Fritsch Thomas, Kwak Jung, Grant Stacey, Lang Josh, Montgomery Rhonda R, Basting Anne D
Center on Age & Community, University of Wisconsin, Milwaukee, Milwaukee, WI 53201, USA.
Gerontologist. 2009 Feb;49(1):117-27. doi: 10.1093/geront/gnp008. Epub 2009 Mar 18.
Creative expression (CE) programs are emerging interventions to improve the quality of care and life of persons with dementia (PWDs) in long-term care settings. However, limited empirical evidence exists to support the effectiveness of these programs. Here, we report the findings from an assessment of the impact of TimeSlips (TS), a group storytelling program that encourages CE among PWDs and those who care for them.
Instruction in TS was provided through a 10-week on-site training. An observational study using an experimental design was conducted in 20 nursing home facilities in 2 states, 10 of which were randomly selected to implement TS. Two weeks after the implementation of TS at the intervention sites, we conducted 4 days of direct observation, using a time-sampling approach, of residents and staff in each facility. Using surveys, we also assessed staff job satisfaction, attitudes toward residents, and burnout.
Compared with residents in the control facilities, those in the TS facilities were more engaged and more alert. In TS facilities, there were more frequent staff-resident interactions, social interactions, and social engagement. Also, staff who participated in the TS program had more positive views of residents with dementia and devalued residents less than did the control group staff. There were no differences in staff job satisfaction and burnout among staff in the TS and non-TS facilities.
Implementing the TS program in nursing facilities improves the care environment for PWDs. However, additional studies are needed to offer further insights into the mechanisms by which TS improves both staff and resident outcomes.
创造性表达(CE)项目是一种新兴的干预措施,旨在改善长期护理机构中痴呆症患者(PWD)的护理质量和生活质量。然而,支持这些项目有效性的实证证据有限。在此,我们报告了对TimeSlips(TS)影响的评估结果,TS是一个鼓励PWD及其护理人员进行创造性表达的小组故事讲述项目。
通过为期10周的现场培训提供TS指导。在两个州的20家养老院设施中进行了一项采用实验设计的观察性研究,其中10家被随机选择实施TS。在干预地点实施TS两周后,我们采用时间抽样方法对每个设施中的居民和工作人员进行了4天的直接观察。我们还通过调查评估了工作人员的工作满意度、对居民的态度以及职业倦怠情况。
与对照设施中的居民相比,TS设施中的居民参与度更高、更警觉。在TS设施中,工作人员与居民之间的互动、社交互动和社会参与更为频繁。此外,参与TS项目的工作人员对痴呆症居民的看法更为积极,对居民的贬低程度低于对照组工作人员。TS设施和非TS设施的工作人员在工作满意度和职业倦怠方面没有差异。
在护理机构中实施TS项目可改善PWD的护理环境。然而,需要进一步的研究来深入了解TS改善工作人员和居民结局的机制。