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1.
ABSTRACT

Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts’ nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an intervention targeting Certified Nurses’ Aides (CNAs) was developed and tested. We hypothesized that following the training, CNAs would have increased knowledge and self-efficacy toward providing oral health care to the residents in their charge.

This pilot study used a one-group pretest-posttest design to test the effectiveness of a psycho-educational training intervention. Utilizing the constructs of knowledge and self-efficacy from the Theory of Planned Behavior and the Social Cognitive Theory, we framed the content of a training intervention and administered a 21-item instrument. The survey was distributed to the CNA staff of a single midsize nursing home immediately prior to and after the intervention. The 1-hour training intervention was empirically supported by formative data and delivered by dental faculty researchers.

Findings indicate increases in two areas of oral health knowledge: toothbrush position and frequency of brushing. Self-efficacy, however, did not significantly change. Although the results marginally supported our hypothesis, this pilot study demonstrates the feasibility of delivering interventions to CNAs who have direct responsibility for promoting the oral health of long-term care facility residents.  相似文献   

2.
The purpose of this study was to determine the impact of a progressive mobility restorative program on nursing home residents' ability to perform selected activities of daily living (ADLs) and the amount of staff assistance needed to help residents complete these ADLs. A one group repeated measures design study was conducted in a 255-bed university affiliated geriatrics center. A certified nursing assistant (CNA) specially trained in restorative mobility techniques worked with residents individually for at least 15 minutes per day, five days per week to achieve their individualized mobility goals. Items on ADL Self-Performance and ADL Support Provided from the Minimum Data Set (MDS) were collected at baseline, three months, and six months. Thirty-eight of 42 residents (90%) were included in the analyses and 31 residents (82%) completed at least 25 days of restorative activities. Some residents improved their ADL self-performance at three and six months (15% and 33%, respectively) and decreased in the amount of ADL support provided at three and six months (26% and 31%, respectively). Total ADL self-performance and support provided did not change significantly over the six-month period. Most residents maintained their baseline ADL self-performance and level of ADL support provided over the six-month study. A progressive mobility restorative program implemented by a certified nursing assistant specially trained in restorative techniques resulted in most residents maintaining their baseline ADL self-performance abilities and the level of assistance provided by staff. Studies are needed to determine if these types of programs can actually improve functional abilities and decrease the level of staff assistance needed to complete ADLs or if they are effective in maintaining or delaying functional loss and staff burden.  相似文献   

3.
Previous research has indicated that (1) older adults are predisposed to reflect on the meaning and integrity of their lives, (2) few legitimate opportunities to reminisce are available to the elderly, and (3) oral history has been used successfully as a teaching method with young students who worked with the elderly. The oral histories of 13 residents of a Veterans Administration Hospital nursing home care unit were collected by 11 members of the staff. The histories were reviewed by teachers and were used to establish the content of two experimental courses that were open only to residents who had been interviewed. At the conclusion of the classes, data were collected from attendance records and from the teachers, members of the staff, and friends and relatives of the residents. The data were used to assess the impact of the project on the residents and on the staff. The implications of the study for teachers and administrators and for educational researchers are discussed.  相似文献   

4.
《Educational gerontology》2013,39(5):381-391
As we enter the 21st century, increasing numbers of older adults will reside, either temporarily or permanently, in nursing homes. Training in nursing home care must become an integral part of the curriculum for internal and family medicine residency programs. The changing demographics of the Lebanese population have created an imperative for medical schools to increase their emphasis on the education and training of residents in the care of the elderly. A four-week block rotation was started for residents in the family medicine department in Hotel Dieu (The French Medical School). The rotation is taking place at the comprehensive Geriatric Program at Ain Wazein Community Hospital. The goal of the rotation is to provide formal training in nursing home care to family practice residents as a component of the geriatrics curriculum. The organization and the curriculum content of the rotation are presented. The initial evaluation of the rotation by the residents showed that the residents became more comfortable with elderly issues by the end of the rotation. Residents responded on a scale of one to six regarding four constructs. The rotation was positively evaluated by residents and staff. Consequently, the rotation has been incorporated into the curriculum of family medicine residents in Hotel Dieu.  相似文献   

