Research Development, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Psychogeriatrics. 2019 Sep;19(5):440-456. doi: 10.1111/psyg.12422. Epub 2019 Feb 26.
Dementia care staff working in long-term care settings are often exposed to a variety of complex situations that can be emotionally challenging, and a lack of adequate support and limited training opportunities may contribute to high levels of staff turnover in this area. Good-quality training may be beneficial for improving the quality of care provided, and in improving staff confidence and morale. This systematic review aimed to establish how dementia care home staff perceived their own competence and confidence in relation to the care they deliver, whether there are any specific interventions that improve these feelings, and whether feeling more competent and confident impacts on care delivery.
A search of the literature focusing on staff perceptions of competence and confidence identified 14 873 studies. Following the removal of duplicates and papers that did not meet the inclusion criteria, 19 studies were included in the review and subject to quality assessment.
Studies varied in terms of quality and design, and were categorised as either intervention or non-intervention studies. Four studies found a significant increase in feelings of competence and confidence following intervention, although many studies did not statistically analyze their data. The most successful interventions seemed to be those that involved practical support alongside education, and non-intervention studies highlighted the importance of specific dementia and palliative care training with regard to feelings of competence and confidence.
Teaching alone may not be an adequate method of training dementia care staff, and the most successful interventions were those where practical support was also provided. Most studies suggested that improvements in competence and confidence also had benefits for care delivery and staff wellbeing. More research needs to be done using validated outcome measures and with competence and confidence as the primary aim.
长期护理机构中的痴呆症护理人员经常面临各种复杂情况，这些情况可能会带来情感上的挑战，而缺乏足够的支持和有限的培训机会可能导致该领域的员工流动率很高。高质量的培训可能有助于提高护理质量，并提高员工的信心和士气。本系统评价旨在确定痴呆症护理院工作人员如何看待自己在提供护理方面的能力和信心，是否有任何特定的干预措施可以改善这些感觉，以及感觉更有能力和信心是否会影响护理服务。
对重点关注工作人员对能力和信心的看法的文献进行了搜索，共确定了 14873 项研究。在去除重复项和不符合纳入标准的论文后，有 19 项研究被纳入了综述，并进行了质量评估。
研究在质量和设计方面存在差异，分为干预研究和非干预研究。四项研究发现干预后能力和信心显著增强，尽管许多研究没有对其数据进行统计学分析。最成功的干预措施似乎是那些同时提供实践支持和教育的措施，而非干预研究强调了针对痴呆症和姑息治疗的特定培训对能力和信心的重要性。
仅教学可能不是培训痴呆症护理人员的充分方法，最成功的干预措施是提供实际支持的干预措施。大多数研究表明，能力和信心的提高也有益于护理服务和员工的幸福感。需要使用经过验证的结果衡量标准，并以能力和信心为主要目标进行更多的研究。
