Jung Dukyoo, Yoo Leeho, Shin Soogyung, Byeon Sukyung, Seo Hyein, Choi Eunju
College of Nursing, Ewha Womans University, Ewhayeodae- gil, Seodaemun-gu, Seoul, 03760, Republic of Korea.
College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea.
BMC Geriatr. 2025 Sep 2;25(1):677. doi: 10.1186/s12877-025-06315-8.
Mealtime assistance is essential in long-term care for older adults with dementia, as it promotes autonomy, social interaction, and dignity. Flexible and accessible training for direct care workers (DCWs) is crucial in improving mealtime support. This study aimed to develop and evaluate the effectiveness of a YouTube-based mealtime assistance education program for dementia care based on the cognitive theory of multimedia learning. The intervention was designed to provide accessible and flexible training for DCWs in care facilities.
A quasi-experimental, mixed-methods design was used. Twenty-four DCWs and five supervising nurses from two long-term care facilities participated in this study. To maximize participation, DCWs were non-randomly assigned to the intervention based on facility recommendations and individual work schedules. The effectiveness of the program was evaluated using Kirkpatrick's four-level model. Reactions were measured by collecting satisfaction data from the DCWs through surveys and focus group interviews (FGIs). Learning outcomes were assessed using self-reported questionnaires to measure mealtime assistance knowledge with pre- and post-intervention comparisons. Behavioral changes were evaluated by supervising nurses using an observation-based questionnaire and analyzed using pre- and post-intervention data. Organizational results and the dissemination effect were explored through FGIs with nurses and thematically analyzed.
The median mealtime assistance knowledge score increased significantly (Pre: 91.67, Post: 100.00, p = .002, effect size = 0.45, interquartile range: 83.3-97.92). The median mealtime assistance behavior score showed significant improvement (Pre: 67.00, Post: 92.00, p < .001, effect size = 0.56, interquartile range: 82.33-92.00). Supervising nurses observed enhanced ethical attitudes and behavioral changes among DCWs during mealtime assistance.
YouTube-based multimedia learning interventions effectively improved the knowledge, attitudes, and behaviors of DCWs in mealtime assistance for older adults with dementia. Its accessibility and practicality suggest that this approach can be a useful educational model in long-term care settings. Further studies are needed to explore the role of opinion leaders in sustaining and expanding these effects.
用餐协助对于患有痴呆症的老年人的长期护理至关重要，因为它能促进自主性、社交互动和尊严。为直接护理人员（DCW）提供灵活且易于获取的培训对于改善用餐支持至关重要。本研究旨在基于多媒体学习的认知理论，开发并评估一个基于YouTube的痴呆症护理用餐协助教育项目的有效性。该干预措施旨在为护理机构中的DCW提供易于获取且灵活的培训。
采用了准实验性混合方法设计。来自两个长期护理机构的24名DCW和5名督导护士参与了本研究。为了最大限度地提高参与度，根据机构建议和个人工作时间表，DCW被非随机分配到干预组。使用柯克帕特里克的四级模型评估该项目的有效性。通过调查和焦点小组访谈（FGI）从DCW收集满意度数据来衡量反应。使用自我报告问卷评估学习成果，通过干预前后的比较来衡量用餐协助知识。督导护士使用基于观察的问卷评估行为变化，并使用干预前后的数据进行分析。通过与护士的FGI探索组织成果和传播效果，并进行主题分析。
用餐协助知识得分中位数显著提高（干预前：91.67，干预后：100.00，p = 0.002，效应大小 = 0.45，四分位间距：83.3 - 97.92）。用餐协助行为得分中位数显示出显著改善（干预前：67.00，干预后：92.00，p < 0.001，效应大小 = 0.56，四分位间距：82.33 - 92.00）。督导护士观察到DCW在用餐协助期间的道德态度和行为有所改善。
基于YouTube的多媒体学习干预有效地改善了DCW在为患有痴呆症的老年人提供用餐协助方面的知识、态度和行为。其可及性和实用性表明，这种方法可以成为长期护理环境中一种有用的教育模式。需要进一步研究以探索意见领袖在维持和扩大这些效果方面的作用。
