Cardoso Graça, Papoila Ana, Tomé Gina, Killaspy Helen, King Michael, Caldas-de-Almeida José Miguel
Chronic Diseases Research Centre (CEDOC), NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056, Lisbon, Portugal.
Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
Soc Psychiatry Psychiatr Epidemiol. 2017 Nov;52(11):1435-1445. doi: 10.1007/s00127-017-1416-7. Epub 2017 Jun 30.
This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial.
All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit's manager. Half the units (n = 12) were randomly assigned to continue providing treatment as usual, and half (n = 11) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users' level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users' quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117).
Knowledge acquired by the staff during the initial workshops increased significantly (p ≤ 0.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up.
The intervention increased the level of knowledge of staff without leading to an improvement in service users' engagement in activities, quality of life, or quality of care in the units.
本研究旨在通过一项整群随机对照试验，评估一项员工培训干预措施在提高服务使用者参与活动程度及护理质量方面的效果。
邀请所有每天至少有12小时员工支持的住宿单元（n = 23）参与。护理质量由单元经理在线填写的康复护理质量指标（QuIRC）进行评估。一半的单元（n = 12）被随机分配继续照常提供治疗，另一半（n = 11）接受一项员工培训干预，该干预侧重于让服务使用者参与活动的技能，培训师与员工一起工作，将所学内容融入服务中。主要结局是服务使用者的活动水平（通过时间使用日记测量），在4个月和8个月时重新评估。次要结局是所提供护理的质量（QuIRC）以及服务使用者的生活质量（曼彻斯特生活质量简短评估），在8个月时重新评估。使用广义线性混合效应模型评估两个试验组中各单元结局的差异。该试验已在当前对照试验注册（参考编号NCT02366117）。
员工在初始研讨会上获得的知识显著增加（p≤0.01）。然而，在两次随访中，干预组和对照组在主要和次要结局方面均无显著差异。
该干预提高了员工的知识水平，但并未改善服务使用者在各单元中的活动参与度、生活质量或护理质量。
