Schneider Catherine E, Bristol Alycia, Ford Ariel, Lin Shih-Yin, Palmieri Joyce, Meier Martina R, Brody Abraham A
Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA.
Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing, New York, New York, USA.
J Pain Symptom Manage. 2020 Aug;60(2):e7-e13. doi: 10.1016/j.jpainsymman.2020.05.010. Epub 2020 May 15.
As the aging population grows, the incidence of dementia continues to increase substantially. However, the lack of a significant geriatric health care workforce as well as little dementia training among generalist health care workers leads to suboptimal care for persons living with dementia (PLWD). In particular, few evidence-based interventions exist to improve the quality of dementia care among hospice interdisciplinary teams caring for PLWD. Aliviado Dementia Care-Hospice Edition is a quality assurance and performance improvement program that includes training, mentoring, and workflow enhancements, which aims to improve quality of hospice care provided to PLWD and their caregivers.
To determine the effectiveness of the Aliviado Dementia Care program in increasing dementia symptom knowledge of hospice interdisciplinary team members.
About 53 hospice team members from two diverse hospices, consisting of social workers, chaplains, physicians, and nurses, participated in the Aliviado training program. In this prepost trial, 39 participants completed the Dementia Symptom Knowledge Assessment before and after completion of the program.
Paired t-tests showed significant differences before and after Aliviado training in depression knowledge and confidence, as well as behavioral and psychological symptoms of dementia (BPSD) knowledge, confidence, and interventions. The greatest percent change increases were in depression (15.2%) and BPSD (13.3%) confidence as well as BPSD interventions (18.4%). Qualitative feedback consistently emphasized that trainees could now effectively assess their patients for specific symptoms such as pain and agitation.
Aliviado is an evidence-based system-level intervention that improves clinical knowledge, attitudes, and confidence in treating PLWD enrolled in hospice.
随着人口老龄化加剧,痴呆症的发病率持续大幅上升。然而,老年保健劳动力严重短缺,且全科医护人员接受的痴呆症培训较少,导致痴呆症患者的护理质量欠佳。特别是,在照顾痴呆症患者的临终关怀跨学科团队中,几乎没有基于证据的干预措施来提高痴呆症护理质量。Aliviado痴呆症护理 - 临终关怀版是一项质量保证和绩效改进计划,包括培训、指导和工作流程优化,旨在提高为痴呆症患者及其护理人员提供的临终关怀质量。
确定Aliviado痴呆症护理计划在增加临终关怀跨学科团队成员痴呆症状知识方面的有效性。
来自两家不同临终关怀机构的约53名团队成员,包括社会工作者、牧师、医生和护士,参加了Aliviado培训计划。在这项前后测试验中,39名参与者在计划完成前后完成了痴呆症状知识评估。
配对t检验显示,Aliviado培训前后在抑郁知识和信心、以及痴呆的行为和心理症状(BPSD)知识、信心和干预措施方面存在显著差异。变化百分比增加最大的是抑郁(15.2%)和BPSD(13.3%)信心以及BPSD干预措施(18.4%)。定性反馈一致强调,学员现在能够有效地评估患者是否存在疼痛和躁动等特定症状。
Aliviado是一种基于证据的系统级干预措施,可提高对临终关怀中痴呆症患者进行治疗的临床知识、态度和信心。