The impact of cultural practice and policy on dementia care in Nepal.
Aging
Alzheimer’s
Culture
Dementia
Nepal
Older people
Policy
Service Provision
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
16 Oct 2024
16 Oct 2024
Historique:
received:
17
07
2024
accepted:
04
10
2024
medline:
17
10
2024
pubmed:
17
10
2024
entrez:
16
10
2024
Statut:
epublish
Résumé
People's wider culture plays a vital role in both dementia care and policy. This study aims to explore the cultural practice and policy influence around caring for People Living with Dementia (PLWD) in Nepal. An exploratory qualitative study was designed to investigate dementia care in Nepal. The study comprised four in-depth interviews and four focus group discussions with 29 participants, including family members, health care professionals, and other stakeholders. Data were analysed using thematic analysis. Four major themes (each with several sub-themes) were identified: (1) Cultural practice in dementia care; (2) Impact of policy on the dementia care; (3) Service provision; and (4) Education and training. There is a need for community-based awareness raising on dementia and its care, to sensitise all relevant stakeholders to meet the needs of PLWD. In addition, capacity building of health workforce is needed to enhance their knowledge of and skills in providing culturally appropriate dementia care.
Sections du résumé
BACKGROUND
BACKGROUND
People's wider culture plays a vital role in both dementia care and policy. This study aims to explore the cultural practice and policy influence around caring for People Living with Dementia (PLWD) in Nepal.
METHODS
METHODS
An exploratory qualitative study was designed to investigate dementia care in Nepal. The study comprised four in-depth interviews and four focus group discussions with 29 participants, including family members, health care professionals, and other stakeholders. Data were analysed using thematic analysis.
RESULT
RESULTS
Four major themes (each with several sub-themes) were identified: (1) Cultural practice in dementia care; (2) Impact of policy on the dementia care; (3) Service provision; and (4) Education and training.
CONCLUSION
CONCLUSIONS
There is a need for community-based awareness raising on dementia and its care, to sensitise all relevant stakeholders to meet the needs of PLWD. In addition, capacity building of health workforce is needed to enhance their knowledge of and skills in providing culturally appropriate dementia care.
Identifiants
pubmed: 39415098
doi: 10.1186/s12877-024-05438-8
pii: 10.1186/s12877-024-05438-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
842Informations de copyright
© 2024. The Author(s).
Références
World Health Organisation (WHO). Dementia: Key facts. 2023. https://www.who.int/news-room/fact-sheets/detail/dementia . Accessed 15 March 2023.
Patterson C. World Alzheimer Report 2018—the state of the art of dementia research: New frontiers. Alzheimer’s Disease Int. 2018. https://www.alzint.org/u/WorldAlzheimerReport2018.pdf
Prince M, Guerchet M, Prina M. The epidemiology and impact of dementia - current state and future trends. WHO Thematic Briefing. 2015. https://www.researchgate.net/publication/277217355 . Accessed 26 May 2015.
National Statistic Office, Government of Nepal. National population and housing census 2021: national report. Kathmandu; 2021; 614. Accessed March 2024.
UN ESCAP. Ageing in Asia and the Pacific: key fact. 2023. https://www.population-trends-asiapacific.org/data/pacific
Jha A, Sapkota N. Dementia assessment and management protocol for doctors in Nepal. J Nepal Med Association. 2013;52(189). https://doi.org/10.31729/jnma.567 .
Saldanha D, Mani RN, Mujawar S, Chaudhury S. A study of dementia in old age homes. Industrial Psychiatric J. 2021;30(1):149–54. https://doi.org/10.4103/0972-6748.328806 .
doi: 10.4103/0972-6748.328806
Nepal S, Sapkota N, Kumar R, BK D, Mishra SK. Prevalence of dementia among elderly patients attending psychiatry OPD of tertiary care hospital and its association with socio demographic variables. Psychiatrists’ Association Nepal. 2017;6(1). https://doi.org/10.3126/jpan.v6i1.21766 .
Sideman BA, Al Rousan T, Tsoy E, Escudero SDP, Pintado-Caipa M, Kanjanapong S, et al. Facilitators and barriers to dementia assessment and diagnosis: perspectives from dementia experts within a global health center. Front Neurol. 2022;13. https://doi.org/10.3389/fneur.2022.769360 .
