臺灣博碩士論文加值系統

BACKGROUND:
According to the World Health Organization (WHO), Alzheimer's Disease (AD) refers to a chronic and progressive brain deficit, in which various functions of the cerebral cortex, such as the ability to learn, calculate, speak and judge are disrupted (WHO,2019). The most common kind of dementia is Alzheimer's disease (AD), but there is currently no cure or treatment that is even close to being entirely effective. Care for AD patients becomes an issue for family caregivers and the healthcare systems.
This Umbrella review can be important to find evident knowledge about nursing care for Alzheimer’s disease.
AIM
To systematically explore what systematic review projects had been done about the nursing care for Alzheimer’s disease patients.
METHODS:
This project used an approach known as umbrella review, gathered systematic review studies that have been reviewed previously on a subject, and presented it in an overview format. This umbrella review ensured that data was acquired by the keywords: Alzheimer’s disease, nurs*, and systematic review. Five electronic databases including The Cochrane Library, PubMed, Ebsco host web, Proquest dissertation and thesis, and Science Direct were searched in this study for the umbrella review because of their accessibility and popularity in the field of the healthcare profession. Based on the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), data collection and screening processes were employed for data extraction. The Critical Appraisal Skills Program (CASP) checklist for systematic review was utilized to assess the level of quality of the selected articles.
FINDINGS:
Eight included articles were focused on specific aspects of Alzheimer’s disease care. This project found various interventions for preventing falls in individuals with Alzheimer's disease (AD) and related dementias, categorizing them into exercise-based, staff-directed, and multidisciplinary approaches. Exercise programs showed potential but inconclusive results, while staff-directed interventions like enhanced supervision significantly reduced falls. Multidisciplinary approaches had mixed effectiveness. A comprehensive Alzheimer's care was extracted covering diagnosis challenges, pharmacological and non-pharmacological treatments, and the significant role of caregivers and nurses. Nurses faced communication challenges, emotional strain, and workload issues, highlighting the need for better education and support. The importance of holistic, patient-centered care and effective nursing strategies was emphasized.
DISCUSSION AND IMPLICATIONS:
The discussion chapter focuses on the above-extracted knowledge dimensions. Regarding fall prevention interventions like exercise programs, staff-directed programs would be helpful for the nursing staff who take care of Alzheimer’s disease patients. Understanding the diagnosis and pharmacological management of Alzheimer’s disease was valuable for nurses and other healthcare professionals. Family caregiver education highlighted that environmental planning, music therapy, and physical activity helped optimize the interaction between patients and family caregivers. Alzheimer’s patients might have impaired verbal skills or difficulty understanding instructions. These impairments in communication with nurses were challenging and staffing shortages and inadequate dementia care training worsened nurses’ workload concerns.
CONCLUSION:
This umbrella review provides an overview of the systematic review of nursing care for patients with Alzheimer's disease. Extracted knowledge related to fall prevention to Alzheimer's disease overview, nursing interventions, challenges faced by nurses, and the need for improved nursing education. In addition, an evident suggestion commented that the use of PRISMA guidelines and checklists in systematic reviews greatly contributes to the overall quality of reporting.

TABLE OF CONTENTS
CHAPTER 1 INTRODUCTION 1
CHAPTER 2 LITERATURE REVIEW 3
2.1 UMBRELLA REVIEW 3
2.2 QUALITY OF REVIEW PROJECT 5
2.3 CRITICAL APPRAISAL SKILL PROGRAMME 6
2.3.1 Effectiveness of Critical Appraisal Skill Programs 7
2.4 NURSING CARE WITH ALZHEIMER’S PATIENTS 7
2.4.1 Nurse’s Knowledge and Attitudes 9
2.4.2 Work-load difficulties 10
2.4.3 Nurse’s Communication Management 10
CHAPTER 3 METHOD 13
3.1 RESEARCH AIM 13
3.2 SEARCH STRATEGY 13
3.3 INCLUSION AND EXCLUSION CRITERIA 15
3.3.1 Criteria for Inclusion 15
3.3.2 Criteria for Exclusion 16
3.4 QUALITY ASSESSMENT 23
CHAPTER SUMMARY 26
CHAPTER 4 FINDINGS 27
4.1 QUALITY OF EVIDENCE REGARDING THE REPORTING GUIDELINE OF PRISMA 34
4.2 KNOWLEDGE EXTRACTED FROM THE INCLUDED ARTICLES 38
4.2.1 Fall Prevention Programs 38
4.2.2 Management of Early stage of Alzheimer’s disease 40
4.2.3 Caregiver’s Education 41
4.2.3.1 Psychological stress faced by caregivers 41
4.2.3.2 Nursing Approach to Alzheimer's disease and their family caregivers 43
4.2.4 Nursing interventions for Alzheimer’s disease patients 43
4.2.5 Challenges and work-load issues faced by Nurses 45
4.2.6 Workload issues and aggression behaviour 46
4.2.6.1 Difficulty associated with playing a mediator role in addition to nursing duties 47
4.2.6.2 Lacking systematic support for dementia patient care 47
4.2.7 Elderly Healthcare Policy Critique 48
CHAPTER 5 DISCUSSION 50
5.1　 DISCUSSION OF FALL PREVENTION PROGRAMS 50
5.2　RELIABLE SUGGESTION ON THE EARLY-STAGE OF ALZHEIMER’S DISEASE 50
5.3 FAMILY CAREGIVER'S EDUCATION AND PSYCHOLOGICAL STRESS 51
5.4 DISCUSSION OF CHALLENGES AND WORKLOAD ISSUES OF NURSES 52
5.5 DISCUSSION ON NURSING INTERVENTION FOR ALZHEIMER’S DISEASE 53
5.6 DISCUSSION OF HEALTHCARE POLICY 53
5.7 NURSING CARE IMPLEMENTATION IN INDIA 54
CHAPTER 6 CONCLUSION 57
REFERENCES 61
LIST OF TABLES
Table3.1 Brief Introduction of Electronic Databases 13
Table 3.2 The study’s inclusion and exclusion criteria 17
Table 3.3 The characteristics of the included articles 20
Table 3.4 Quality appraisal checklist for systematic review 24
Table 4.1 The characteristics of eight included articles 28
Table 4.2 Whether the selected articles apply PRISMA guidelines 35
Table 4.3 The themes of Nurse’s caring experience of 46
Alzheimer’s disease patients.

LIST OF FIGURES
Figure 3.1 The article screening process based on PRISMA flow diagram 19

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