title: Issues experienced while administering care to patients with dementia in acute care hospitals: a study based on focus group interviews.
abstract: OBJECTIVE
  Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan.
  
  
  METHODS
  This was a qualitative study using focus group interviews (FGIs). The setting was six acute hospitals with surgical and medical wards in the western region of Japan. Participants were nurses in surgical and internal medicine wards, excluding intensive care units. Nurses with less than 3 years working experience, those without experience in dementia patient care in their currently assigned ward, and head nurses were excluded from participation. FGIs were used to collect data from February to December 2008. Interviews were scheduled for 1-1.5 h. The qualitative synthesis method was used for data analysis.
  
  
  RESULTS
  In total, 50 nurses with an average experience of 9.8 years participated. Eight focus groups were formed. Issues in administering care to patients with dementia at acute care hospitals were divided into seven groups. Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle. This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals. In coping with this cycle, the nurses develop protection plans for themselves and for the hospital.
  
  
  CONCLUSIONS
  The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were as follows: (a) the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle, and (b) nurses do their best to adapt to these conditions despite feeling conflicted.
authors.affiliation: Nursing and Health Science, Graduate School of Medicine, Ehime University, Ehime, Japan; r-fukuda@umin.ac.jp.
authors.forename: Risa
authors.initials: R
authors.lastname: Fukuda
authors.affiliation: Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Seto
mesh_terms: D000328:Adult; D015897:Comorbidity; D003704:Dementia / Q000150:complications / Q000451:nursing*; D005260:Female; D017144:Focus Groups; D005851:Geriatric Nursing; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D007564:Japan; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009741:Nursing Staff, Hospital; D036301:Qualitative Research; D055815:Young Adult
keywords: Difficulties in administering care; KJ method; elderly; focus groups; geriatric nursing; patient care management