School of Health and Human Sciences, Southern Cross University, Hogbin Dr, Coffs Harbour, NSW, 2450, Australia.
School of Health and Human Sciences, Southern Cross University, Southern Cross Dr, Bilinga, QLD, 4225, Australia.
Arch Gerontol Geriatr. 2018 Jul-Aug;77:24-30. doi: 10.1016/j.archger.2018.03.013. Epub 2018 Mar 27.
Given the social burden and significant cost of dementia care in Australia, finding evidence-based approaches that improve outcomes, maintain independence, and reduce the impact on patients and families is essential. Finding effective ways to train and assist the healthcare staff who support these individuals is also critical, as they are considered to be at risk of workplace stress, burnout, and other psychological disturbances which negatively affects standards of care. The current paper describes a protocol for evaluating the effects of a Montessori-based approach to dementia care, in non-residential respite centres. An 18 month prospective observational, cohort controlled design is suggested that will compare participants from a community respite service that has undergone a Montessori-based workplace culture change and those from a service that provides a person-centred 'care as usual' approach. To achieve this, the protocol includes the assessment of participants across multiple variables on a monthly basis including the cognitive, behavioural, and emotional functioning of clients with dementia, levels of caregiver burden experienced by informal carers, and burnout, compassion satisfaction and workplace engagement among respite staff. The protocol also employs a qualitative evaluation of program fidelity. This approach will provide further insight into the potential benefits of early intervention with Montessori approaches for persons living with dementia in the community, their caregivers, and the staff and volunteers who assist them.
鉴于痴呆症护理在澳大利亚带来的社会负担和巨大成本，寻找基于证据的方法来改善结果、保持独立性并减轻患者和家庭的影响至关重要。找到培训和协助支持这些人的医疗保健人员的有效方法也很关键，因为他们被认为面临工作场所压力、倦怠和其他心理障碍的风险，这些障碍会对护理标准产生负面影响。本文介绍了一种在非居住式暂托中心评估基于蒙台梭利的痴呆症护理方法效果的方案。建议采用为期 18 个月的前瞻性观察性队列对照设计，将经历基于蒙台梭利的工作场所文化变革的社区暂托服务的参与者与提供以患者为中心的“常规护理”方法的服务的参与者进行比较。为了实现这一目标，该方案包括每月对多个变量进行评估，包括痴呆症患者的认知、行为和情绪功能、非正式照顾者经历的照顾者负担水平以及暂托工作人员的倦怠、同情满足和工作场所参与度。该方案还采用了对计划保真度的定性评估。这种方法将进一步深入了解蒙台梭利方法对社区中患有痴呆症的人、他们的照顾者以及帮助他们的工作人员和志愿者的早期干预的潜在益处。
