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中国养老护理员文化敏感性痴呆症能力教育培训(DECENT)项目效果的准实验研究。

Effect of a culturally sensitive DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in China: A quasi-experimental study.

机构信息

School of Nursing, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing, 210000, Jiangsu Province, China.

Xiangya Nursing School, Central South University, No. 172 Tongzi Slopes Road, Yuelu District, Changsha, 410000, Hunan Province, China.

出版信息

Nurse Educ Today. 2022 Sep;116:105434. doi: 10.1016/j.nedt.2022.105434. Epub 2022 Jun 14.

Abstract

BACKGROUND

Existing educational programmes for building capacity in dementia care are developed in the Western culture; their applicability and cultural relevancy to other cultures is questionable. There is a dearth of culturally specific dementia-care educational programme for Chinese communities.

OBJECTIVES

To evaluate a culturally specific DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in mainland China.

DESIGN

A multi-site quasi-experimental study.

METHODS

Nursing homes were pair-matched and allocated into intervention (n = 5) and control group (n = 5). The DECENT programme was delivered face-to-face using multiple pedagogies for 60-90 min per session by a trained educator once per week over 8 weeks. The primary outcome was the sense of competence in dementia care. The secondary outcomes were dementia knowledge, attitudes towards people with dementia, person-centred care in nursing homes and the severity of behavioral and psychological symptoms of dementia of residents with dementia and staff-perceived disturbance. They were measured at baseline (T0), immediately post-intervention (T1) and 3 months after the intervention (T2).

RESULTS

The intervention group has significantly greater improvement than control group in sense of competence both at T1 (B = 5.24, p < .001) and T2 (B = 4.43, p = .013). Regarding dementia knowledge and person-centred care, intervention group only showed greater improvement than control group at T1 (B = 3.18, p = .001; B = 5.75, p = .018, respectively), but not at T2 (p = .089 and .104, respectively). Group differences in attitudes and severity of behavioral and psychological symptoms of dementia and staff-perceived disturbance were not significant at both time points.

CONCLUSIONS

The DECENT programme is applicable and beneficial in improving staff's sense of competence in dementia care in Chinese communities, but reinforcement strategies are needed to sustain the effect for maintaining the learnt knowledge and changed person-centred care practice.

摘要

背景

现有的痴呆症护理能力建设教育计划是在西方文化中制定的;其在其他文化中的适用性和文化相关性值得怀疑。针对华人社区的文化特异性痴呆症护理教育计划非常匮乏。

目的

评估中国内地一项具有文化特异性的失智症照护能力教育计划(DECENT)。

设计

多地点准实验研究。

方法

养老院以配对方式分为干预组(n=5)和对照组(n=5)。由一名经过培训的教育者以多种教学法,每周一次,每次 60-90 分钟,通过面对面的方式实施 DECENT 计划,共 8 周。主要结局指标是对痴呆症护理的胜任感。次要结局指标包括痴呆症知识、对痴呆症患者的态度、养老院的以患者为中心的护理以及痴呆症患者的行为和心理症状严重程度和员工感知的干扰。这些指标在基线(T0)、干预后即刻(T1)和干预后 3 个月(T2)进行测量。

结果

干预组在 T1(B=5.24,p<.001)和 T2(B=4.43,p=.013)时的胜任感均显著优于对照组。在痴呆症知识和以患者为中心的护理方面,干预组仅在 T1 时优于对照组(B=3.18,p=.001;B=5.75,p=.018),而在 T2 时无显著差异(p=.089 和.104)。在态度、行为和心理症状严重程度以及员工感知干扰方面,两组在两个时间点的差异均无统计学意义。

结论

DECENT 计划在中国社区中适用于提高员工对痴呆症护理的胜任感,并且需要强化策略来维持所学到的知识和改变以患者为中心的护理实践的效果。

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