Swinburne University of Technology, Hawthorn, Australia.
Deakin University, Burwood, Australia.
J Gerontol Soc Work. 2022 Aug-Sep;65(6):678-689. doi: 10.1080/01634372.2021.2025185. Epub 2022 Jan 12.
Previous studies have demonstrated inconsistency in the effectiveness of staff training programs in consumer directed care (CDC) as a means of enhancing the quality of life (QoL) of residents. The aim of this study was to investigate why this might be the case. We analyzed disaggregated cluster-by-cluster resident QoL outcomes after nursing home staff completed a CDC training program. In total, 33 nursing homes (11 clusters) participated in the study. As with previous studies, the outcomes across nursing homes were inconsistent - QoL improved at some sites but at many it remained stable or declined. Analysis of facilitator notes from the most and least successful clusters indicated that a lack of organizational support, for both the training and subsequent practice of CDC, was potentially the key barrier to effective implementation of training and so improvement in resident QoL. These findings demonstrate that all levels of aged care organizations - on the floor staff, managers and senior staff - need to fully support a CDC model of care to optimize outcomes for residents. Staff require training in CDC as well as long-term culture change within the nursing home so that training can be translated into practice.
先前的研究表明，员工培训计划在消费者导向护理（CDC）方面的效果并不一致，无法有效提升居民的生活质量（QoL）。本研究旨在探讨造成这种情况的原因。我们分析了护理人员完成 CDC 培训计划后，按护理院分组的居民 QoL 结果。共有 33 家护理院（11 个组）参与了这项研究。与先前的研究一样，各护理院的结果并不一致——有些地方的 QoL 有所提高，但在许多地方，其 QoL 保持稳定或下降。对最成功和最不成功的两组的协调员记录进行分析后发现，缺乏对培训和随后实施 CDC 的组织支持，可能是培训有效实施以及居民 QoL 改善的关键障碍。这些发现表明，老年人护理组织的各个层面——包括基层员工、管理人员和高级员工——都需要全面支持 CDC 护理模式，以优化居民的护理效果。员工需要接受 CDC 培训，还需要在护理院内进行长期的文化变革，从而将培训转化为实践。
