以患者为中心的痴呆症护理培训方案对医院工作人员态度、角色效能和照顾痴呆症患者的认知的影响:一项重复测量研究。

Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study.

机构信息

School of Health and Communities Studies, Faculty of Health and Social Sciences, Leeds Beckett University, UK.

School of Dementia Studies, Faculty of Health Studies, University of Bradford, UK.

出版信息

Int J Nurs Stud. 2016 Jan;53:144-51. doi: 10.1016/j.ijnurstu.2015.09.009. Epub 2015 Sep 25.

Abstract

BACKGROUND

People with dementia occupy up to one quarter of acute hospital beds. However, the quality of care delivered to this patient group is of national concern. Staff working in acute hospitals report lack of knowledge, skills and confidence in caring for people with dementia. There is limited evidence about the most effective approaches to supporting acute hospital staff to deliver more person-centred care.

OBJECTIVES

This study aimed to evaluate the efficacy of a specialist training programme for acute hospital staff regarding improving attitudes, satisfaction and feelings of caring efficacy, in provision of care to people with dementia.

DESIGN

A repeated measures design, with measures completed immediately prior to commencing training (T1), after completion of Foundation level training (T2: 4-6 weeks post-baseline), and following Intermediate level training (T3: 3-4 months post-baseline).

SETTING

One NHS Trust in the North of England, UK.

PARTICIPANTS

40 acute hospital staff working in clinical roles, the majority of whom (90%) were nurses.

METHODS

All participants received the 3.5 day Person-centred Care Training for Acute Hospitals (PCTAH) programme, comprised of two levels, Foundation (0.5 day) and Intermediate (3 days), delivered over a 3-4 months period. Staff demographics and previous exposure to dementia training were collected via a questionnaire. Staff attitudes were measured using the Approaches to Dementia Questionnaire (ADQ), satisfaction in caring for people with dementia was captured using the Staff Experiences of Working with Demented Residents questionnaire (SEWDR) and perceived caring efficacy was measured using the Caring Efficacy Scale (CES).

RESULTS

The training programme was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline. A significant positive effect was found on the ADQ between baseline and after completion of Foundation level training, but not for either of the other measures.

CONCLUSIONS

Training acute hospital staff in Intermediate level person-centred dementia care is effective in producing significant improvements in attitudes towards and satisfaction in caring for people with dementia and feelings of caring efficacy. Foundation level training is effective in changing attitudes but does not seem to be sufficient to bring about change in satisfaction or caring efficacy.

摘要

背景

痴呆症患者占急性医院病床的四分之一。然而,人们对这一患者群体的护理质量表示担忧。在急性医院工作的医护人员报告称,他们缺乏护理痴呆症患者的知识、技能和信心。目前,支持急性医院工作人员提供更以患者为中心的护理的最有效方法的证据有限。

目的

本研究旨在评估针对急性医院工作人员的专业培训计划在改善提供痴呆症患者护理的态度、满意度和护理效能感方面的效果。

设计

重复测量设计,在开始培训前(T1)、完成基础水平培训后(T2:基线后 4-6 周)和完成中级水平培训后(T3:基线后 3-4 个月)进行测量。

地点

英国英格兰北部的一个 NHS 信托机构。

参与者

40 名从事临床工作的急性医院工作人员,其中大多数(90%)是护士。

方法

所有参与者都接受了为期 3.5 天的以患者为中心的急性医院护理培训(PCTAH)计划,该计划由基础(0.5 天)和中级(3 天)两个水平组成,在 3-4 个月内完成。工作人员的人口统计学数据和以前接受痴呆症培训的情况通过问卷收集。使用态度评估痴呆症问卷(ADQ)衡量工作人员的态度,使用照顾痴呆症居民的工作人员体验问卷(SEWDR)衡量对照顾痴呆症患者的满意度,使用护理效能感量表(CES)衡量感知护理效能感。

结果

与基线相比,中级培训后,所有三种结果衡量标准在培训计划后都显示出了显著的积极变化。在基础水平培训后与基线之间,ADQ 上出现了显著的积极影响,但其他两个衡量标准没有。

结论

在中级水平的以患者为中心的痴呆症护理方面对急性医院工作人员进行培训,可以有效改善对痴呆症患者的护理态度和满意度以及护理效能感。基础水平的培训可以改变态度,但似乎不足以带来满意度或护理效能感的改变。

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