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Title: Providing quality care : exploring contextual influences and ethical issues inherent in the delivery of quality care for people with dementia
Author: O'Connor, Pauline
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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Findings are based on the work and experiences of twenty-four carers who were observed and interviewed during the course of caring for twenty female patients living with severe dementia. Based on a grounded theory approach to data collection the following five themes or aspects of care delivery emerged providing a focus for an in-depth analysis of how care was delivered: the management of care according to daily and weekly scheduled tasks; the promotion of the physical needs of patients over other aspects of care; communication difficulties in patient-carer encounters; environmental issues relating to the location, layout and design of the study site; and the management of patients with challenging behaviour. The findings revealed that the overall approach to care had its roots in well established prescribed methods of nursing practice, which were sustained by three independent but related factors: staff training, previous work experience and carers’ understanding of dementia. These factors seemed to be foundational to issues identified of an ethical nature in terms of the management of aspects of patient care. The ethical concerns explored in the study were primarily associated with assumptions made by carers regarding the inability of the patients to make choices or express preferences for example with respect to care and the management of their environment. While the study recognises the physical health and cognitive functioning of patients it recommends carers become aware of alternative practices underpinning a new culture of dementia care. The study concludes that combining the essential elements of the organic model with respect to diagnosis and medical treatment with an approach that is cognizant of a patient’s history, biography and subjective experiences is likely to ensure the delivery of improved quality care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available