Pathak KP, Gaire T. Dementia in Nepal: early recognition knowledge, management barriers and practices of registered nurses - a pilot study. J Gerontol Geriatric Res. 2020;9(3):512. https://doi.org/10.35248/2167-7182.20.9.512 .
doi: 10.35248/2167-7182.20.9.512
Kharel B. Family caregiving of the elderly in the U.S. and Nepal. Cornerstone: A Collection of Scholarly and Creative Works for Minnesota State University, Mankato. 2023. https://cornerstone.lib.mnsu.edu/etds/1276/ . Accessed 25 April 2023.
Gurung D, Poudyal A, Wang YL, Neupane M, Bhattarai K, Wahid SS, et al. Stigma against mental health disorders in Nepal conceptualised with a ‘what matters most’ framework: a scoping review. Epidemiol Psychiatric Sci. 2022;31:1–18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8851063/ .
doi: 10.1017/S2045796021000809
Adhikari-Baral M, Chhetri BK, Bhandari P. Abuse of older adults before moving to old age homes in Pokhara Lekhnath Metropolitan City, Nepal: a cross-sectional study. PLoS ONE 2021; 16(5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104417/
Chalise H. Depression among elderly living in Briddashram (old age home). Adv Ageing Res. 2014;3(1):6–11. https://doi.org/10.3233/JAD-230906 .
doi: 10.3233/JAD-230906
Katiwada R, Lyu S, Wang H, Bhandari S, Liu Y. The knowledge and attitude of Nepalese nursing students towards dementia. Heliyon. 2023;9(8). https://doi.org/10.1016/j.heliyon.2023.e19247 .
Baral K, Dahal M, Pradhan M. Knowledge regarding Alzheimer’s disease among college students of Kathmandu, Nepal. Int J Alzheimer ’s Disease 2020; 20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199541/
Pathak KP. Dementia among health workers: knowledge, practice and obstacles. PhD Thesis. 2015. [Online] https://dspace.lib.uom.gr/bitstream/2159/18746/1/PathakKrishnaPrasad_Phd2015.pdf
Shrestha S, Tranvag O. Dementia care in Nepalese old age homes: critical challenges as perceived by healthcare professionals. Int J Older People Nurs. 2022;17(4). https://doi.org/10.1111/opn.12449 .
Sapkota N, Subedi S. Dementia as a public health priority. Psychiatrists’ Association Nepal. 2019;8(2). https://doi.org/10.3126/jpan.v8i2.28016 .
Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753–60. https://doi.org/10.1177/1049732315617444 .
doi: 10.1177/1049732315617444
pubmed: 26613970
Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med. 2022;292:114523. https://doi.org/10.1016/j.socscimed.2021.114523 .
doi: 10.1016/j.socscimed.2021.114523
pubmed: 34785096
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa .
doi: 10.1191/1478088706qp063oa
Cofie M, Braund H, Dalgarno N. Eight ways to get a grip on intercoder reliability using qualitative-based measures. Can Med Educ J 2022; 13(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099179/
Lincoln YS, Guba EG. (1985). Naturalistic inquiry. Sage. https://doi.org/10.1016/0147-1767(85)90062-8
Low LF, Purwaningrum F. Negative stereotypes, fear and social distance: a systematic review of depictions of dementia in popular culture in the context of stigma. BMC Geriatr. 2020;20(477). https://doi.org/10.1186/s12877-020-01754-x .
Hossain M, Crossland J, Stores R, Dewey A, Hakak Y. Awareness and understanding of dementia in South asians: a synthesis of qualitative evidence. Dement (London England). 2020;19(5):1441–73. https://doi.org/10.1177/1471301218800641 .
doi: 10.1177/1471301218800641
Mushi D, Rongai A, Paddick SM, Dotchin C, Mtuya C, Walker R. Social representation and practices related to dementia in Hai District of Tanzania. BMC Public Health. 2014;14:26. http://www.biomedcentral.com/1471-2458/14/260 .
doi: 10.1186/1471-2458-14-260
Hindley G, Kissima J, Oates LL, Paddick SM, Kisoli A, Brandsma C, et al. The role of traditional and faith healers in the treatment of dementia in Tanzania and the potential for collaboration with allopathic healthcare services. Age Aging. 2016;46(1):130–7. https://doi.org/10.1093/ageing/afw167 .
