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一项关于痴呆症行为和心理症状优化管理的跨学科员工培训干预措施的开发:一项定性研究。

The Development of an Intradisciplinary Staff Training Intervention on the Optimal Management of Behavioural and Psychological Symptoms of Dementia: A Qualitative Study.

作者信息

Carrier Daphnée, Toulouse Élodie, Rochefort Christian M

机构信息

School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.

Research Centre, Hôpital Charles-Le Moyne, Longueuil, QC, Canada.

出版信息

Dement Geriatr Cogn Dis Extra. 2024 Oct 9;14(1):106-114. doi: 10.1159/000541517. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

Behavioural and psychological symptoms of dementia (BPSDs) are a group of highly prevalent symptoms in residents with a neurocognitive disorder, including agitation and depressive symptoms. Caregiving staff often mention knowledge and skills deficits regarding optimal BPSD management. While several staff training on BPSDs management exist internationally, their transferability to other clinical contexts is limited, owing to methodological challenges. Therefore, to address this implementation gap, there is a strong need for training based on high-quality research to strengthen existing evidence, and ensure feasibility and reproducibility.

METHODS

This qualitative study, part of a larger research project, occurred in 2022 on long-term care (LTC) centre unit and an alternate level of care (ALC) hospital unit located in the Province of Quebec, Canada. This study aimed to (1) evaluate the needs and perceptions of staff caregivers regarding BPSD management, (2) identify the training content and modalities to prioritize according to experts, (3) develop intradisciplinary training on BPSD management, and (4) pretest the preliminary version of the training. Objectives one and two were evaluated using focus groups and objective four using individual cognitive interviews. Qualitative interview data was audio-recorded with participants' consent, transcribed verbatim, and thematically content analysed using an established method.

RESULTS

Overall, thirteen caregivers participated in objective one (8 from the LTC unit, and 6 from the ALC unit). The main staff training need identified on each site was the management of resident's aggressive behaviours. Staff verbalized a preference for virtual training. Objective 2 involved a panel of eight experts. Experts recommended the use of an online training platform, and certain training models and indicators. Based on caregivers' and experts' input, five interactive online staff training capsules lasting from 20 to 25 min each and an algorithm guiding the evaluation and management of BPSDs were created. The training capsules and the algorithm were iteratively improved following cognitive interviews with 4 caregivers from the participating sites.

CONCLUSION

An interactive virtual staff training on BPSD management was created based on staff and expert consultation. The next step in the investigation will be to evaluate the feasibility and acceptability of the training.

摘要

引言

痴呆的行为和心理症状(BPSD)是神经认知障碍患者中一组高度普遍的症状,包括激越和抑郁症状。护理人员经常提到在BPSD最佳管理方面存在知识和技能缺陷。虽然国际上有几项关于BPSD管理的员工培训,但由于方法上的挑战,它们在其他临床环境中的可转移性有限。因此,为了弥补这一实施差距,迫切需要基于高质量研究的培训,以加强现有证据,并确保可行性和可重复性。

方法

这项定性研究是一个更大研究项目的一部分,于2022年在加拿大魁北克省的一个长期护理(LTC)中心单元和一个替代护理级别(ALC)医院单元进行。本研究旨在:(1)评估护理人员对BPSD管理的需求和看法;(2)确定专家应优先考虑的培训内容和方式;(3)开展关于BPSD管理的跨学科培训;(4)对培训的初步版本进行预测试。目标一和目标二通过焦点小组进行评估,目标四通过个体认知访谈进行评估。定性访谈数据在参与者同意的情况下进行录音,逐字转录,并使用既定方法进行主题内容分析。

结果

总体而言,13名护理人员参与了目标一(长期护理单元8名,替代护理级别单元6名)。每个地点确定的主要员工培训需求是对居民攻击行为的管理。员工表示倾向于虚拟培训。目标二涉及一个由八名专家组成的小组。专家们建议使用在线培训平台以及某些培训模式和指标。根据护理人员和专家的意见,创建了五个交互式在线员工培训单元,每个单元持续20至25分钟,并创建了一个指导BPSD评估和管理的算法。在对参与地点的4名护理人员进行认知访谈后,对培训单元和算法进行了反复改进。

结论

基于员工和专家的咨询,创建了一个关于BPSD管理的交互式虚拟员工培训。调查的下一步将是评估该培训的可行性和可接受性。

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