Lee Den-Ching A, Russell Grant, Haines Terry P, Hill Keith D, O'Connor Claire M C, Layton Natasha, Swaffer Kate, Long Marita, Devanny Catherine, Callisaya Michele L
Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC 3199, Australia.
National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, VIC 3199, Australia.
Nurs Rep. 2024 Oct 21;14(4):3108-3125. doi: 10.3390/nursrep14040226.
BACKGROUND/OBJECTIVES: Rehabilitation helps reduce disability in dementia. The Australian National Dementia Action Plan identifies a gap in clear treatment pathways post-diagnosis, affecting the quality of life for those with dementia. This study assessed the impact of a one-day dementia training course and follow-up on GPs' and practice nurses' knowledge, attitudes, and confidence regarding dementia rehabilitation.
The training, led by two experienced GPs and an academic physiotherapist, covered dementia diagnosis, allied health roles, care planning, and referrals. The follow-up involved applying the learnt material and completing a reflective task. Three longitudinal surveys (Dementia Knowledge Assessment Scale-DKAS, General Practitioners' Attitudes and Confidence towards Dementia Survey-GPACS-D, and Dementia Rehabilitation Scale) and Likert-scale statements were conducted pre-course, post-course, and at four-month follow-up, alongside a focus group. Descriptive and regression analyses were applied to survey data, and content analysis was used for focus group data.
Seventeen participants (14 GPs, 3 nurses) completed the pre-post-course survey, with eight (6 GPs, 2 nurses) participating in follow-up and focus group discussions. Post-course, DKAS scores increased by 12.1%, GPACS-D by 10.1%, and the dementia rehabilitation scale by 9.4%. Likert-scale statements improved by 8-79%. At the four-month follow-up, there was a slight, non-significant decline in most measures. Focus groups highlighted the training's impacts, useful components, barriers, and suggestions for improvement.
Training GPs and practice nurses in dementia rehabilitation enhances knowledge, awareness, and confidence. Ongoing efforts are needed to sustain benefits and address referral barriers for better access to dementia rehabilitation services.
背景/目的:康复有助于减少痴呆症患者的残疾状况。澳大利亚国家痴呆症行动计划指出,痴呆症诊断后明确的治疗途径存在缺口,这影响了痴呆症患者的生活质量。本研究评估了为期一天的痴呆症培训课程以及后续跟进对全科医生(GPs)和执业护士关于痴呆症康复的知识、态度和信心的影响。
该培训由两名经验丰富的全科医生和一名学术物理治疗师主持,涵盖痴呆症诊断、联合健康角色、护理计划和转诊。后续跟进包括应用所学材料并完成一项反思任务。在课程前、课程后和四个月的随访时进行了三项纵向调查(痴呆症知识评估量表 - DKAS、全科医生对痴呆症的态度和信心调查 - GPACS - D以及痴呆症康复量表)和李克特量表陈述,同时还进行了焦点小组讨论。对调查数据进行描述性和回归分析,对焦点小组数据进行内容分析。
17名参与者(14名全科医生,3名护士)完成了课程前后的调查,其中8名(6名全科医生,2名护士)参与了随访和焦点小组讨论。课程结束后,DKAS分数提高了12.1%,GPACS - D提高了10.1%,痴呆症康复量表提高了9.4%。李克特量表陈述提高了8 - 79%。在四个月的随访中,大多数指标略有下降,但不显著。焦点小组强调了培训的影响、有用的部分、障碍以及改进建议。
对全科医生和执业护士进行痴呆症康复培训可增强知识、意识和信心。需要持续努力以维持益处并消除转诊障碍,以便更好地获得痴呆症康复服务。