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综合评价与老年痴呆症医护人员培训项目在综合医院环境中的有效性:霍尔顿三级模式应用的叙述性综合分析

Evaluation and Effectiveness of Dementia Staff Training Programs in General Hospital Settings: A Narrative Synthesis with Holton's Three-Level Model Applied.

机构信息

Network Aging Research, Heidelberg University, Heidelberg, Germany.

School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

J Alzheimers Dis. 2020;78(3):1089-1108. doi: 10.3233/JAD-200741.

Abstract

BACKGROUND

People with Dementia (PwD) are frequently admitted to hospital settings. The lack of proper dementia knowledge, poor communication skills, negative attitudes toward dementia, and lack of confidence affects the quality of care, thus development of dementia trainings has increased. Nevertheless, literature regarding the effectiveness of training implementation is limited.

OBJECTIVE

The aim of this narrative synthesis is to 1) identify the characteristics of training programs and 2) explore the effectiveness of these training programs in everyday clinical practice.

METHODS

A systematic search in PubMed, PsycINFO, CINAHL, and Cochrane was conducted, including qualitative and quantitative peer-reviewed studies. Holton's evaluation model with its three outcome levels (learning, individual performance, and organizational results) was adopted. 14 studies were included.

RESULTS

The synthesis of the results was divided into two parts: 1) to describe the characteristics and content of trainings 2) to evaluate the effectiveness of training programs according to the three outcome levels of Holton's model, taking into consideration its construct domains: ability, motivation, and environment. Learning outcomes were assessed in all selected studies: 13 studies observed changes in individual performance, four studies reported changes within the organizational level, and only five showed sustainable changes over time.

CONCLUSION

Person-centered care (PCC) approaches, interactive and varied teaching methods, supporting conditions like champions, action plans, and setting care policies, are all characteristics of effective trainings. Successful programs should be sustainable over time, demonstrating positive outcomes across the organization. Based on current findings, there is a lack of adequate evaluation with regard to training programs on the organizational level.

摘要

背景

痴呆症患者(PwD)经常被收治住院。由于缺乏适当的痴呆症知识、沟通技巧不佳、对痴呆症的负面态度以及缺乏信心,这影响了护理质量,因此增加了痴呆症培训。然而,有关培训实施效果的文献有限。

目的

本叙述性综述旨在:1)确定培训计划的特点,2)探索这些培训计划在日常临床实践中的效果。

方法

对 PubMed、PsycINFO、CINAHL 和 Cochrane 进行了系统检索,包括定性和定量同行评审研究。采用 Holton 评估模型及其三个结果水平(学习、个人绩效和组织结果)。共纳入 14 项研究。

结果

结果综合分为两部分:1)描述培训的特点和内容,2)根据 Holton 模型的三个结果水平评估培训计划的效果,同时考虑其构建领域:能力、动机和环境。所有入选研究均评估了学习结果:13 项研究观察到个人绩效的变化,4 项研究报告了组织层面的变化,只有 5 项研究显示出随时间的可持续变化。

结论

以患者为中心的护理(PCC)方法、互动和多样化的教学方法、支持条件如拥护者、行动计划和制定护理政策,都是有效的培训特点。成功的项目应该具有可持续性,在整个组织中展现积极的成果。根据目前的研究结果,关于组织层面的培训计划,评估工作不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/166e/7739966/eeb5a5691c4a/jad-78-jad200741-g001.jpg

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