ABSTRACT

User participation has been one of the central guiding principles in health and social services for decades, but there are many obstacles in practice, especially when service users’ have difficulties in exercising their autonomy. Many residents with dementia in nursing homes belong to this group. This article is based on a critical interpretive review of the factors affecting user participation for residents with dementia living in nursing homes. The search yielded 1555 articles; in total 82 full-text articles were retrieved, of which 38 met the inclusion criteria. Six broad analytical themes were identified; characteristics of the residents, staff, co-residents, relatives, tools for promoting participation and socio-material context, which indicates that user participation for this group and this context is multifactorial. Another interesting finding is that very few of the included articles question to whether the residents have real power in influencing the provision of individual services; moreover user participation on collective level with the overall aim of influencing service delivery in nursing homes was non-existent. An open question is whether residents with dementia in nursing homes are primarily considered patients more than fellow citizens.

摘要

几十年来，用户参与一直是卫生和社会服务的核心指导原则之一，但在实践中存在许多障碍，尤其是当服务用户难以行使自主权时。疗养院中的许多患有痴呆症的居民都属于这一群体。本文基于对居住在养老院的痴呆症居民影响用户参与的因素的批判性解释性审查。搜索结果为 1555 篇；共检索到全文文章82篇，其中38篇符合纳入标准。确定了六个广泛的分析主题；居民、工作人员、共同居民、亲属、促进参与的工具和社会物质环境的特征，这表明该群体和该环境的用户参与是多因素的。另一个有趣的发现是，纳入的文章中很少有人质疑居民是否拥有影响个人服务提供的实际权力；此外，不存在以影响疗养院服务提供为总体目标的集体层面的用户参与。一个悬而未决的问题是，养老院的痴呆症居民是否主要被视为患者而不是同胞。