5.
This study compared staff and elderly knowledge, attitudes, and practices related to sexual expression by elderly persons in a long‐term care setting. Volunteers (N = 194) responded agree or disagree to 159 items. Significant differences were observed between the staff and elderly responses on 36 items. Areas of greatest differences involved knowledge and attitudes about consensual sex and sexual abuse, issues related to family attitudes toward remarriage and sexual expression, and age‐related changes and health problems related to sexuality. Items related to masturbation received the greatest percentage of no response. The staff had significantly higher total scores as compared to the elderly reflecting more knowledge, positive attitudes, and support for more proactive responses toward elderly sexuality. Findings have major implications for staff training in long‐term care settings.  相似文献   

6.
This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global assessments of job-satisfaction, psychological stress, and perceived pressures that may affect provision of care. There were also items dealing with the perceived benefit of prospective in-service training programs. Content analyses indicated interactions with residents as the most frequent source of stress and ethical challenges encountered by nursing staff. Further, results of correlational analyses suggested psychological stress to be associated with job satisfaction and pressure to take shortcuts in the provision of care. Continuing education via in-service training that addresses workplace stress and ethical challenges in nursing care is discussed.  相似文献   

7.
Managing Behavioral and Psychological Symptoms of Dementia (BPSD) is a significant challenge for staff working in long-term care facilities. This study examines the effectiveness of a psycho-educational training aimed at changing staff’s attitudes. The results indicated that participants’ attitudes toward dementia were more positive, person-centered, and hopeful; some participants’ attitudes were unchanged or altered negatively after the training sessions. The conclusiveness of evaluation findings was limited due to time constraints for staff to participate in the complete educational program and the small dataset. Further research is indicated to revise the methodology of the training to ascertain if the framework regarding education on dementia influences staff’s attitude and the overall well-being of the residents.  相似文献   

8.
The autonomy of long‐term care residents is an increasing concern of researchers, practitioners, and regulatory personnel. A cooperative extension workshop called Upswing was developed for staffs of long‐term care facilities who work with residents’ councils. Eoctension field staff were trained to conduct the workshop at the county level. Relevant literature is reviewed and workshop objectives, content, and materials are described. Evaluations of a two‐county eoctension Upswing workshop and an eocpanded workshop for long‐term care staffs in another state provide data regarding the participants’ perceived knowledge gain.  相似文献   

9.
Dementia is a major public health concern. Educating health-care providers about dementia warning signs, diagnosis, and management is paramount to fostering clinical competence and improving patient outcomes. The objective of this project was to describe and identify educational and training needs of staff at community-based outpatient clinics related to treating and managing veterans with dementia. Health professionals took an online survey consisting of questions related to general knowledge and skills in working with veterans with dementia and their families, staff training, and attitudes toward people with dementia. Most participants considered knowledge of dementia important; however, few reported having received training in dementia care within the past year. Furthermore, over half of participants considered themselves beginners in terms of knowledge and skills in dementia care. Regarding training needs, topics that could improve the overall care of veterans with dementia and their caregivers were most often cited. Participants reported being most satisfied with in-person training. Physicians rated their dementia knowledge and skill as greater than nurses'/other medical professionals’ and support staff's. Compared with support staff, nurses/other medical professionals held more positive attitudes toward persons with dementia. Survey results suggest that staff are interested in improving knowledge of, and skills for, working with persons with dementia, and that job classification is associated with differences in attitudes.  相似文献   

10.
Board and care owners and administrators must find new and innovative ways to meet the training needs of those on their staffs. The authors investigated computer-based instruction as a way to teach injury prevention techniques to these care providers. A computer-based (CB) training program was used that had been adapted from a print-based/instructor-led (IL) program. This article discusses the effectiveness of the CB training as compared to the effectiveness of the traditional IL format. The CB and IL versions of a prevention training program were presented to board and care staff during five sessions. The 78 participants were randomly assigned to either the CB or IL groups. Both the CB and IL groups significantly increased their knowledge scores from pretest to posttest. The CB participants reported that they enjoyed the training and had no difficulty using the computers, even though some of them had never used a computer previously for any activity. Computer-based training can be an effective alternative training technique for this population.  相似文献   

