English.Review Methods
The search identified 19 intervention studies that examined the effects of interventions to reduce the resistance-to-care behaviours of nursing home residents with dementia in a personal-care context. These 19 papers met the quality assessment requirements of the critical appraisal criteria for experimental studies, which were published by the Joanna Briggs Institute.ResultsOnly three studies were RCTs and the rest were quasi-experimental. The sample size ranged from 7–127. Nine music interventions, such as pre-recorded music played to a group or playing a resident's preferred music, during his or her personal care, resulted in significant reductions in resistance-to-care behaviours. Resistance-to-care behaviours also were significantly reduced in three of four bathing interventions that focused on person-centred care. In the ability-focused interventions, only two out of five studies reported significant reductions in resistance-to-care behaviours.Conclusion
Non-pharmacological interventions are options to consider to reduce resistance-to-care behaviours in older people with dementia, even though the evidence level is low, given the lack of alternatives. More randomized controlled trials are recommended to confirm the effects of non-pharmacological interventions during personal care.
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