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Evidence-based practice incorporates optimum clinical practice and expert opinion. EBP includes knowledge, critical thinking, and judgment needed to adopt best practise and improve professional experience. Proper implementation of dementia practice to improve patient quality of life helps educate healthcare professionals and consider patient wishes and execute programs (Li et al., 2019). Improve the practice with multimodal stimulation, social activities, and external memory aids. Dementia patients have trouble speaking, walking, and swallowing. The patient also struggles to identify persons in time and location. Overworked nurses struggle to manage work, which affects patient health (Gitlin et al., 2020). Physical pain from the sickness, inability to create overactivity, and lack of patient engagement are other issues. A multitude of reasons may induce dementia, which gradually decreases numerous areas of function. Care must enhance dignity and quality of life (Galvin et al., 2021). The next article will discuss the necessity of evidence-based dementia care.
The progression of dementia makes meaningful discussion impossible. Current approaches, such as memory/life story strategies, promote individualized techniques and may improve a person's quality of life. In this scenario, a thorough care plan was required to improve dementia patient quality of life. Dementia is common, with 7.1% of people over 65 in the UK suffering from it, requiring proper treatment. Poor early intervention raises the risk of dementia, which will affect over 1 million people by 2025. Rapid aging reduces independence and increases the risk of immobility, pneumonia, malnutrition, falls, and death, which worsens dementia symptoms. Dementia patients struggle to handle long-term issues, lowering quality of life. Healthcare practitioners must respect patients and follow their wishes while executing care plans (Livingston et al., 2020). During Dignity Therapy, a skilled therapist helps a person through a recorded, guided application procedure to create a preconventional record that leaves a written legacy. Dignity Therapy lets people start clinical decision-making while they can talk, giving them meaning and purpose. The study aims to assess the acceptability of dignity treatment in caring for older adults with dementia and reduce the obstacles caregivers have in motivating and caring for them (Jenewein et al., 2021).
Well-being OR dementia OR general happiness OR living standards OR quality of life among dementia patients) AND (dementia OR Alzheimer* OR Lewy OR Fronto) are search strategies for finding publications. The second search string can include: (well-being OR wellbeing OR life satisfaction OR quality of life OR *QoL* OR health status) AND (well-being OR wellbeing OR life satisfaction OR quality of life OR *QoL* OR health status) AND... Other keywords for article collection include “Dignity Therapy AND Dementia patient”, “Alzheimer’s patient AND dignity therapy”, “Dignity therapy AND Patient safety”, “Dignity Therapy AND role of caregivers”, “Dignity therapy AND Dementia Quality”, “Psychological therapy AND Nurse issue”, and “Nurses issue AND Dementia”.
We searched review articles' reference lists for further research by the main authors. Dementia patients of any kind, severity, age, or living situation were studied using dignity treatment. We searched for observational studies that examined cross-sectional and longitudinal correlations between variables and QoL, life satisfaction, and well-being ratings on standardized questionnaires or rating scales. Intervention studies without baseline data and those with less than 75% dementia patients were eliminated. The research comprised 2015–2022 articles. The analysis eliminated unavailable publications (Grewal et al., 2016).
Search databases utilized to find relevant publications include NCBI, Google Scholar, PubMed, and CINHL. Peer-review, evidence-based practice, year, and language filters are offered. The analysis includes English-language articles from 2015 to 2022.
Article: "How individuals with dementia in nursing homes maintain dignity through life storytelling - a case study" (Heggestad & Slettebø, 2015).
Evidence-based practice is crucial in healthcare and nursing (Ellis, 2019). Nursing practitioners must carefully choose evidence to follow this method. Clinical practitioners must use evidence-based therapies to guarantee patient health and safety (Camargo et al., 2018). Critical assessment involves thoroughly checking and assessing a research article's credibility (LoBiondo-Wood & Haber, 2021).
Healthcare professionals must prioritize and execute effective therapies for dementia, a major mental health concern among older adults (Jørgensen et al., 2018). Several researches have found dignity treatment useful in managing dementia in adults (D'Iapico, 2022). The evidence must be confirmed before this technique may be safely used on patients.
The relevance and value of the research article “How individuals with dementia in nursing homes maintain their dignity through life storytelling - a case study” will be discussed in the context of dignity therapy implementation for dementia patients using the Critical Appraisal Skills Programme (CASP) tool (Casp-uk.net., 2018).
The CASP checklist for qualitative research focuses on 10 questions about a research article's findings, methods, and ethics. The study paper by Heggestad and Slettebø (2015) focused on the responses of persons with dementia. This study examined dementia patients' self-management techniques for retaining dignity in nursing homes. Multiple trustworthy sources demonstrate that dementia quality worsens considerably. Thus, dignity is frequently lost (Steinbock & Menzel, 2018). To maintain dignity, patients may need self-management skills. Thus, the study problem's context is correct and important. Most Norwegian nursing home residents have dementia. Patients with dementia are more vulnerable, and their self-worth is threatened. Maintaining their self-esteem is crucial. The writers have underlined this setting from the start and explored the same issues throughout the investigation. According to the CASP criteria, the study's findings were legitimate since the researchers properly defined the goals and the results showed meaningful information.
