scholarly journals Effects of a Person Centered Dementia Training Program in Greek Hospital Staff—Implementation and Evaluation

2020 ◽  
Vol 10 (12) ◽  
pp. 976
Author(s):  
Mara Gkioka ◽  
Birgit Teichmann ◽  
Despina Moraitou ◽  
Sotirios Papagiannopoulos ◽  
Magda Tsolaki
Keyword(s):  
Training Program ◽  
Health Care Professionals ◽  
Repeated Measures ◽  
Hospital Staff ◽  
Individual Performance ◽  
Organizational Level ◽  
General Hospitals ◽  
Staff Members ◽  
People With Dementia ◽  
Over Time

People with Dementia (PwD) are frequently admitted in general hospitals. However, health care professionals have lack of dementia knowledge, negative attitudes toward dementia, and lack of confidence in caring those patients. The aim of this study is to develop, implement and evaluate a dementia staff training program in Greek general hospitals. It was a repeated-measures research design. Fourteen (14) two-day workshops were conducted, consisting of six targeted and interactive modules. Staff members (N = 242) attended the program and were assessed according to (1) individual performance: questionnaires about attitudes towards dementia, confidence in care, knowledge about dementia and anxiety before, immediately after the training and three months later, (2) an overall training evaluation immediately after the training and (3) an evaluation of training implementation three months later. Positive attitudes towards dementia, improvement of confidence in care and decrease of feeling of anxiety as a trait, were sustained over time. Knowledge about dementia also increased after the training and sustained, with, however, a slight decrease over time. A well applied training program seems to provide the basis of a better care in PwD during hospitalization. However, changes in the organizational level and a transformation of care culture are necessary for training sustainability over time.

scholarly journals Evaluation and Effectiveness of Dementia Staff Training Programs in General Hospital Settings: A Narrative Synthesis with Holton’s Three-Level Model Applied

2020 ◽  
Vol 78 (3) ◽  
pp. 1089-1108 ◽  
Author(s):  
Mara Gkioka ◽  
Julia Schneider ◽  
Andreas Kruse ◽  
Magda Tsolaki ◽  
Despina Moraitou ◽  
...  
Keyword(s):  
Training Programs ◽  
Evaluation Model ◽  
Individual Performance ◽  
Organizational Level ◽  
Narrative Synthesis ◽  
People With Dementia ◽  
Effectiveness Of Training ◽  
Organizational Results ◽  
Practice Methods ◽  
Over Time

Background: People with Dementia (PwD) are frequently admitted to hospital settings. The lack of proper dementia knowledge, poor communication skills, negative attitudes toward dementia, and lack of confidence affects the quality of care, thus development of dementia trainings has increased. Nevertheless, literature regarding the effectiveness of training implementation is limited. Objective: The aim of this narrative synthesis is to 1) identify the characteristics of training programs and 2) explore the effectiveness of these training programs in everyday clinical practice. Methods: A systematic search in PubMed, PsycINFO, CINAHL, and Cochrane was conducted, including qualitative and quantitative peer-reviewed studies. Holton’s evaluation model with its three outcome levels (learning, individual performance, and organizational results) was adopted. 14 studies were included. Results: The synthesis of the results was divided into two parts: 1) to describe the characteristics and content of trainings 2) to evaluate the effectiveness of training programs according to the three outcome levels of Holton’s model, taking into consideration its construct domains: ability, motivation, and environment. Learning outcomes were assessed in all selected studies: 13 studies observed changes in individual performance, four studies reported changes within the organizational level, and only five showed sustainable changes over time. Conclusion: Person-centered care (PCC) approaches, interactive and varied teaching methods, supporting conditions like champions, action plans, and setting care policies, are all characteristics of effective trainings. Successful programs should be sustainable over time, demonstrating positive outcomes across the organization. Based on current findings, there is a lack of adequate evaluation with regard to training programs on the organizational level.

scholarly journals Evaluation and Effectiveness of a Two-Day Dementia Training Program for Hospital Staff Working in an Emergency Department

