Spirituality and dementia: the perspective of people living with dementia

The aim of this systematic review was to establish the experience of spirituality from the perspective of people living with dementia. A metasynthesis approach was used to critically appraise the available qualitative research... [ view full abstract ]

The aim of this systematic review was to establish the experience of spirituality from the perspective of people living with dementia.
A metasynthesis approach was used to critically appraise the available qualitative research evidence. A review protocol was drawn up. Key words from a preliminary scoping review were used to direct the database searches. Each set of keywords was combined using the boolean operator ‘or’ and then the outcome of each set was combined using ‘and’. Both free text and thesaurus or MesH searches were conducted as appropriate. No time limits were applied and the reference lists of retrieved materials were searched to identify further relevant studies.
In total, 667 studies were identified; 629 were excluded on title and abstract review. With duplicates removed, twenty-seven studies remained for full text review. Fourteen were rejected as irrelevant. Thirteen papers were subjected to a quality review using an adaptation of the COREQ 32 item checklist. The final review included eight studies of acceptable quality. Data relevant to the review purpose were extracted using a standardised form and subjected to content analysis. The final interpretation of the research phenomenon was constructed using an iterative process of comparison and contrast of emergent concepts within and across studies.
Findings demonstrated the ongoing importance of spirituality to people with dementia and its importance as a means of finding hope, meaning and linkage with past, present and future. Expression of spirituality via faith practices, contact with faith communities, and the impact of dementia on these, were also highlighted.
The review supports the need for nurses to understand the importance of spiritual awareness and practice in dementia. It further suggests a need for nurses to place spiritual assessment and the enabling of spiritual expression as important nursing actions if person-centred dementia care is to be realised.