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医院工作人员在将温和劝导方法应用于痴呆症护理方面的经验。

The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care.

作者信息

Hung Lillian, Son Cathy, Hung Rebecca

机构信息

Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.

Simon Fraser University, Vancouver, British Columbia, Canada.

出版信息

J Psychiatr Ment Health Nurs. 2019 Feb;26(1-2):19-28. doi: 10.1111/jpm.12504. Epub 2018 Dec 6.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Although the seminal work of McCormack et al. (International Practice Development Journal, 2015, 5, 1) and Nolan, Davies, Brown, Keady, and Nolan () provides useful conceptual frameworks in person-centred care, research is needed to understand how theoretical concepts can be applied into practice to support dementia care. Also, evidence is needed to demonstrate the impacts of implementing person-centred care and staff experiences. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper adds to the emerging work that is providing a greater understanding of how team education in practice can make a difference in building capacity to improve dementia care. We offer timely evidence and useful insights into how an education programme, Gentle Persuasive Approaches (GPA), was implemented ("what worked" and "how") in a large Canadian hospital to improve knowledge and skills among staff in dementia care. The GPA education helped hospital staff enact person-centred care by cultivating shared values and a learning environment to change attitudes, practices and conditions for continuous practice development. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses in advance practice are well positioned to lead dementia education and advocate for person-centred care in hospitals. Hospital leaders are responsible for providing resources to cultivate a supportive environment for continuous learning to ensure the workforce gains the capacity to meet the changing demands and needs of the ageing population. System support is essential for creating conditions to enable person-centred care. ABSTRACT: Introduction Hospital staff lacks knowledge and skills in dementia care. There is a need to understand how person-centred care theory can be operationalized in staff's practices to improve dementia care. Aims To describe the staff's experiences of learning and applying the Gentle Persuasive Approaches (GPA) to enact person-centred care in a hospital. Methods Mixed methods, including posteducation survey and focus groups, were used. Thematic analysis was conducted to identify themes that describe participants' experiences. Results Three hundred and ten staff and leaders in a hospital participated in the GPA education and completed a posteducation survey (n = 297). After 1 year, two follow-up focus groups were conducted with interdisciplinary staff (n = 24) across medicine and mental health programmes. Our analysis identified three themes to enable person-centred care: (a) changing attitudes, (b) changing practices and (c) changing conditions. Discussion This study contributes to the literature by providing evidence of how an education programme was implemented in a large Canadian hospital to build capacity for dementia care. Joint education for interprofessional staff offers value in enabling person-centred care. Implication Mental health nurses are in position to lead dementia education and advocate for person-centred care in hospitals. Staff need structural support to engage in team learning for practice improvement.

摘要

关于该主题已知的信息有哪些?:尽管麦科马克等人(《国际实践发展杂志》,2015年,第5卷,第1期)以及诺兰、戴维斯、布朗、基迪和诺兰的开创性工作提供了以患者为中心护理的有用概念框架,但仍需要开展研究以了解如何将理论概念应用于实践以支持痴呆症护理。此外,还需要证据来证明实施以患者为中心的护理的影响以及工作人员的体验。

本文对现有知识有何补充?:本文补充了正在兴起的工作,这些工作有助于更深入地理解实践中的团队教育如何在提升痴呆症护理能力方面发挥作用。我们及时提供了证据,并对一个名为“温和劝导方法”(GPA)的教育项目在加拿大一家大型医院的实施方式(“哪些措施有效”以及“如何实施”)提供了有用见解,该项目旨在提高痴呆症护理工作人员的知识和技能。GPA教育通过培养共同价值观和学习环境来改变态度、实践方式以及持续实践发展的条件,从而帮助医院工作人员践行以患者为中心的护理。

对实践有何启示?:高级实践心理健康护士处于有利位置,可在医院中引领痴呆症教育并倡导以患者为中心的护理。医院领导有责任提供资源,营造支持持续学习的环境,以确保工作人员有能力满足老年人群不断变化的需求。系统支持对于创造实现以患者为中心护理的条件至关重要。

摘要

引言 医院工作人员在痴呆症护理方面缺乏知识和技能。有必要了解如何在工作人员的实践中运用以患者为中心的护理理论来改善痴呆症护理。目的 描述工作人员学习并应用“温和劝导方法”(GPA)在医院践行以患者为中心护理的体验。方法 采用混合方法,包括教育后调查和焦点小组访谈。进行主题分析以确定描述参与者体验的主题。结果 一家医院的310名工作人员和领导参与了GPA教育并完成了教育后调查(n = 297)。1年后,对跨医学和心理健康项目的跨学科工作人员(n = 24)进行了两次随访焦点小组访谈。我们的分析确定了实现以患者为中心护理的三个主题:(a)改变态度,(b)改变实践方式,(c)改变条件。讨论 本研究通过提供关于一个教育项目在加拿大一家大型医院如何实施以增强痴呆症护理能力的证据,为文献做出了贡献。跨专业工作人员的联合教育在实现以患者为中心的护理方面具有价值。启示 心理健康护士有能力在医院引领痴呆症教育并倡导以患者为中心的护理。工作人员需要结构支持以参与团队学习来改善实践。

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