Office of Research Administration, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda.
Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
Biomed Res Int. 2022 Mar 23;2022:9443229. doi: 10.1155/2022/9443229. eCollection 2022.
The global need for efficient and cost-effective use of healthcare resources in low-income countries has led to the introduction of lay health workers (LHWs) as a link of the community to healthcare services. As such, the LHWs perform a variety of tasks such as education, support for care delivery, and social support across all disease types. However, little is known about their ability to support dementia care and management in the community.
The goal of the pilot intervention was to evaluate the 5-day training intervention for LHWs in rural southwestern Uganda in community-based care and management of people with dementia, and implementation of the knowledge and skills gained.
This was a "pre" and "post" pilot intervention study which involved a qualitative assessment of LHWs' knowledge on community-based management and care for people with dementia. We focused on four core competency domains in the WHO dementia toolkit. The intervention included a five-day training of the LHWs on dementia care, eight weeks of implementation, and an evaluation of the experiences. Analysis focused on the needs assessment, early detection and management, community engagement, support for people with dementia; and evaluation of the eight weeks implementation.
Before the training, the LHWs did not know much about what dementia-related support to provide in the community. Activities were limited to general support, including nutrition, and health education. After the training, LHWs had a basic understanding of dementia and began sensitizing the communities. They felt more comfortable working with people with dementia and reported a notable change in the attitude of family members. However, they reported challenges in differentiating the signs of early dementia from superstitious beliefs.
With enhanced capacity, LHWs may be able to support community-based management for people with dementia. A larger study is needed to explore potential roles for LHWs and further assess effectiveness of the LHWs' skills.
全球各国都需要在低收入国家实现医疗资源的高效利用和成本效益，这导致了非专业卫生工作者（LHWs）的引入，他们是社区与医疗服务之间的纽带。因此，LHWs 承担着各种任务，例如各种疾病类型的教育、提供护理支持和社会支持。然而，对于他们在社区中支持痴呆症护理和管理的能力，人们知之甚少。
本试点干预的目的是评估对乌干达西南部农村地区的 LHWs 进行为期 5 天的培训干预，以进行基于社区的痴呆症患者护理和管理，并实施所获得的知识和技能。
这是一项“前”和“后”试点干预研究，涉及对 LHWs 关于社区为基础的管理和护理痴呆症患者的知识进行定性评估。我们专注于世界卫生组织痴呆症工具包中的四个核心能力领域。干预措施包括对 LHWs 进行为期五天的痴呆症护理培训、八周的实施以及对经验的评估。分析重点是需求评估、早期发现和管理、社区参与、对痴呆症患者的支持以及对八周实施情况的评估。
在培训之前，LHWs 对在社区中提供哪些与痴呆症相关的支持知之甚少。活动仅限于一般支持，包括营养和健康教育。培训后，LHWs 对痴呆症有了基本的了解，并开始让社区敏感起来。他们在与痴呆症患者合作时感到更加舒适，并报告说家庭成员的态度发生了明显变化。然而，他们报告说在区分早期痴呆症的迹象和迷信信仰方面存在挑战。
随着能力的增强，LHWs 可能能够支持基于社区的痴呆症管理。需要进行更大规模的研究，以探索 LHWs 的潜在作用，并进一步评估 LHWs 技能的有效性。
