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养老院工作人员使用针对神经精神症状评估和治疗的跨学科目标模型(TIME)的体验 - 一项定性研究。

Experiences of nursing home staff using the targeted interdisciplinary model for evaluation and treatment of neuropsychiatric symptoms (TIME) - a qualitative study.

机构信息

a Centre For Old Age Psychiatric Research , Innlandet Hospital Trust , Ottestad , Norway.

b Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway.

出版信息

Aging Ment Health. 2019 Aug;23(8):966-975. doi: 10.1080/13607863.2018.1464116. Epub 2018 Apr 19.

Abstract

Neuropsychiatric symptoms (NPS) in dementia pose great challenges for residents and staff in nursing homes. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) has recently in a randomized controlled trial demonstrated reductions in NPS. We explored the participating staff's experiences with the model and how it meets the challenges when dealing with the complexity of NPS. Three to six months after the end of the intervention, we interviewed 32 of the caregivers, leaders, and physicians participating in the trial, in five focus groups. We used thematic content analysis. The analysis yielded two main themes: (1) a systematic reflection method enhanced learning at work; (2) the structure of the approach helped staff to cope with NPS in residents with dementia. TIME shifts the way of learning for the staff from a traditional to a more innovative and reflection-based learning through a process of learning how to learn at work. The staff's experienced increased coping in their approach to complex problems. Our results emphasise the importance of a structured and biopsychosocial approach to NPS in clinical practice. Future research should explore models for integrating situated learning in daily routines in nursing homes.

摘要

神经精神症状(NPS)在痴呆症患者中给养老院的居民和工作人员带来了巨大的挑战。最近,目标导向的跨学科评估和治疗神经精神症状模型(TIME)在一项随机对照试验中证明可以减少 NPS。我们探讨了参与该模型的工作人员的经验,以及该模型如何应对处理 NPS 复杂性的挑战。在干预结束后 3 至 6 个月,我们在五个焦点小组中采访了参与试验的 32 名护理人员、领导和医生。我们使用了主题内容分析。分析产生了两个主要主题:(1)系统的反思方法增强了工作中的学习;(2)该方法的结构帮助工作人员应对痴呆症患者的 NPS。TIME 通过学习如何在工作中学习的过程,将工作人员的学习方式从传统的学习方式转变为更具创新性和基于反思的学习方式。工作人员在处理复杂问题时的应对能力有所提高。我们的研究结果强调了在临床实践中对 NPS 进行结构化和生物心理社会方法的重要性。未来的研究应该探索在养老院日常工作中整合情境学习的模式。

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