Communication Sciences and Disorders, University of South Florida, Tampa, FL, USA.
Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI, USA.
J Psychiatr Ment Health Nurs. 2018 Apr;25(3):176-187. doi: 10.1111/jpm.12452. Epub 2018 Feb 8.
Person-centered care, as compared to standard approaches, is a widely accepted, evidence-based approach for managing aggressive behaviour in persons with dementia. The attitudes, beliefs and values of long-term care and mental health nursing employees are important prerequisites to implementing person-centered practices. Research shows that nursing employees typically support person-centered approaches; however, less is known about the attitudes of non-nursing employee groups.
Nurse managers and administrators tended to agree with person-centered approaches for managing aggression in dementia, suggesting some prerequisites are in place to support wider adoption of person-centered frameworks. Employees with more resident contact tended to support person-centered approaches the least, suggesting discipline-specific trainings may not be adequate for preparing frontline staff to use person-centered techniques. Attitudes towards aggressive behaviour may be especially varied and contradictory within certain employee groups, providing implications for facility-wide initiatives.
Person-centered values and practices should be monitored and reinforced across the organization. Person-centered trainings should be interdisciplinary in nature and focused on care areas, such as mealtime or bathing. Long-term care facilities should consider allowing nurse management and registered nurses to share the burden of direct resident care with frontline employees on a more regular basis.
Introduction Implementing person-centered care requires shared attitudes, beliefs and values among all care employees. Existing research has failed to examine the attitudes of non-nursing employees. Aim This study examined attitudes towards aggression among nursing and non-nursing employees to address gaps in existing research and assess readiness for wider adoption of person-centered frameworks. Method The Management of Aggression in People with Dementia Attitude Questionnaire was used to survey attitudes of employees in Michigan-based nursing homes. Results Overall, employees preferred person-centered over standard approaches. Job title was a significant predictor of paradigm support. Frontline employees were found to support person-centered attitudes the least. Wide-ranging responses were noted within employee groups. Discussion Job title may influence the degree to which an employee supports and utilizes person-centered approaches. Employees with the most contact with persons with dementia may be the least likely to implement person-centered approaches. In contrast to prior studies, years of experience was not a significant predictor of attitude towards aggressive behaviour. Wide-ranging responses indicate that employee attitudes are varied and complex. Implications Person-centered approaches should be trained within care areas rather than individual employee groups. Programs should be interdisciplinary and seek to establish a shared understanding of person-centered beliefs and values.
已知信息：与标准方法相比，以患者为中心的护理是一种广泛接受的、基于证据的管理痴呆症患者攻击行为的方法。长期护理和精神健康护理员工的态度、信念和价值观是实施以患者为中心实践的重要前提。研究表明，护理员工通常支持以患者为中心的方法；然而，对于非护理员工群体的态度知之甚少。
新增信息：护士长和管理人员倾向于同意以患者为中心的方法来管理痴呆症中的攻击行为，这表明已经为支持更广泛地采用以患者为中心的框架做好了一些准备。与居民接触较多的员工对以患者为中心的方法支持最少，这表明针对特定学科的培训可能不足以让一线员工准备好使用以患者为中心的技术。在某些员工群体中，对攻击行为的态度可能特别多样化和矛盾，这为整个设施的倡议提供了启示。
实践意义：组织内应该监测和加强以患者为中心的价值观和实践。以患者为中心的培训应该是跨学科的，侧重于护理领域，如用餐或洗澡时间。长期护理机构应考虑允许护士管理和注册护士更经常地与一线员工分担直接居民护理的负担。
摘要：介绍 实施以患者为中心的护理需要所有护理员工共同持有态度、信念和价值观。现有研究尚未考察非护理员工的态度。目的 本研究调查了护理和非护理员工对攻击行为的态度，以弥补现有研究的空白，并评估更广泛地采用以患者为中心框架的准备情况。方法 使用《管理痴呆症患者攻击行为态度问卷》对密歇根州养老院的员工进行了态度调查。结果 总体而言，员工更喜欢以患者为中心的方法而不是标准方法。职称是支持范式的重要预测因素。一线员工发现最不支持以患者为中心的态度。员工群体内部存在广泛的反应。讨论 职称可能会影响员工支持和使用以患者为中心方法的程度。与痴呆症患者接触最多的员工可能最不可能实施以患者为中心的方法。与之前的研究不同，工作年限不是攻击行为态度的重要预测因素。广泛的反应表明员工态度是多样和复杂的。影响 应该在护理领域而不是在个别员工群体中进行以患者为中心的方法培训。计划应该是跨学科的，并寻求建立对以患者为中心的信念和价值观的共同理解。
