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线上转移:养老院员工在线交流教育变革试验的初步临床研究

Moving Online: A Pilot Clinical Trial of the Changing Talk Online Communication Education for Nursing Home Staff.

机构信息

University of Kansas School of Nursing, Kansas City, USA.

University of Iowa College of Nursing, Iowa City, USA.

出版信息

Gerontologist. 2021 Nov 15;61(8):1338-1345. doi: 10.1093/geront/gnaa210.

Abstract

BACKGROUND AND OBJECTIVES

Staff-resident communication is a critical part of nursing home (NH) care. Reducing elderspeak and increasing person-centered communication has been shown to reduce behavioral symptoms experienced by persons living with dementia. An online version of a successful classroom-based communication-training program that reduced staff elderspeak and resident behavioral symptoms was evaluated. The objective of this study was to establish feasibility and determine the preliminary effects of the online program in preparation for a national pragmatic clinical trial.

RESEARCH DESIGN AND METHODS

Seven NHs were randomized to immediate intervention or wait-list control conditions. The NHs were provided with the web-based training program that staff individually accessed. Primary outcomes were knowledge scores and communication ratings of a video-recorded interaction, using pre- to posttraining comparisons.

RESULTS

Knowledge increased from a mean pretest score of 61.9% (SD = 20.0) to a mean posttest score of 84.6% (SD = 13.5) for the combined group. Knowledge significantly improved between Time 1 and Time 2 for the immediate intervention participants (p < .001), but not for the wait-list control participants (p = .091), and this difference was statistically significant (p < .001). Ability to recognize ineffective, inappropriate, nonperson-centered, and elderspeak communication improved after training (p < .001). The magnitude of improvement in communication recognition was comparable to that of the original classroom format.

DISCUSSION AND IMPLICATIONS

The adapted communication intervention was feasible and improved knowledge and communication. Online instruction can improve access to quality education and is an effective means to improve dementia care by overcoming barriers to in-person training. Clinical Trials Registration Number: NCT03849937.

摘要

背景与目的

员工与居民的交流是养老院(NH)护理的关键部分。减少“长辈式语言”并增加以患者为中心的交流,已被证明可以减少患有痴呆症的患者的行为症状。本研究评估了一种成功的基于课堂的沟通培训计划的在线版本,该计划可减少员工的“长辈式语言”并减轻居民的行为症状。本研究的目的是为全国实用临床试验做准备,确定该在线计划的可行性并确定其初步效果。

研究设计与方法

7 家 NH 被随机分配到立即干预组或候补名单对照组。NH 为员工提供了可在线访问的基于网络的培训计划。主要结果是通过预测试和后测试比较,评估视频记录互动的知识得分和沟通评分。

结果

综合组的知识从平均预测试分数 61.9%(SD=20.0)增加到平均后测试分数 84.6%(SD=13.5)。立即干预组的知识在时间 1 和时间 2 之间有显著提高(p<0.001),而候补名单对照组则没有(p=0.091),且差异具有统计学意义(p<0.001)。培训后,识别无效、不适当、非以患者为中心和“长辈式语言”的能力有所提高(p<0.001)。沟通识别能力的提高幅度与原始课堂形式相当。

讨论与意义

改编后的沟通干预是可行的,并且可以提高知识和沟通水平。在线教学可以改善获得高质量教育的机会,并且是通过克服面对面培训的障碍来改善痴呆症护理的有效手段。临床试验注册号:NCT03849937。

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