2021 ◽  
pp. 1-14
Author(s):  
Julia Schneider ◽  
Jennifer Miller ◽  
Winfried Teschauer ◽  
Andreas Kruse ◽  
Birgit Teichmann
Keyword(s):  
Emergency Department ◽  
Organizational Performance ◽  
Training Program ◽  
Qualitative Content Analysis ◽  
Hospital Setting ◽  
Hospital Staff ◽  
Individual Performance ◽  
Working Environment ◽  
Structured Interviews ◽  
People With Dementia

Background: Entering the hospital via an emergency department (ED) is a pivotal moment in the life of people with dementia (PwD) and often starts an avoidable downward spiral. Therefore, it is required to further educate ED staff to raise awareness of the needs of PwD. Although there are many studies about existing dementia training programs for the hospital setting, empirical evidence for the ED setting and cross-level training evaluations are lacking. Objective: The study aims to evaluate a two-day dementia training course for ED staff on the outcome levels of learning, individual performance, and organizational performance. Furthermore, the study examines whether the training fulfilled participants’ expectations. Methods: Mixed methods were used to assess data from head nurses, nursing, and administrative staff working in EDs. We conducted semi-structured interviews three weeks before (N = 18) and eight months after (N = 9) the training. Questionnaire data were assessed before the training, three months, and six months after the training (N = 44). A qualitative content analysis was conducted to analyze qualitative data; quantitative data was described descriptively. Results: The intervention seems to be effective on both learning and individual performance levels. However, we did not observe any changes in the organizational performance. The training program met attendees’ expectations only partly. The working environment of EDs needs to be taken more into account. Conclusion: Hospital staffs’ expectations of a dementia training program depend on the work area in which they operate. Results support the implementation of intervention bundles to enable sustainable cross-level changes.

scholarly journals Hospital Staff’s Attitudes Toward and Knowledge About Dementia Before and After a Two-Day Dementia Training Program

2020 ◽  
Vol 77 (1) ◽  
pp. 355-365 ◽  
Author(s):  
Julia Schneider ◽  
Anton Schönstein ◽  
Winfried Teschauer ◽  
Andreas Kruse ◽  
Birgit Teichmann
Keyword(s):  
Training Program ◽  
Attitude Change ◽  
Challenging Behavior ◽  
Hospital Staff ◽  
Attitude Scale ◽  
Positive Trend ◽  
Long Term Effects ◽  
Targeted Interventions ◽  
People With Dementia

Background: The outcomes of hospitalized People with Dementia (PwD) are likely to be negative due to, among other key causes, negative staff attitudes and limited staff knowledge regarding dementia. Targeted interventions have been shown to positively change the attitudes of the hospital staff while also increasing their overall knowledge of dementia. However, training effects are often short-lived and frequently long-term effects are not examined in studies. Objective: To examine whether attending a dementia training program changes the attitudes of hospital staff toward PwD and/or increases their knowledge levels about dementia, and whether or not these changes are stable. Methods: The training program lasted two days and N = 60 attending hospital staff members agreed to participate in the study. Data were assessed with questionnaires prior to the training, 3 months, and 6 months after the training. German versions of the Dementia Attitude Scale (DAS-D) and the Knowledge in Dementia (KIDE) scale were used. Additionally, data about perception of PwD and confidence in dealing with challenging behavior were collected and analyzed. Results: After the training program, participants showed a significantly better attitude toward PwD as measured by DAS-D. These time-effects occurred in both DAS-D subscales (“dementia knowledge” and “social comfort”). Although a positive trend could be seen in the KIDE scale, no statistically significant increase occurred over time. Conclusion: Specialist training programs seem to be promising in positively changing attitudes toward and increasing knowledge about PwD with long-term effects. Further research should address the effects of attitude change in patient care.