11.
Creative activities are a challenge for long-term care facilities. The Passport intervention uses web-based video technology to provide long-term care residents with a virtual travel experience. Passport broadcasts were conducted and staff and residents were interviewed about the experience. A thematic analysis of interviews was used to discern benefits and challenges. Reported benefits included experience with technology, interaction with student visitors, reminiscing, and active learning. Challenges involved technical quality concerns related to the audio and visual needs of seniors. The pilot found the Passport intervention as a promising tool for creative activities in a long-term care setting.  相似文献   

12.
This study investigated the relationship between conditions of employment of direct-care staff in The Netherlands and the distribution of their activities in residential facilities for people with intellectual disability. Three hundred and eighty-eight direct-care staff working at 39 living groups in 10 residential facilities participated. Data were obtained by natural observations. The results suggest that (a) leaders of living groups are clearly different from other direct-care staff in terms of their distribution of activities, (b) educational and training level of staff did not differentially affect resident-oriented care, and (c) extent of contract does affect time staff spend on organisation and housekeeping. Generally, employee characteristics tended to affect nonresident-oriented activities of direct-care staff (i.e., organisation, housekeeping, and off-task) rather than resident-oriented activities, such as stimulative custodial care, recreation, and training.  相似文献   

13.
The present study compares changes in job satisfaction and career commitment among Alzheimer's care staff participating in a two-phase, state-level training collaborative to improve dementia care. Results reveal an increase in extrinsic job satisfaction and a decrease in career commitment. Findings could be related to the effects of both the training interventions and the time lag in data collection. Decreases in career identity depended on whether participants showed a deeper involvement in aging concerns with respect to future employment. Implications for the implementation of future interventions for direct-care staff within a context of organizational and systems-based change are discussed.  相似文献   

14.
This pilot-study aimed to assess a psychoeducational program for staff in care homes. The program was designed to increase knowledge regarding dementia care, promote skills to integrate motor and multisensory stimulation in daily care, and develop coping strategies to manage emotional work-related demands. Six staff members received eight psychoeducational sessions held fortnightly and individualized assistance during the provision of morning care to six residents with dementia. An audio-recorded focus group interview with staff and video recordings of residents' behavior during morning care were made and used to assess the program. Staff reported several benefits: acquisition of new knowledge; demystification of preexisting beliefs related to dementia; group cohesion; self-worth feelings; and positive coping. A trend towards improvements at residents' levels of interaction was found. The findings suggest the need of interventions to go beyond the objectives exclusively centered on staff education and the promotion of residents' well-being. This should be achieved by also allowing workers to feel supported and empowered.  相似文献   

15.
General practitioners are responsible for the management of an increasing number of patients with neurological illness, and thus a solid education in neurosciences is a necessary component of their training. This study examines the effects of an intensive clinical neuroanatomy course on twenty general practice residents’ perceptions, attitudes, and knowledge. A knowledge test was completed by the participants and by a control group at four different time points. The participants were asked to answer a questionnaire about their reasons for signing up for the course and their attitudes and perceptions toward the course experience. Experimental and control groups demonstrated identical mean baseline test scores. The experimental group significantly increased its test scores (plus 49.0% correct answers, a mean improvement of 120%) relative to controls after the educational intervention. There were no differences among scores from the evaluated time points after the educational intervention in the experimental group. In the control group, there were likewise no significant differences between the four evaluated time points. Most participants indicated that they signed up for the course to update/acquire knowledge and skills in the field of neurosciences, and also because they had difficulty in diagnosing and managing patients with neurological diseases. Participants’ attitudes and perceptions toward the course experience were very positive. Most of the participants (n = 17; 85%) rated the course as “extremely useful,” and 3 (15%) rated it as “very useful.” This study provides evidence demonstrating the potential positive effect of neurosciences education to general practice residents. Anat Sci Educ 10: 465–474. © 2017 American Association of Anatomists.  相似文献   