Qualitative research methods are utilized to comprehend an idea or experience of persons (Aspers & Corte, 2019). The above study uses phenomenological and hermeneutic design, which are common qualitative research approaches. In education and other human sciences like nursing, hermeneutic phenomenology is a popular qualitative research method. Hermeneutics expresses the reflecting quality of human experience in language and other creative signals, while phenomenology clarifies, characterizes, and makes logical sense of pre-reflective human experience (Neubauer, Witkop & Varpio, 2019). These strategies help identify qualitative data. The qualitative technique used in this study is accurate and well-maintained.
The researchers intended to examine how dementia patients in nursing homes maintain a dignified living and determine whether dignity treatment is beneficial. To acquire information directly from the experiencer, hermeneutics and phenomenology may be the best technique. The hermeneutic approach stressed the importance of concepts based on past experiences, knowledge, and research. Researchers cannot grasp another' experiences without prejudices. In this research, the researchers used case studies and narrative analysis. Phenomenology values people' subjective first-hand experiences. Stories represent subjective experiences. An open inquiry prevented prearranged subjects from being used for responses. This matches dialogical studies. Consistent approach. Given this methodical study structure, the qualitative technique may be appropriate.
Research participant recruiting approach is another essential factor in article evaluation. Three qualitative dementia care decency case studies are discussed in the essay. The examples are based on participant observation and qualitative interviews with five residents from two nursing facilities, one special care and one general. The research included 15 nursing home dementia patients. The researchers have thoroughly detailed how they recruited study participants in this publication, making it reputable.
Data collecting is crucial to research (Williams, Boylan & Nunan, 2020). Next, the researchers provided a step-by-step data gathering process. Participant observation occurred in two phases: March–May 2010 and October–December 2010. The researchers spent over 185 hours monitoring people, which implies extensive data gathering for this paper. This criteria may also determine data authenticity. Each chosen informant was interviewed next. In primary qualitative research, interviews are one of the most cost-effective ways to gather subjective data (Barrett & Twycross, 2018). Thus, this data gathering strategy is suitable for studying dementia patients' dignity-preserving measures.
According to the ethics of this study, the researchers got informed permission from all participants before interviewing them. The first author's private room was used for participant interviews to offer a pleasant and comfortable setting. Researchers and participants develop a partnership or conformable connection. Withdrawal will not damage them, they were informed. This shows that the researchers properly considered and managed ethical considerations.
The first author noted that patients felt obliged to narrate their life story when she engaged with them in the living room, visited them in their private places as a passive observer in nursing home wards, and interviewed them. These stories may include how they met their spouse or other memorable experiences. Their identity was molded by storytelling. The study found that dementia patients in nursing homes may use life stories to cope and find safety. Stories may also express and maintain self-identity. This may preserve society or personal dignity. Based on the CASP criteria, this research's outcome meets its purpose.
The researchers determined that life narrative may help dementia patients maintain their dignity. Health care personnel must listen to dementia patients' life tales. The relevance and importance of this essay suggest that nursing personnel must treat dementia patients with dignity. Thus, nursing home staff should understand how dementia patients use life story to maintain dignity.
Overall, Heggestad and Slettebø (2015) study provides useful data for dementia management. Healthcare providers may use this reputable source to administer evidence-based dignity treatment for dementia.
The reviewed research revealed that life narrative may help dementia sufferers preserve dignity. The global burden of dementia affects healthy eating economy and quality of life. Maintaining dignity in Norwegian nursing homes, where 80% of patients have dementia, is unstudied (Evans et al., 2016). According to Huang et al. (2020), a 2004 UK program modeled dignity as a crucial aspect of therapeutic treatment. Most patients experience continuing loss of dignity, worth, and security, and cognitive impairment reduces dignity. Cognitive decline limits their capacity to remember the past, thus they lose their identity as dementia progresses. Improving dignity also depends on lack of autonomy in clinical treatment and inadequate therapeutic rapport to narrate the journey (Fetherstonhaugh et al., 2017). The study showed that recounting prior tales gives people a feeling of belonging and safety, which improves dignity. The study found that Eli and Dagny's upbringing, family, and other cherished memories gave them a feeling of belonging and protection. These results are important for improving dementia care in Norwegian nursing homes and other study fields. One study found that story telling helps dementia patients manage chaos and find safety, which can inform future research on knowledge and skills to ensure adequate storytelling opportunities (Røen et al., 2016). This study will help researchers perform qualitative studies on dementia patients and their families by addressing their lived experience of storytelling, since nurses must protect patient dignity. It will also help future researchers determine what training and abilities nurses need to encourage storytelling and dignity. Other literature supports this conclusion. Story telling provided life satisfaction and social and personal connection, according to Karlsson et al. (2014). Thus, dementia patients who had opportunity showed self-reliance and confidence in their capacity to live a meaningful life. This research encourages future researchers to use combined methods to examine narrative (qualitative data) and memory and cognition (quantitative data). Similar to this study, Novy (2018) noted that story telling may need extensive nursing assistance and that nonverbal interactive story telling strategies help patients establish a culture of reciprocity and therapeutic rapport. Thus, it will guide future study on different storytelling methods that preserve dignity and slow illness development. These results are useful to other research and multifunctional team and governing body experts (Midtbust et al., 2018). Ineffective therapeutic relationships, informed consent from family members, and effective services are common when nurses, neurologists, psychologists, and occupational therapists lack dignity knowledge. This study will help clinicians understand narrative telling, remove inefficient treatments, and sustain patient health. Policy and technique for storytelling must be discussed while addressing relevance.
