DIFFICULTIES NURSES EXPERIENCE IN PROVIDING CARE FOR ELDERLY PATIENTS WITH DEMENTIA IN ACUTE CARE HOSPITALS

This study aims to elucidate the difficulties that nurses experience in providing care for elderly patients with dementia in acute care hospitals in Japan. A self-rating questionnaire survey was completed by 115 nurses working in acute care hospitals with more than 200 beds. A content analysis based on Krippendorffs method was conducted. We performed an analysis by dividing the data into semantic contents, with the emphasis on the context, then organized the data according to similarities in the semantic contents, and categorized these into categories and subcategories. We collected 105 （91.3％） valid responses. The mean age of the participants was 34.4 years and the mean length of experience of providing dementia care was 7.4 years. The analysis yielded 69 contexts, 3 categories, and 11 subcategories, including the following three categories: 1） difficulties related to the symptoms of dementia, 2） conflicts with responsibilities as a nurse, and 3） difficulties caused by the wards not specialized in dementia care. It is necessary to help nurses overcome the difficulties they experience in providing care for elderly patients with dementia in acute care hospitals by developing educational programs suitable for the nursing care of the elderly with dementia while investigating factors related to the difficulties. In this study nurses working in acute care hospitals experienced difficulties in responding to core symptoms and behavioral and psychological symptoms of dementia （BPSD）. Nurses faced a dilemma because they had to restrain patients due to the importance of safety although they wished to provide nursing that places greater importance on the dignity of patients. The findings suggest that nurses experience difficulties because they are in charge of many severely ill and dementia afflicted patients and they must provide for the safety of these patients, and this is complex because the disturbed behavior of elderly people with dementia affect other inpatients. It is necessary to create questions from the categories and subcategories identified in this study, conduct a questionnaire survey for nurses who provide care for elderly patients with dementia in acute care hospitals to elucidate details of the difficulties of dementia nursing, and examine the factors related to the difficulties.