Construction of Essential Care Service Package for People Living with Dementia in Smoke-free Environment under Disease Pandemic in China

Abstract

In recent years, the harm of smoking has attracted more and more public attention. Creating a healthy smoke-free environment has been widely favored and supported by the public. Smokeless environment has a certain positive effect on the rehabilitation of dementia patients. Sustained smoking cessation is associated with significantly decreased the future prevalence of dementia. Therefore, hospitals often establish a special organizational structure and management model for tobacco control, and carry out training and assessment for all staff. The nursing group also took it as the basic nursing standard. The 2019 disease pandemic has posed unique health threats to people living with dementia (PLWD). Therefore, a strict smoke-free environment is more necessary for the nursing group. One of the key challenges is scaling up long-term care services to meet the needs of the rapidly growing population of PLWD in developing countries. The aim of the study is to explore the care service needs, utilization and build an essential care service package (ECSP) for PLWD under the disease pandemic in China. Methods: From July 2018 to October 2019, a total of 1255 elderly with dementia in six cities in China by a cluster sampling were investigated with the self-designed questionnaire. Care service needs and utilization for PLWD with different levels of cognitive impairment were summarized. Results: The ECSP for PLWD was composed of 30 service items (7 for core care) in order to guarantee that all PLWD enjoy equal care services, basing on public financing and implementing strategies and taking China's situations into account. The selection plan for ECSP at different levels is designed as ‘General Care Services + Selective Care Services’, in which respective service items for low, mid, and high-level care for PLWD are 7+3, 7+6, and 7+10, and requires 151.41 hours, 201.88 hours, and 252.35 hours per month, respectively.  Conclusion: The present study provides the first large-scale data on care service needs and utilization for PLWD in mainland China. The ECSP for PLWD based on the needs advanced in the paper was a practicable and effective quantitative management means that deserves a large-scale application. Some safeguard mechanisms and operational implementing pathways of ECSP for PLWD during and after the disease pandemic in China are proposed.