Factors affecting user participation for nursing home residents with dementia: a critical interpretive synthesis

Abstract

User participation has been one of the central guiding principles in health and social services for decades, but there are many obstacles in practice, especially when service users’ have difficulties in exercising their autonomy. Many residents with dementia in nursing homes belong to this group. This article is based on a critical interpretive review of the factors affecting user participation for residents with dementia living in nursing homes. The search yielded 1555 articles; in total 82 full-text articles were retrieved, of which 38 met the inclusion criteria. Six broad analytical themes were identified; characteristics of the residents, staff, co-residents, relatives, tools for promoting participation and sociomaterial context, which indicates that user participation for this group and this context is multifactorial. Another interesting finding is that very few of the included articles question to whether the residents have real power in influencing the provision of individual services; moreover user participation on collective level with the overall aim of influencing service delivery in nursing homes was non-existent. An open question is whether residents with dementia in nursing homes are primarily considered patients more than fellow citizens.