Moyle Wendy, Venturato Lorraine, Cooke Marie, Murfield Jenny, Griffiths Susan, Hughes Julian, Wolf Nathan
School of Nursing & Midwifery,Centre for Health Practice Innovation,Menzies Health Institute Queensland,Griffith University,Nathan,Brisbane,Queensland,Australia.
Faculty of Nursing,University of Calgary,Calgary,Canada.
Int Psychogeriatr. 2016 Jul;28(7):1091-100. doi: 10.1017/S1041610216000296. Epub 2016 Mar 10.
This 12 month, Australian study sought to compare the Capabilities Model of Dementia Care (CMDC) with usual long-term care (LTC), in terms of (1) the effectiveness of the CMDC in assisting care staff to improve Quality Of Life (QOL) for older people with dementia; and (2) whether implementation of the CMDC improved staff attitudes towards, and experiences of working and caring for the person with dementia.
A single blind, non-randomized controlled trial design, involving CMDC intervention group (three facilities) and a comparison usual LTC practice control group (one facility), was conducted from August 2010 to September 2011. Eighty-one staff members and 48 family members of a person with dementia were recruited from these four LTC facilities. At baseline, 6 and 12 months, staff completed a modified Staff Experiences of Working with Demented Residents questionnaire (SEWDR), and families completed the Quality of Life - Alzheimer's Disease questionnaire (QOL-AD).
LTC staff in the usual care group reported significantly lower SEWDR scores (i.e. less work satisfaction) than those in the CMDC intervention group at 12 months (p = 0.005). Similarly, family members in the comparison group reported significantly lower levels of perceived QOL for their relative with dementia (QOL-AD scores) than their counterparts in the CMDC intervention group at 12 months (p = 0.012).
Although the study has a number of limitations the CMDC appears to be an effective model of dementia care - more so than usual LTC practice. The CMDC requires further evaluation with participants from a diverse range of LTC facilities and stages of cognitive impairment.
这项为期12个月的澳大利亚研究旨在比较痴呆症护理能力模型(CMDC)与常规长期护理(LTC),具体涉及以下方面:(1)CMDC在协助护理人员提高痴呆症老年人生活质量(QOL)方面的有效性;(2)CMDC的实施是否改善了工作人员对痴呆症患者的态度以及工作和护理体验。
2010年8月至2011年9月进行了一项单盲、非随机对照试验设计,涉及CMDC干预组(三个机构)和常规LTC实践对照组(一个机构)。从这四个长期护理机构招募了81名工作人员和48名痴呆症患者的家庭成员。在基线、6个月和12个月时,工作人员完成了一份修改后的《与痴呆症居民工作的工作人员体验问卷》(SEWDR),家庭成员完成了《阿尔茨海默病生活质量问卷》(QOL-AD)。
在12个月时,常规护理组的长期护理工作人员报告的SEWDR分数显著低于CMDC干预组(即工作满意度较低)(p = 0.005)。同样,在12个月时,对照组的家庭成员报告其痴呆症亲属的感知生活质量水平(QOL-AD分数)显著低于CMDC干预组的对应人员(p = 0.012)。
尽管该研究存在一些局限性,但CMDC似乎是一种有效的痴呆症护理模式——比常规LTC实践更有效。CMDC需要对来自不同类型长期护理机构和认知障碍阶段的参与者进行进一步评估。