Centre for Dementia Research, Leeds Beckett University, Leeds, UK.
Centre for Applied Dementia Studies, University of Bradford, Bradford, UK.
Aging Ment Health. 2020 Mar;24(3):511-521. doi: 10.1080/13607863.2018.1531382. Epub 2018 Dec 29.
People with dementia occupy around one quarter of general hospital beds, with concerns consistently raised about care quality. Improving workforce knowledge, skills and attitudes is a mechanism for addressing this. However little is known about effective ways of training healthcare staff about dementia. This study aimed to understand models of dementia training most likely to lead to improved practice and better care experiences for people with dementia, and to understand barriers and facilitators to implementation. A collective case study was conducted in three National Health Service Acute Hospital Trusts in England. Multiple data sources were used including interviews with training leads/facilitators, ward managers and staff who had attended training; satisfaction surveys with patients with dementia and/or carers; and observations of care using Dementia Care Mapping. Interactive face-to-face training designed for general hospital staff was valued. Simulation and experiential learning methods were felt to be beneficial by some staff and stressful and distressing by others. Skilled delivery by an experienced and enthusiastic facilitator was identified as important. Staff identified learning and practice changes made following their training. However, observations revealed not all staff had the knowledge, attitudes and skills needed to deliver good care. Patient and carer satisfaction with care was mixed. A major barrier to training implementation was lack of resources. Supportive managers, organisational culture and strong leadership were key facilitators. Dementia training can lead to improved care practices. There are a range of key barriers and facilitators to implementation that must be considered.
痴呆患者占据了综合医院约四分之一的床位，人们一直对其护理质量表示担忧。提高工作人员的知识、技能和态度是解决这一问题的一种机制。然而，对于培训医疗保健人员了解痴呆症的有效方法却知之甚少。本研究旨在了解最有可能导致改善实践和改善痴呆患者护理体验的痴呆培训模式，并了解实施的障碍和促进因素。在英格兰的三个国民保健服务急性医院信托基金中进行了一项集体案例研究。使用了多种数据源，包括与培训负责人/促进者、病房经理和参加培训的工作人员的访谈；对痴呆症患者和/或照顾者的满意度调查；以及使用痴呆症护理映射进行护理观察。专为综合医院工作人员设计的互动式面对面培训受到重视。一些员工认为模拟和体验式学习方法是有益的，而另一些员工则认为这些方法有压力和令人痛苦。经验丰富且热情的促进者的熟练交付被认为是重要的。工作人员确定了在接受培训后所做的学习和实践改变。然而，观察结果显示，并非所有员工都具备提供优质护理所需的知识、态度和技能。患者和照顾者对护理的满意度参差不齐。培训实施的主要障碍是资源缺乏。支持性的经理、组织文化和强有力的领导是关键的促进因素。痴呆症培训可以改善护理实践。实施过程中存在一系列关键的障碍和促进因素，必须加以考虑。
