van Weert Julia C M, van Dulmen Alexandra M, Spreeuwenberg Peter M M, Ribbe Miel W, Bensing Jozien M
NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.
Patient Educ Couns. 2005 Sep;58(3):312-26. doi: 10.1016/j.pec.2004.07.013.
OBJECTIVE: To investigate the effectiveness of snoezelen, integrated in 24-hour care, on the communication of Certified Nursing Assistants (CNAs) and demented nursing home residents during morning care. METHODS: A quasi-experimental pre- and post-test design was conducted, comparing sic psychogeriatric wards, that implemented snoezelen, to six control wards, that continued in giving usual care. Measurements were performed at baseline and 18 months after a training 'snoezelen for caregivers'. Independent assessors analysed 250 video-recordings directly from the computer, using an adapted version of the Roter Interaction Analysis System (RIAS) and non-verbal measurements. RESULTS: Trained CNAs showed a significant increase of resident-directed gaze, affective touch and smiling. The total number of verbal utterances also increased (more social conversation, agreement, talking about sensory stimuli, information and autonomy). Regarding residents, a significant treatment effect was found for smiling, CNA-directed gaze, negative verbal behaviours (less disapproval and anger) and verbal expressed autonomy. CONCLUSION: The implementation of snoezelen improved the actual communication during morning care. PRACTICE IMPLICATIONS: Teaching CNAs to provide snoezelen has added value for the quality of care. Morning care by trained CNAs appeared to take more time. This suggests that (some) time investment might be required to achieve positive effects on CNA- resident communication.
目的:探讨将多感官刺激疗法融入24小时护理中,对护理助理与痴呆症养老院居民在晨间护理期间沟通的有效性。 方法:采用准实验前后测试设计,将实施多感官刺激疗法的6个老年精神科病房与继续提供常规护理的6个对照病房进行比较。在“护理人员多感官刺激疗法培训”的基线和18个月后进行测量。独立评估人员使用改良版的罗特互动分析系统(RIAS)和非语言测量方法,直接从电脑上分析250段视频记录。 结果:经过培训的护理助理对居民的注视、情感触摸和微笑显著增加。言语表达的总数也有所增加(更多的社交对话、认同、谈论感官刺激、信息和自主性)。对于居民而言,在微笑、对护理助理的注视、负面言语行为(更少的不赞同和愤怒)以及言语表达的自主性方面发现了显著的治疗效果。 结论:多感官刺激疗法的实施改善了晨间护理期间的实际沟通。 实践意义:教导护理助理提供多感官刺激疗法对护理质量具有附加价值。经过培训的护理助理进行晨间护理似乎需要更多时间。这表明可能需要(投入一些)时间来对护理助理与居民的沟通产生积极影响。
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