Hanniffy Janette, Kelly Michelle E
School of Psychology, University of Galway, H91 TK33 Galway, Ireland.
Department of Psychology, National College of Ireland, D01 K6W2 Dublin, Ireland.
Behav Sci (Basel). 2025 Jun 26;15(7):870. doi: 10.3390/bs15070870.
Approximately 72% of older adults in residential care have dementia and present with different levels of functioning. People living with dementia (PLwD) may not always be facilitated to independently carry out activities of daily living (ADLs) in care, increasing the likelihood of excess disability. This study incorporated Behavioural Skills Training (BST) to train healthcare staff how to increase opportunities for independence for PLwD by using task analyses and least-to-most (L-M) prompting procedures during ADLs. Three healthcare staff, two female and one male (mean age = 42.67, SD = 16.82), participated in the intervention. The What Works Clearinghouse (WWC) Single-Case Design Technical Documentation guided the study's design. A randomised single-case experimental (N-of-1) design was employed, using a multiple-baseline design (MBD) across participants ( = 3) for three separate ADLs. The dependent variable (DV) was the percentage of correct staff responses when implementing the L-M prompting procedure for each step during ADLs. Visual and statistical analyses demonstrated an increase in the correct use of a task analysis and L-M prompting for all three participants during the intervention compared to the baseline: for ADL1 (assistance to stand), effect sizes were d = 5.39, d = 9.38, and d = 6.79 for the three participants, respectively; for ADL2 (assistance with drinking), effect sizes were d = 3.27, d = 8.55, and d = 3.67; and for ADL3 (assistance to brush teeth), effect sizes were d = 5.99, d = 12.93, and d = 9.39. Maintenance data ranged from 70% to 100% correct responses at follow-up (mean = 93.11% SD = 7.85). Participants successfully generalised skills learned to two new ADLs (PLwD eating a meal and putting on a jumper). BST was demonstrated to be an effective training strategy to increase opportunities for independent responding for PLwD in care environments. The contingencies influencing staff behaviour require attention within the healthcare environment.
在寄宿护理机构中，约72%的老年人患有痴呆症，且功能水平各异。痴呆症患者（PLwD）在护理中可能并不总能得到帮助以独立进行日常生活活动（ADLs），这增加了过度残疾的可能性。本研究纳入了行为技能培训（BST），以培训医护人员如何通过在日常生活活动中使用任务分析和从最少到最多（L-M）提示程序，为痴呆症患者增加独立机会。三名医护人员参与了干预，其中两名女性，一名男性（平均年龄 = 42.67，标准差 = 16.82）。有效方法信息中心（WWC）单病例设计技术文档指导了该研究的设计。采用随机单病例实验（N-of-1）设计，对三名参与者的三项不同日常生活活动采用多基线设计（MBD）。因变量（DV）是在日常生活活动的每个步骤中实施L-M提示程序时工作人员正确反应的百分比。视觉和统计分析表明，与基线相比，干预期间所有三名参与者在任务分析和L-M提示的正确使用方面均有所增加：对于日常生活活动1（协助站立），三名参与者的效应大小分别为d = 5.39、d = 9.38和d = 6.79；对于日常生活活动2（协助饮水），效应大小分别为d = 3.27、d = 8.55和d = 3.67；对于日常生活活动3（协助刷牙），效应大小分别为d = 5.99、d = 12.93和d = 9.39。随访时维持数据的正确反应率在70%至100%之间（平均 = 93.11%，标准差 = 7.85）。参与者成功地将所学技能推广到两项新的日常生活活动中（痴呆症患者用餐和穿套头衫）。行为技能培训被证明是一种有效的培训策略，可在护理环境中为痴呆症患者增加独立反应的机会。在医疗环境中，影响工作人员行为的意外情况需要引起关注。