Effects of garden visits on people with dementia: A pilot study

Dementia ◽  
2018 ◽  
Vol 19 (4) ◽  
pp. 1009-1028
Author(s):  
Man-Li Liao ◽  
Sheng-Jung Ou ◽  
Chung Heng Hsieh ◽  
Zhelin Li ◽  
Chia-Chun Ko
Keyword(s):  
Pilot Study ◽  
Repeated Measures ◽  
Long Term Memory ◽  
Natural Environments ◽  
Language Abilities ◽  
Staff Members ◽  
Positive Effects ◽  
People With Dementia

The number of people with dementia is increasing rapidly worldwide. Developing strategies to improve quality of life for those with dementia is crucial and is receiving more attention. Natural environments are known for their healing effects on most people. This pilot study aimed to understand the benefits that natural environments, such as gardens, can provide for people with dementia. In total, 42 staff members in nine dementia care facilities were recruited as participants in this study and answered a semistructured questionnaire. One-way analysis of variance with repeated measures and the Mann–Whitney U test were used to compare the effects of garden visits on evaluated characteristics and the differences in evaluated characteristics between free garden use and unfree garden use groups. Data from open-ended questions underwent text analysis to obtain the principal beliefs of the participants. The staff members reported that garden visits had positive effects on mood, social interaction, depression, and agitation in people with dementia because of the multisensory, gentle stimuli of the natural environment. Of the evaluated cognitive characteristics, attention and orientation to time were improved the most after residents with dementia had spent time in a garden. Additionally, staff members in the free garden use group scored the effects of garden visits on the mood, long-term memory, language abilities, spatial ability, aggression, and agitation of patients with dementia as significantly higher than staff members in the unfree garden use group. Recommendations for future studies are discussed.

Decision-aids for non-expert decision makers

2020 ◽  
Vol 16 (2) ◽  
pp. 169-188
Author(s):  
Grant Beck ◽  
Maia Farkas ◽  
Patrick Wheeler ◽  
Vairam Arunachalam
Keyword(s):  
Repeated Measures ◽  
Decision Aids ◽  
Cost Benefit ◽  
Individual Performance ◽  
Face Validity ◽  
Content Type ◽  
Performance Effects ◽  
Improved Performance ◽  
Strongly Agree ◽  
Over Time

Purpose This study extends prior accounting research on decision aids (DAs) relating to face validity. Specifically, this study aims to examine the effects of face validity through the presence of two levels of bias in DA output. The presence of bias in a DA will not affect how statistically informative an aid is but will decrease the face validity. The findings suggest that non-expert DA users recognize the bias in the DA’s suggestions as evidenced by users’ low agreement with the aid; however, they do not adjust for the bias in their performance, suggesting that non-expert users do not learn from the DA. Design/methodology/approach This repeated-measures experimental design allows us to examine performance effects over time in response to different levels of bias in the DA output. The participants in the study are provided with outcome feedback to examine learning effects. Findings The findings suggest that non-expert DA users recognize the bias in the DA’s suggestions as evidenced by users’ low agreement with the aid; however, they do not adjust for the bias in their performance, suggesting that non-expert users do not learn from the DA. Although users of an unbiased DA strongly agree with the DA’s output, individual performance deteriorates over time. Initially, the users of an unbiased DA perform better than those who use a biased DA; however, over time, the performance of users of an unbiased aid deteriorates and the performance of users of the biased aid does not improve. Practical implications Companies developing DAs may need to consider the effects of using a DA under circumstances different from those under which the aid was developed and that may lead to the biased DA output. This study has implications for firms that design, develop and use DAs. Originality/value This study considers a yet unexamined face validity issue – observable bias in DA output. This study examines deterministic DAs designed to assist the decision-maker through their ability to combine multiple cues in a systematic and consistent manner. This study has implications for firms that design, develop and use DAs. Firms need to consider the effects of using a DA under circumstances different from those under which the aid is developed, thereby, potentially leading to biased DA output. Each additional variable added to the DA will be associated with an incremental cost in a DA’s development, use and modification. The results of this study provide insights contributing to the information available for cost–benefit analyses conducted when developing a DA or when considering the modification of existing aid. Failure to change a DA because of face validity issues alone may result in a decline in user performance. Thus, the cost of modifying a DA must be weighed against the benefits resulting from improved performance. This study contributes insights into how users’ responses to DA bias could affect the assessments of the benefits of including an omitted variable in a DA.

