Ito Kumiko, Kawai Hisashi, Nishida Kazumasa, Ejiri Manami, Obuchi Shuichi
Tokyo Metropolitan Institute of Gerontology.
Institute for Health Economics and Policy.
Nihon Koshu Eisei Zasshi. 2023 May 26;70(5):311-320. doi: 10.11236/jph.22-083. Epub 2023 Mar 10.
Objectives As the birthrate declines and the population ages, increase in the number of older adults certified as requiring long-term care and shortage of care staff are important issues to be considered. This study developed a sub-staff training program that trains community residents as sub-staff (paid auxiliary staff who possess knowledge and skills in care prevention and confidentiality) to provide care for enhancing independence of older adults with the support of staff in day-care facilities. The study also examined the program's feasibility and key factors, through the introduction of practical examples and surveys, for implementation in care prevention projects of local governments.Methods The four-month training program included lectures on care prevention and provided job training to ensure participants understood the goals and contents of the care plan and learnt to provide care services with the assistance of facility staff. The training program was conducted at 14 facilities in Tokyo and Chiba from 2015 to 2017. The evaluation focused on the completion rate, change in understanding of care prevention and confidence regarding activities at the facility and in the community, participation in community activities after program completion, the psychological impact on care service recipients, and the perception of workload reduction by the facility staff.Results A total of 96 out of 104 participants completed the training program (completion rate of 92.3%). The survey results showed that participants' confidence in activities at the facilities and understanding of care prevention increased significantly; 65.3% participated in new community activities after program completion, including activities at the facilities. The results of the survey of care service recipients showed that negative psychological effects did not increase among those who received care services from the participants compared to those who did not receive care from participants. Among the facility staff, 85.7% indicated that their workload had reduced after the community residents' participation in care services.Conclusion The training program improved participants' confidence in care-related activities and their understanding of care prevention. More than half of them engaged in new community activities afterwards. Participants' provision of care services had a less negative impact on the service recipients and led to a reduction in workload for the facility staff. These results suggest high feasibility of the training program for care prevention projects.
目标 随着出生率下降和人口老龄化，经认证需要长期护理的老年人数量增加以及护理人员短缺成为需要考虑的重要问题。本研究开发了一个辅助人员培训项目，该项目将社区居民培训为辅助人员（具备预防护理和保密知识与技能的带薪辅助工作人员），以便在日间护理设施工作人员的支持下为增强老年人的独立性提供护理服务。该研究还通过引入实际案例和调查，考察了该项目在地方政府预防护理项目中实施的可行性和关键因素。
方法 为期四个月的培训项目包括预防护理讲座，并提供在职培训，以确保参与者理解护理计划的目标和内容，并学会在设施工作人员的协助下提供护理服务。该培训项目于2015年至2017年在东京和千叶的14个设施中开展。评估重点包括完成率、对预防护理的理解变化、对设施及社区活动的信心、项目完成后参与社区活动的情况、对护理服务接受者的心理影响以及设施工作人员对工作量减少的认知。
结果 104名参与者中有96人完成了培训项目（完成率为92.3%）。调查结果显示，参与者对设施活动的信心和对预防护理的理解显著提高；65.3%的参与者在项目完成后参与了新的社区活动，包括设施内的活动。护理服务接受者的调查结果显示，与未接受参与者护理服务的人相比，接受参与者护理服务的人负面心理影响并未增加。在设施工作人员中，85.7%表示社区居民参与护理服务后他们的工作量有所减少。
结论 该培训项目提高了参与者对护理相关活动的信心以及对预防护理的理解。超过半数的参与者随后参与了新的社区活动。参与者提供护理服务对服务接受者的负面影响较小，并减少了设施工作人员的工作量。这些结果表明该培训项目在预防护理项目中具有很高的可行性。
