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基于以人为本护理的老年痴呆患者跌倒干预项目对护理人员的影响

[Effects of a fall intervention program for elderly patients with dementia based on person-centered care on care staff].

作者信息

Suzuki Mizue, Matsui Youko, Ootaka Etuko, Ichikawa Chieko, Abe Kunihiko, Furuta Yoshie, Naito Tomoyoshi, Kato Mayumi, Taniguchi Yoshimi, Hiramatsu Tomoko, Maruoka Naoko, Kobayashi Sayuri, Rokkaku Ryouko, Seki Yukari, Izumi Kiyoko, Kanamori Masao

机构信息

Faculty of Nursing, Hamamastu University School of Medicine.

Medical Corporation Shiraumekai Agataikeaho-mu.

出版信息

Nihon Ronen Igakkai Zasshi. 2019;56(4):487-497. doi: 10.3143/geriatrics.56.487.

Abstract

AIM

This study aimed to clarify the effects of a fall prevention intervention that focused on the characteristics of falls among elderly patients with dementia and was based on person-centered care in geriatric facilities on care staff.

METHODS

This study was conducted between May 2016 and January 2017, and the subjects were classified into two groups: the intervention group, consisting of members who had participated in a three-month education training program, and the control group, consisting of members who provided the usual care. The study period was nine months divided as follows: training period (three months), fall prevention practice (three months), and follow-up period (three months). The quality of care was measured using the Nursing Quality Indicator for Preventing Falls (NQIPFD), and the assessment scale of health care professionals' recognition of the successful Interdisciplinary Team Approach in Health Care Facilities for the Elderly was also used. In total, the care staff members were evaluated four times: once to obtain baseline values before training, and again after the training period, after the fall prevention practice, and after the follow-up period. The results were analyzed using an analysis of variance (fixed factors = group and time, random factor = subjects, and covariance = years of experience working at the geriatric facility and type of job).

RESULTS

There were 50 care staff subjects in the intervention group and 69 people in the control group. The results of the analysis of variance indicated that there was a significant difference in the NQIPFD between baseline 68.60 (±9.09) and follow-up 70.02 (±9.88) in the intervention group. With regard to the differences by intervention, the effect size of the dementia knowledge scale scores was 0.243 higher than the others, which was significant (p<0.01).

CONCLUSIONS

The results showed that the participation of care staff in a fall intervention program to support elderly patients with dementia based on person-centered care significantly improved the NQIPFD and other measured factors. These findings suggest that the program fostered positive effects among the care staff.

摘要

目的

本研究旨在阐明一项预防跌倒干预措施的效果,该措施聚焦于老年痴呆患者跌倒的特征,并基于老年护理机构中以患者为中心的护理理念,针对护理人员开展。

方法

本研究于2016年5月至2017年1月进行,将研究对象分为两组:干预组,由参加了为期三个月教育培训项目的人员组成;对照组,由提供常规护理的人员组成。研究周期为九个月,划分如下:培训期(三个月)、预防跌倒实践期(三个月)和随访期(三个月)。使用预防跌倒护理质量指标(NQIPFD)来衡量护理质量,同时还使用了老年护理机构中医疗保健专业人员对成功的跨学科团队护理方法的认可评估量表。总共对护理人员进行了四次评估:一次在培训前获取基线值,另外三次分别在培训期后、预防跌倒实践期后和随访期后。使用方差分析(固定因素=组和时间,随机因素=研究对象,协变量=在老年护理机构工作的年限和工作类型)对结果进行分析。

结果

干预组有50名护理人员作为研究对象,对照组有69人。方差分析结果表明,干预组基线时NQIPFD为68.60(±9.09),随访时为70.02(±9.88),存在显著差异。关于干预带来的差异,痴呆知识量表得分的效应量比其他得分高0.243,具有显著性(p<0.01)。

结论

结果表明,护理人员参与基于以患者为中心的护理来支持老年痴呆患者的跌倒干预项目,显著改善了NQIPFD及其他测量因素。这些发现表明该项目在护理人员中产生了积极影响。

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