doi: 10.1093/ageing/afw167
Kumar CS, George S, Kallivayalil RA. Towards a dementia-friendly India. Indian J Psychol Med. 2019;41(5):476–81. https://doi.org/10.4103/IJPSYM.IJPSYM_25_19 .
doi: 10.4103/IJPSYM.IJPSYM_25_19
pubmed: 31548773
pmcid: 6753713
Willis R, Zaidi A, Balouch S, Farina N. Experiences of people with dementia in Pakistan: help-seeking, understanding, stigma, and religion. Gerontologist. 2020;60(1):145–54. https://doi.org/10.1093/geront/gny143 .
doi: 10.1093/geront/gny143
pubmed: 30452635
Balouch S, Zaidi A, Farina N, Willis R. Dementia awareness, beliefs and barriers among family caregivers in Pakistan. Dement (London England). 2021;20(3):899–918. https://doi.org/10.1177/1471301220915066 .
doi: 10.1177/1471301220915066
Abhayasinghe K, Dissanayake L, Saunders B, Campbell P, Sumathipala A. Dementia research activity in Sri Lanka: a review. J Neurodegenerative Disorders. 2020;3(1):89–100. https://doi.org/10.36959/459/603 .
doi: 10.36959/459/603
Herat-Gunaratne R, Cooper C, Mukadam N, Rapaport P, Leverton M, Higgs P, et al. In the Bengali vocabulary, there is no such word as care home: caring experiences of UK Bangladeshi and Indian family carers of people living with dementia at home. Gerontologist. 2020;60(2):331–9. https://doi.org/10.1093/geront/gnz120 .
doi: 10.1093/geront/gnz120
pubmed: 31587053
Weiss J, Tumosa N, Perweiler E, Forciea MA, Miles T, Blackwell E, et al. Critical workforce gaps in dementia education and training. J Am Geriatr Soc. 2020;68(3):625–9. https://doi.org/10.1111/jgs.16341 .
doi: 10.1111/jgs.16341
pubmed: 31967320
pmcid: 7384174
Goodson M, McLellan E, Rosli R, Tan MP, Kamaruzzaman S, Robinson L, et al. A qualitative study on formal and informal carers’ perceptions of dementia care provision and management in Malaysia. Front Public Health. 2021;9. https://doi.org/10.3389/fpubh.2021.637484 .
Smith SJ, Parveen S, Sass C, Drury M, Oyebode JR, Surr CA. An audit of dementia education and training in UK health and social care: a comparison with national benchmark standards. BMC Health Serv Res. 2019;19(711). https://doi.org/10.1186/s12913-019-4510-6 . https://bmchealthservres.biomedcentral.com/articles/ .
Rosli R, Goodson M, Tan MP, Mohan D, Reidpath D, Allotey P, et al. Challenges and research priorities for dementia care in Malaysia from the perspective of health and allied health professionals. Int J Environ Res Public Health. 2021;18(21). https://doi.org/10.3390/ijerph182111010 .
Ministry of Health and Population (MoHP). Government of Nepal. National Mental Health Strategy and Work Plan. 2021; 1–54. https://drive.google.com/file/d/13BHh05nqDMKfWRJm-kR1tGWUsRxU3z6Z/view . Accessed 12 May 2021.
Ministry of Health and Population (MoHP), Government of Nepal. Medical treatment of deprived citizens. 2022. [Online] https://mohp.gov.np/program/medical-treatment-of-deprived-citizens/en
World Health Organisation (WHO). The Global Dementia Observatory Reference Guide. 2018. https://iris.who.int/bitstream/handle/10665/272669/WHO-MSD-MER-18.1-eng.pdf?sequence=1&isAllowed=y
Department of Health Service. Annual report 2019/2020. Ministry of Health and Population, Government of Nepal. 2020. http://dohs.gov.np/wp-content/uploads/2021/07/DoHS-Annual-Report-FY-2076-77-for-website.pdf . Accessed 5 July 2022.
Briceno EM, Dakal U, Sharma U, Adhikari N, Pradhan MS, Shrestha L, et al. Neuropsychological assessment of older adults in Nepal for population-based dementia ascertainment: needs, challenges, and opportunities. J Alzheimers Dis. 2023;96(4):1339–52. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10739926/ .
doi: 10.3233/JAD-230906
pubmed: 37980674
pmcid: 10739926