“Good Readers Make Good Doctors”: Community Readings and the Health of the Community

PMLA ◽  
2010 ◽  
Vol 125 (2) ◽  
pp. 426-436
Author(s):  
Amy Levin ◽  
Phoebe Stein Davis
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Sudden Change ◽  
Hospital Staff ◽  
Ambiguous Genitalia ◽  
Sex Reassignment Surgery ◽  
Sex Reassignment ◽  
Literary Interpretation ◽  
Good Readers ◽  
Staff Members

One of my best experiences as a professor of literature—one of those moments that make the whole endeavor worthwhile—occurred during a discussion of Kafka's The Metamorphosis in the visitation room of a former funeral parlor. The building had been acquired by my local hospital and converted into a meeting space with rickety metal folding tables, and it was home to my first Literature & Medicine reading and discussion group.That night, I was experimenting with a risky pairing, linking Kafka's text with an article on doctors and sex-reassignment surgery for infants born with ambiguous genitalia (Feder 294–320). As health-care professionals, members of this reading community were excited by Kafka's adeptness at conveying the array of emotions experienced by Gregor Samsa and his family, including shame, rage, helplessness, and fear at the sudden change in a loved one. The economic dilemmas of the isolated family, together with their sudden questioning of the definition of the monstrous, gained new echoes and generated fresh readings.For me as a scholar, the insights evoked by this pairing generated the same excitement and sense of discovery I experience after successfully explaining a complicated bit of literary interpretation. In turn, the Literature & Medicine programs sponsored by many state humanities councils create valuable reading communities by bringing scholars into hospitals to discuss texts about medical issues with doctors, nurses, and other employees. They offer critically important opportunities for health-care workers to talk about issues that may not arise elsewhere. For example, discussions of sex-reassignment surgery remain taboo in many hospitals, precisely because for many staff and family members the very idea of intersexuality is monstrous. On a broader basis, the effect of Gregor's change on his family echoes the consequences of the sudden disability of a family member. The pairing I presented thus allowed hospital staff members new, more sympathetic insights as well as opportunities to talk about the topics outside the press of everyday practice.—Amy Levin

scholarly journals Identifying features associated with higher-quality hospital care and shorter length of admission for people with dementia: a mixed-methods study

2020 ◽  
Vol 8 (22) ◽  
pp. 1-92
Author(s):  
Rahil Sanatinia ◽  
Mike J Crawford ◽  
Alan Quirk ◽  
Chloe Hood ◽  
Fabiana Gordon ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Health Services ◽  
Quantitative Data ◽  
Inpatient Care ◽  
Qualitative Data ◽  
Hospital Staff ◽  
Mixed Methods Study ◽  
General Hospitals ◽  
People With Dementia

Background Concerns have repeatedly been expressed about the quality of inpatient care that people with dementia receive. Policies and practices have been introduced that aim to improve this, but their impact is unclear. Aims To identify which aspects of the organisation and delivery of acute inpatient services for people with dementia are associated with higher-quality care and shorter length of stay. Design Mixed-methods study combining a secondary analysis of data from the third National Audit of Dementia (2016/17) and a nested qualitative exploration of the context, mechanism and outcomes of acute care for people with dementia. Setting Quantitative data from 200 general hospitals in England and Wales and qualitative data from six general hospitals in England that were purposively selected based on their performance in the audit. Participants Quantitative data from clinical records of 10,106 people with dementia who had an admission to hospital lasting ≥ 72 hours and 4688 carers who took part in a cross-sectional survey of carer experience. Qualitative data from interviews with 56 hospital staff and seven carers of people with dementia. Main outcome measures Length of stay, quality of assessment and carer-rated experience. Results People with dementia spent less time in hospital when discharge planning was initiated within 24 hours of admission. This is a challenging task when patients have complex needs, and requires named staff to take responsibility for co-ordinating the discharge and effective systems for escalating concerns when obstacles arise. When trust boards review delayed discharges, they can identify recurring problems and work with local stakeholders to try to resolve them. Carers of people with dementia play an important role in helping to ensure that hospital staff are aware of patient needs. When carers are present on the ward, they can reassure patients and help make sure that they eat and drink well, and adhere to treatment and care plans. Clear communication between staff and family carers can help ensure that they have realistic expectations about what the hospital staff can and cannot provide. Dementia-specific training can promote the delivery of person-centred care when it is made available to a wide range of staff and accompanied by ‘hands-on’ support from senior staff. Limitations The quantitative component of this research relied on audit data of variable quality. We relied on carers of people with dementia to explore aspects of service quality, rather than directly interviewing people with dementia. Conclusions If effective support is provided by senior managers, appropriately trained staff can work with carers of people with dementia to help ensure that patients receive timely and person-centred treatment, and that the amount of time they spend in hospital is minimised. Future work Future research could examine new ways to work with carers to co-produce aspects of inpatient care, and to explore the relationship between ethnicity and quality of care in patients with dementia. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 22. See the NIHR Journals Library website for further project information.

