Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA.
Chicago Medical School - Rosalind Franklin University, 3333 Green Bay Road, North Chicago, IL, 60064, USA.
BMC Med Educ. 2022 Jun 28;22(1):506. doi: 10.1186/s12909-022-03430-7.
Individuals with advanced Parkinson's Disease (PD) and Parkinson-related disorders (PRD) are frequently referred for home allied therapies and nursing care, yet home healthcare professionals have limited training in PD/PRD. While recognizing the need for such care, patients and families report home healthcare professionals are unfamiliar with these conditions, which may be driven by neurophobia and may contribute to suboptimal care and early termination of services. We sought to determine the feasibility and effects of a virtual, multimodal educational intervention on PD knowledge, confidence, and empathy among home health professionals.
Home health nurses, occupational therapists, physical therapists and physical therapy assistants, and speech-language pathologists participated in a daylong, virtual symposium on advanced PD/PRD, combining focused lectures, discipline-specific breakout sessions, immersive virtual reality vignettes, and interactive panels with both patients and families, and movement disorders and home healthcare experts. Participants completed online pre- and post-symposium surveys including: demographics; PD/PRD knowledge (0-10 points possible); empathy (Interpersonal Reactivity Index); and 10-point scales of confidence with and attitudes towards individuals with PD/PRD, respectively. Pre-post intervention changes and effect sizes were evaluated with paired t-tests and Cohen's d. We performed qualitative analyses of post-symposium free-text feedback using a grounded theory approach to identify participants' intentions to change their practice.
Participants had a mean improvement of 3.1 points on the PD/PRD knowledge test (p < 0.001, d = 1.97), and improvement in confidence managing individuals with PD/PRD (p = 0.0003, d = .36), and no change in empathy. The interactive, virtual format was rated as effective by 95%. Common themes regarding symposium-motivated practice change included: interdisciplinary collaboration; greater involvement and weighting of the patient and caregiver voice in care plans; attention to visit scheduling in relation to patient function; recognition and practical management of the causes of sudden change in PD/PRD, including infections and orthostatic hypotension.
A virtual, multimodal, brief educational pilot intervention improved PD/PRD-specific knowledge and confidence among home healthcare nurses and allied health professionals. Future studies are necessary to test the short- and long-term effects of this intervention more broadly and to investigate the impact of this education on patient and caregiver outcomes.
患有晚期帕金森病（PD）和与帕金森相关疾病（PRD）的患者经常被转介接受家庭联合治疗和护理，但家庭保健专业人员对 PD/PRD 的培训有限。尽管认识到这种护理的必要性，但患者和家属报告称，家庭保健专业人员对这些疾病不熟悉，这可能是由神经恐惧症驱动的，可能导致护理不佳和服务提前终止。我们旨在确定一种虚拟的、多模式的教育干预措施对家庭保健专业人员 PD 知识、信心和同理心的可行性和效果。
家庭保健护士、职业治疗师、物理治疗师和物理治疗助理以及言语治疗师参加了为期一天的高级 PD/PRD 虚拟研讨会，该研讨会结合了重点讲座、特定学科的分组会议、沉浸式虚拟现实小插曲以及与患者和家属以及运动障碍和家庭保健专家的互动小组。参与者完成了在线会前和会后调查，包括：人口统计学；PD/PRD 知识（0-10 分）；同理心（人际反应指数）；以及对 PD/PRD 患者的信心和态度的 10 分制量表。使用配对 t 检验和 Cohen's d 评估干预前后的变化和效果大小。我们使用扎根理论方法对会后自由文本反馈进行了定性分析，以确定参与者改变实践的意图。
PD/PRD 知识测试的参与者平均提高了 3.1 分（p<0.001，d=1.97），管理 PD/PRD 患者的信心提高（p=0.0003，d=0.36），同理心没有变化。95%的人认为互动式虚拟格式有效。与研讨会激发的实践变化相关的常见主题包括：跨学科合作；更多地参与和重视患者和照顾者在护理计划中的声音；关注与患者功能相关的就诊时间安排；认识和实际管理 PD/PRD 突然变化的原因，包括感染和直立性低血压。
虚拟的、多模式的、简短的教育试点干预措施提高了家庭保健护士和联合保健专业人员的 PD/PRD 特定知识和信心。需要进一步的研究来更广泛地测试这种干预措施的短期和长期效果，并研究这种教育对患者和照顾者结果的影响。
