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在养老院的日常护理中实施痴呆症协作指导的可行性

Feasibility of Implementing Dementia Collaborative Coaching into Routine Care in Nursing Homes.

作者信息

Douglas Natalie F, Carpenter Joan, Van Haitsma Kimberly, Abbott Katherine M

机构信息

Department of Communicative Disorders, University of Louisiana, Lafayette, LA, USA.

School of Nursing, University of Maryland, College Park, MD, USA.

出版信息

Clin Gerontol. 2024 Oct 6:1-13. doi: 10.1080/07317115.2024.2411281.

Abstract

OBJECTIVES

The study evaluated the feasibility of implementing Dementia Collaborative Coaching (DCC) into the routine workflow of speech-language pathologists (SLPs) working in nursing homes (NHs). DCC is an intervention delivered by SLPs to train nursing assistants (CNAs) in communication strategies to support people living with dementia (PLWD).

METHODS

We assessed the feasibility of identifying eligible PLWD; estimated intervention fidelity; evaluated suitability of outcome measures; and determined the preliminary impact on behavioral and psychological symptoms of distress (BPSD) among PLWD. SLPs completed a semi-structured interview to collect further acceptability data.

RESULTS

Four SLPs in four NHs completed DCC with 10 CNAs and 15 eligible PLWD that they appropriately identified from their caseloads. SLPs conducted 90 DCC sessions with 64% fidelity and billed Medicare for all sessions. The outcome measure of Minimum Data Set item E0200B: Rejection of Care did not vary enough to be useful, but positive changes were noted on the , t(14) = 10.51,  < .001, Cohen's d = 2.76. Interviews further indicated feasibility.

CONCLUSIONS

It is feasible to implement DCC into the workflow of SLPs in NHs.

CLINICAL IMPLICATIONS

Given the feasibility and preliminary positive impacts, SLPs could consider implementing DCC in routine care.

摘要

目的

本研究评估了将痴呆协作指导(DCC)纳入养老院(NHs)工作的言语治疗师(SLPs)日常工作流程的可行性。DCC是一种由言语治疗师实施的干预措施,用于培训护理助理(CNAs)沟通策略,以支持痴呆症患者(PLWD)。

方法

我们评估了识别符合条件的痴呆症患者的可行性;估计了干预的保真度;评估了结果测量的适用性;并确定了对痴呆症患者痛苦的行为和心理症状(BPSD)的初步影响。言语治疗师完成了一次半结构化访谈,以收集更多的可接受性数据。

结果

四个养老院的四名言语治疗师与10名护理助理和15名符合条件的痴呆症患者完成了DCC,这些患者是他们从自己的病例中适当识别出来的。言语治疗师进行了90次DCC课程,保真度为64%,并为所有课程向医疗保险收费。最小数据集项目E0200B:拒绝护理的结果测量变化不够大,无法发挥作用,但在[具体量表名称未给出]上有积极变化,t(14) = 10.51,p <.001,科恩d值 = 2.76。访谈进一步表明了可行性。

结论

将DCC纳入养老院言语治疗师的工作流程是可行的。

临床意义

鉴于其可行性和初步的积极影响,言语治疗师可考虑在日常护理中实施DCC。

相似文献

2
Preliminary Evidence for Dementia Collaborative Coaching.痴呆症合作辅导的初步证据。
Am J Speech Lang Pathol. 2023 Sep 11;32(5):2146-2157. doi: 10.1044/2023_AJSLP-22-00367. Epub 2023 Jul 12.

本文引用的文献

6
Preliminary Evidence for Dementia Collaborative Coaching.痴呆症合作辅导的初步证据。
Am J Speech Lang Pathol. 2023 Sep 11;32(5):2146-2157. doi: 10.1044/2023_AJSLP-22-00367. Epub 2023 Jul 12.

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