16.
The research reported in this article examined attitudes toward the care of the elderly between and among medical students and residents in training. Data were collected with a 16-item attitude questionnaire. Participants were medical students in their introduction period (prior to clinical experience) and residents of the Department of Internal Medicine, Faculty of Medicine at Siriraj Hospital to answer. There was no difference in the attitudes toward the care for the elderly between medical students and residents. Prior exposure to the elderly may have an influence on attitudes toward the care of the elderly. The geriatric curriculum should be developed to correct misunderstandings and improve the attitudes of the students and residents.  相似文献   

17.
This paper describes and discusses an action research collaboration between a multi-disciplinary team of practice educators, a practice development nurse and a university lecturer in order to explore, evaluate and improve a dementia care training package developed for a range of staff providing care for people with dementia. Whilst it is recognised that the findings of this small evaluation study are only of local interest, we believe the approach we took to be of general use for other teams of practice educators as a way of exploring and evaluating their own practice. This paper will therefore focus mostly on the philosophy, methodology and conduct of the study, including our own reflections and learning as novice action researchers.  相似文献   

18.
An Institutional Resident Quality of Life Project conducted at six institutions throughout Israel during 1994-1997 aimed to: (1) identify and test elements in the life domains of institutional residents that affect their quality of life, and (2) introduce changes in staff attitudes and behavior toward the residents. The article deals with the supplementary training for staff in one of the participating institutions in the project, and the evaluation of this training program. The growing number of elders in the modern world demands accelerated development of community and institutional services. In turn, the growth of these services requires the training of professional and para-professional personnel, with an emphasis on the latter group in light of the more pressing need for day-today caregiving that para-professionals provide. Considerable efforts have been made in Israel in recent years to recruit such workers, train them before they are employed, and deal with various problems once they are on the job. The data gathered during the course of the project illuminated the significant effect of staff-resident relationships on the residents' quality of life. The supplementary training of the staff, moreover, was found to contribute to the improvement of these relationships. A decision was made, therefore, to develop ongoing training programs for professional, and especially, para-professional staff.  相似文献   

19.
Since 1953, Norwegian national standards regulate ratios of children to staff, training requirements, group sizes, leadership and subsidies. Both national and local subsidies support the management and quality level of day care centers. In Norway a current viewpoint on quality in day care is to stimulate innovation in day care activities by rewarding local initiative and creativity. Outdoor activities and giving the children freedom to learn are highly valued. Preschool teacher education, which is three years at college, shares a common frame of a governmental curricular guideline as well as a nationwide curriculum for day care. A responsive and warm interaction between staff, children and parents is a definite moral value of the preschool teacher profession. Current issues of quality are related to the shortage of highly qualified directors and leaders in public day care as well as the expansion of private centers with questionable quality. Quality control of day care centers is now discussed as a necessary surveillance system of the quality of contexts and interactions in children’s daily life.  相似文献   

20.
This paper reports a case study on working closely with a secondary school, to enhance understanding of disruptive behaviour, through the use of bespoke Continuing Professional Development (CPD) materials. This project evolved from the researchers’ previous research on the extent to which teachers believe disruptive pupils can control their behaviour. A notable finding was the sizeable minority of teachers in both primary and secondary schools who appear to be unaware of the psychological underpinnings of disruptive behaviour. That is, that such behaviour frequently communicates unresolved emotional needs, rather than wilful defiance. The current project aims to develop, implement and evaluate CPD resources developed by the researchers, for a one-day staff training day at a secondary school in north England. Prior to training, school staff completed a questionnaire to “audit” their perceptions of disruptive behaviour in school. Following evaluation, the CPD materials will be made available to other schools. It is anticipated that the materials will enable greater mutual understanding and respect for the ways in which disruptive behaviour is perceived by practitioners and school staff. Moreover, they will provide an urgently needed means of facilitating a shared knowledge base and a shared language for addressing emotional barriers to learning.  相似文献   

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