Chang Chia-Chi, Lin Li-Chan
School of Nursing, China Medical University, Taichung, Taiwan.
J Clin Nurs. 2005 Nov;14(10):1185-92. doi: 10.1111/j.1365-2702.2005.01240.x.
The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty.
Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care.
A quasi-experimental study was conducted. Two convenience-chosen dementia-specialized long-term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty-seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in-service classes and one hour of hands-on training, whereas the control group did not receive any training.
The treatment group had significantly more knowledge (F = 47.7, P < 0.001), more positive attitude (F = 15.75, P = 0.001) and better behaviours (t = 6.0, P < 0.001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2.7, P < 0.05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2.1, P < 0.05) than the control group. There was no significant difference on food intake between the two groups (t = 0.8, P = 0.49).
This feeding skills training programme has been found to change nursing assistants' knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients.
This study raises attention regarding on-the-job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.
本研究的目的是为护理助理制定一个全面的喂养技能培训计划，并测试该培训计划对他们的知识、态度和行为的影响，以及对痴呆症患者的结果，包括总进食时间、食物摄入量和喂养困难程度。
痴呆症患者出现喂养问题的可能性很高，这会导致严重的营养不良风险。协助居民进食是护理助理的一项主要任务，他们需要更好的培训以提供足够质量的营养护理。
进行了一项准实验研究。在台湾北部随机选择的两家专门收治痴呆症患者的长期护理机构被随机分为对照组或治疗组。招募了67名护理助理（治疗组：31名；对照组：36名）。在进餐时间观察了20名护理助理和相同数量的痴呆症患者。治疗组参加了一个喂养技能培训计划，包括三小时的在职课程和一小时的实践培训，而对照组没有接受任何培训。
干预后，治疗组在知识方面（F = 47.7，P < 0.001）、态度方面（F = 15.75，P = 0.001）比对照组更积极，行为方面（t = 6.0，P < 0.001）也更好。治疗组的痴呆症患者总进食时间明显更长（t = 2.7，P < 0.05），爱丁堡痴呆症喂养评估得分更高（喂养困难程度更高）（t = 2.1，P < 0.05）。两组之间的食物摄入量没有显著差异（t = 0.8，P = 0.49）。
已发现该喂养技能培训计划改变了护理助理的知识、态度和行为，同时增加了痴呆症患者的进食时间。
本研究引起了对护理助理在职培训的关注。此外，应进一步探讨痴呆症患者的喂养问题以及营养护理。