The Norwegian government has said that concentrating on dignity in dementia care is essential. They advised prioritizing the ‘guarantee of dignity’ on the ‘Care Plan 2015’ to enhance political actions for excellent care (Heggestad & Slettebø, 2015). To guarantee fulfillment, the strategy emphasizes home perception as a whole. The current Dementia Plan 2020 strategy for older individuals improves dignity waste care in dementia. Dementia care is restricted in dignity and assistance. Maintaining residents' dignity means valuing their life, which professionals seldom do and reduces therapeutic adherence and satisfaction (Rokstad et al., 2016). Thus, study findings will help experts create dignity-enhancing organizational policies for dementia patients. It will allow governing bodies to work with policymakers and other agencies to require story telling in Dementia Plan 2020 and draft legislation to enhance care (Clissett et al., 2013). Nursing and other professionals who record and perform a life story with and for persons with cognitive and communication disabilities will feel empowered and self-confident. Thus, designing and implementing life story policies and regulations as part of dignity therapy may improve care and dignity.
Sitting down and listening to residents' life tales lets professionals interact in their world and allow people participate in their own lives. Thus, by actively interacting with the residence's reality, nursing practitioners may reduce negative preconceptions and personal prejudices while respecting patient autonomy (Rokstad et al., 2016). The study's findings may enhance professional training and resources for active story telling. The study can be used to create storytelling-based training and workshops for nurses, neurologists, informal caregivers, and psychologists to learn non-judgmental listening, therapeutic touch, and family involvement to support and respect dignity (Park et al., 2017). Family members may help nursing staff enhance storytelling by using drama and narrative approaches. This study is important to increasing care quality overall. For future study and professional practice, numerous recommendations might be made.
Starting with hybrid methodologies, consider human narrative experience and improve memory and cognitive impairment. The research suggests that study research is important for examining any in its natural setting, thus nursing practitioners should concentrate on dignity-enhancing abilities, like story telling. Second, build organisation policy with local leaders, governing bodies, policy makers, and other agencies to enhance care and storytelling (Rokstad et al., 2016). Third, create training and workshops for nurses and other professionals to enhance narrative telling. To ensure inclusivity, racially minor practitioners may get culturally competent care training and guidelines. To promote collaboration, occupational therapists and social workers might get similar training (Czapka & Sagbakken, 2020). Hospitals and wards must develop guidelines to adopt approach due to professional benefits. To enhance treatment, non-pharmacological approaches beyond guideline creation must be addressed.
Non-pharmacological intervention minimizes the incidence of polypharmacy and medication non-adherence owing to cognitive incompetence in dementia patients. Dementia patients face many challenges, including lack of coordination and understanding medication consumption due to memory loss, which leads to negligence in treatment and impacts the older adult's life (Handley et al., 2017). In this case, dignity therapy and creative art expression-based storytelling programs will help the older adult become more interested in treatment and reduce long-term stress, which can worsen their condition. Lin et al. (2020) conducted a randomized control experiment to see whether creative expressive art-based storytelling improves the health of mild cognitive impairment adults. Early non-pharmacological intervention prevents fast cognitive loss in older adults with moderate cognitive impairment and raises the risk of dementia, according to the research. The patient will gain interest and strength by comprehending or replaying the tale, improving cognitive function (Slamanig et al., 2021). The healthcare practitioner must be trained and qualified to properly examine older adults' neurological systems before implementing narrative exercise programs. The nurse can also include visual art therapy for the older adult to improve psychological health and cognitive function by allowing the patient to express themselves through nonverbal communication and social interaction (Alawafi et al., 2021). Visual art therapy can improve quality of life by reducing social isolation, and storytelling and dignity therapy can be combined with such strategies to help understand patient needs and maintain long-term adherence to treatment by increasing patient interest. Nurses need sufficient training to conduct such a program since they must protect patients' feelings and offer treatment according to ethical norms. Maintaining quality of practice in the company requires training on non-verbal expressions, tale length, and quality.
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