scholarly journals Changes over Time in the Predictors of Athletic Training Program Commitment

2014 ◽  
Vol 9 (2) ◽  
pp. 64-71 ◽  
Author(s):  
Windee M. Weiss ◽  
Peter J. Neibert
Keyword(s):  
Training Program ◽  
Athletic Training ◽  
Repeated Measures ◽  
Social Constraints ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Repeated Measures Analysis ◽  
Data Collection And Analysis ◽  
Changes Over Time ◽  
Over Time

Context Understanding changes in athletic training program (ATP) commitment over time is crucial in retaining high-quality students in an ATP. Objective The purpose of this study was to examine if changes over time in ATP commitment determinants are related to actual changes in ATP commitment. Design Longitudinal and cross-sectional survey. Setting Commission on Accreditation of Athletic Training Education-accredited ATP. Patients or Other Participants A total of 99 male and female athletic training students participated in Time 1. A total of 71 (39% males, 61% females) of the original 99 participants participated in Time 2. Participants ranged in age from 18 to 24 years (mean = 20.05, standard deviation = 1.28). Data Collection and Analysis Previously validated measures assessed students' perceptions of enjoyment, attractive alternatives, investments, social constraints and support, benefits and costs, and commitment to ATP over time. Change scores for Times 1 and 2 were calculated for each predictor and commitment to ATP. Two multiple regression analyses determined which changes in the determinants of commitment predicted a change in commitment. A repeated-measures analysis of variance (ANOVA) determined the magnitude of change in the model variables over time. Lastly, a multivariate ANOVA compared who continued, graduated, and discontinued in the ATP. Results Increases in investments and enjoyment predicted positive changes in commitment from Time 1 to Time 2. Additionally, decreases in classmates' social constraints and increases in professors' social constraints positively predicted changes in commitment. When exploring the magnitude of change in the model variables, only increases and decreases in enjoyment from Time 1 to Time 2 were related to concomitant changes in commitment. Lastly, graduating students reported lower commitment and enjoyment and higher perceived costs than did those students who remained in the ATP and had not yet graduated. Conclusions Athletic training program commitment predictors tend to change over time; ATP enjoyment is critical to continued motivation.

Development and pilot testing of the “focus on the person” form: Supporting care transitions for people with dementia

Dementia ◽  
2017 ◽  
Vol 18 (6) ◽  
pp. 2018-2035 ◽  
Author(s):  
Elissa Burton ◽  
Susan Slatyer ◽  
Mary Bronson ◽  
Pam Nichols ◽  
Eleanor Quested ◽  
...  
Keyword(s):  
Care Transitions ◽  
Relevant Information ◽  
Hospital Staff ◽  
Adverse Outcomes ◽  
Mixed Methods Study ◽  
Phase Iii ◽  
Family Carers ◽  
Staff Members ◽  
People With Dementia ◽  
Form Development

When people with dementia are hospitalised, their capacity to communicate with the staff may be limited, compounding risks of distress and other adverse outcomes. Opportunities for carers to share relevant information to inform appropriate person-centred care are also limited. This four-phase mixed methods study aimed to develop an evidence-based family carer–staff communication form, the Focus on the Person form, to address this concern. In Phase I, a literature review plus consultation with clinicians and carers informed form development. In Phase II, the professionally formatted form was piloted by 31 family carers, who were then interviewed about their experiences. These data, combined with data from 30 hospital staff members who participated in Phase III focus groups, led to final, Phase IV, refinements of the form. The form now provides an opportunity for families to inform the person-centred care of people with dementia in hospital, potentially improving outcomes for this vulnerable group.

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