Effects of the Advanced Innovative Internet-Based Communication Education Program on Promoting Communication Between Nurses and Patients With Dementia

愛思溝通教育方案對增進護理人員與失智患者之溝通成效探討

趙慧珍(Hui-Chen Chao) ； Merrie Kaas ； 蘇英華(Ying-Hwa Su) ； 林梅鳳(Mei-Feng Lin) ； 黃美智(Mei-Chih Huang) ； 王靜枝(Jing-Jy Wang)

《The Journal of Nursing Research》 24卷2期 (2016/06) Pp. 163-172

https://doi.org/10.1097/jnr.0000000000000109

摘要

背景　與失智症患者有效的溝通可確認患者需求及降低護理人員與患者間因溝通不良而產生的衝突，進而提升照護品質。目的　本研究之目的為驗證一項以網路為平台之進階革新失智溝通教育計畫（中文簡稱直接取英文縮寫發音，命名為愛思計畫）對護理人員在面對失智個案之溝通知識、溝通態度、評估患者溝通能力及溝通表現的促進成效。此外，亦間接驗證受照顧的失智症患者的記憶與行為問題與憂鬱狀態之促進成效。方法　本研究採單組、重覆測量之類實驗法，以方便取樣招募南台灣長期照護機構護理人員參與本研究。資料分析則以廣益估計方程式（GEE）分別於參與愛思溝通教育計畫前、參與後第4週及第16週進行成效檢測；共105位護理人員參與並完成二次追蹤測量。結果　護理人員在參與愛思溝通教育計畫後第4週及第16週之溝通知識、評估患者溝通能力及溝通表現與前測比較達統計上顯著差異（p ＜ .01）；但在溝通態度部分則未達統計上顯著差異（p = .40）。在患者成效方面，護理人員在參與愛思溝通教育計畫後其所照顧的失智症患者之記憶與行為問題和憂鬱狀態成效則於參與後第16週達統計上顯著差異（p = .05）。結論　愛思溝通教育計畫可有效改善護理人員在面對失智個案之溝通知識、評估患者溝通能力及溝通表現，更進一步減緩個案記憶與行為問題與和憂鬱狀態。未來愛思溝通計畫可做為失智症溝通教育計畫指標及繼續教育之指引。

關鍵字

溝通教育計畫 ； 失智症 ； 護理人員 ； 長期照護機構

並列摘要

Background: Effective communication between nurses and patients with dementia promotes the quality of patient care by improving the identification of patient needs and by reducing the miscommunication-related frustration of patients and nurses. Purpose: This study evaluates the effects of an advanced innovative Internet-based communication education (AIICE) program on nurses' communication knowledge, attitudes, frequency of assessing patient communication capacity, and communication performance in the context of care for patientswith dementia. In addition, this study attempts to evaluate the indirect effects of this program on outcomes for patients with dementia, includingmemory and behavior-related problems and depressive symptoms. Methods: A quasi-experimental research design with a one-group repeatedmeasure was conducted. Convenience sampling was used to recruit nurses from long-term care facilities in southern Taiwan. Datawere analyzed using general estimating equations to compare changes over time across three points: baseline, fourthweek posttest, and 16th-week posttest. One hundred five nurses completed the AIICE program and the posttest surveys. Results: The findings indicate that nurses' communication knowledge, frequency in assessing patients’ communication capacity, and communication performance had improved significantly over the baseline by either the 4th- or 16th-week posttest (p G .01). However, communication attitude showed no significant improvement in the posttest survey (p = .40). Furthermore, the findings indicate that the memory and behavior-related problems and the depressive symptoms of patients had decreased significantly by the 16th-week posttest (p = .05). Conclusions/Implications for Practice: This study showed that the AIICE program improves nurses' communication knowledge, frequency to assess patients' communication capacity, and communication performance and alleviates the memory and behavior-related problems and depressive symptoms of patients. The continuous communication training of nurses using the AIICE program is thus recommended.

並列關鍵字

communication education program ； dementia ； nurses ； long-term care facilities

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