1. Objectifs

Intentions :
«The families of people with late-stage dementia need to be informed about the course of the dementia and the comfort/palliative care option. A booklet was written for that purpose and can be provided to family members by physicians and nurses. […] Focussing on nurses working in long-term care (LTC) settings, the present paper reports on surveys carried out in French Canada (Quebec), where the booklet was developed, English Canada (Ontario), France, and Japan.» (p. 67)

Questions/Hypothèses :
«The hypothesis was that the booklet would be acceptable in Quebec, Ontario, and France but, owing to significant cultural differences, less acceptable in Japan». (p. 68)

2. Méthode

Échantillon/Matériau :
«The unit of analysis was the nurse, and the inclusion criterion was: nurse working in an LTC setting looking after residents with advanced dementia. Surveys were distributed on a convenience basis in LTC settings known to the researchers. All of the nurses in each facility were invited to take part. There are national differences in the way LTC is organised in different countries, but all of the settings cared for people with advanced dementia. There was a mix of private and public institutions, but all were not for-profit and only one (in English Canada) had a religious affiliation (Catholic). The settings chosen in Canada were two LTC facilities in Sherbrooke, Quebec, and three in Hamilton, Ontario. In France, four facilities in the area of Bayeux (Normandy) were selected and, in Japan, three facilities from the Saitama and Fuluoka regions (near Tokyo).» (p. 68)

Type de traitement des données :
Analyse statistique

3. Résumé

«Palliative care is increasingly considered a relevant option in advanced dementia. The Comfort Care booklet can play a part in informing families about this option and its alternatives, especially when people develop complications related to their advanced dementia. In this study, evaluation of the booklet varied in different areas. Cultural adaptations (van der Steen et al, 2012) probably improve acceptability but to a limited extent, as shown in a previous study in the Netherlands, in which the English Canadian version was evaluated similarly to an adapted Dutch version (van der Steen et al, 2011a), and in Japan, where the booklet had lower acceptability despite multiple adaptations (Nakanishi et al, 2012). The data also suggest that educating staff about a palliative approach for advanced dementia could make a difference. Overall, the booklet is well accepted by nurses in very different settings. If physicians recognise that advanced dementia is a terminal illness and that a palliative care approach is relevant, it is possible that the booklet could help nurses play a more active part in informing families about comfort care, supporting them, and contributing to better quality of end-of-life care.» (p. 73)