VA Capitol Healthcare Network, Mental Illness Research Education and Clinical Center, Baltimore, MD; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI.
J Am Med Dir Assoc. 2019 Jun;20(6):683-688. doi: 10.1016/j.jamda.2019.03.018. Epub 2019 May 2.
Individuals with serious mental illness (SMI; schizophrenia spectrum disorders and affective psychoses) are increasingly aging into older adulthood and are overrepresented in residential long-term care settings. The present study aimed to examine the preparedness of staff in these settings to care for individuals with SMI.
A multidisciplinary US Department of Veterans Affairs (VA) workgroup of professionals with expertise in geriatric mental health collected voluntary feedback via online questionnaire as part of a quality improvement project.
Respondents were mental health providers (N=51) embedded in VA nursing homes called Community Living Centers (CLCs).
The questionnaire contained multiple-choice, Likert-type scale, and open-ended questions regarding the opportunities and challenges associated with caring for Veterans with SMI in CLCs.
Respondents identified a lack of training of front-line staff as a key challenge in providing high-quality care to residents with SMI. Specifically, respondents indicated a need to increase staff knowledge about SMI symptoms and diagnoses, to improve staff communication and interactions with residents with SMI, and to decrease mental illness stigma among staff.
CONCLUSIONS/IMPLICATIONS: The present study revealed significant areas of training need for front-line staff in nursing homes. Many perceived staff training needs overlap with the knowledge and skill set required to provide high-quality dementia care. Integrating training regarding the care of residents with SMI into dementia care training efforts may be a fruitful future direction. Strategies for this and a suggested curriculum are provided.
患有严重精神疾病(SMI;精神分裂症谱系障碍和情感性精神病)的个体正逐渐步入老年期,在居住型长期护理机构中人数过多。本研究旨在检查这些环境中工作人员对 SMI 患者护理的准备情况。
美国退伍军人事务部(VA)的一个多学科工作组由具有老年心理健康专业知识的专业人员组成,作为质量改进项目的一部分,通过在线问卷收集自愿反馈。
受访者是嵌入 VA 养老院(称为社区生活中心,CLC)的心理健康提供者(N=51)。
问卷包含多项选择、李克特量表和开放式问题,涉及在 CLC 中照顾 SMI 退伍军人的相关机会和挑战。
受访者认为,一线工作人员缺乏培训是为 SMI 患者提供高质量护理的主要挑战。具体而言,受访者表示需要增加工作人员对 SMI 症状和诊断的了解,以改善工作人员与 SMI 患者的沟通和互动,并减少工作人员对精神疾病的污名化。
结论/意义:本研究揭示了养老院一线工作人员在培训方面的重大需求。许多人认为工作人员的培训需求与提供高质量痴呆症护理所需的知识和技能相重叠。将针对 SMI 患者护理的培训纳入痴呆症护理培训工作中可能是未来的一个有成效的方向。本文提供了相关策略和建议的课程。