Managing Problem Behaviors in Cognitively Impaired Older People: The Competence and Preparedness of Healthcare Providers in Long-Term Care Facilities

長期照護機構照護人員對失智症老人之問題行為處理能力及照顧準備度之探討

張嘉秀(Chia-Hsiu Chang) ； 林昱宏(Yu-Hung Lin) ； 葉淑惠(Shu-Hui Yeh) ； 林麗味(Li-Wei Lin)

《The Journal of Nursing Research》 18卷3期 (2010/09) Pp. 164-173

https://doi.org/10.1097/JNR.0b013e3181ed5809

摘要

Background: The prevelance of cognitive impairment in older individuals is increasing in Taiwan. Most healthcare providers (HCPs) experience deep frustration while caring for residents of long-term care facilities who are cognitively impaired. Competence and preparedness of HCPs represent key factors in being able to successfully create and maintain a safe environment for elderly wards and are one of the main concerns of cognitive impairment care.
Purpose: The purpose of this study was to investigate the competence and preparedness of HCPs to manage the problem behaviors of cognitively impaired elders living in long-term care facilities.
Methods: This study utilized a correlational research design and included 221 participants that were recruited using a stratified random sampling process. Structured and semistructured questionaires on competence and preparedness of caring for cognitively impaired elders were used to collect data. Descriptive statistics and univariate and multivariate analyses were used to analyze the relationship between HCP demographic characteristics and their competence or preparedness in managing cognitive impairment care.
Results: Ninety-five percent of participants were women. The top scoring item in the competence dimension was ”preventing problem behaviors from occurring” (M±SD=3.89±2.89), and the lowest scoring item was ”reading related books and articles” (2.91±0.85). In the preparedness dimension, ”modification of environment” (3.22±1.07) was the highest scoring item, and ”resources referral skills” was the lowest scoring item (3.02±1.03). Results showed supervisors (F=7.89, p=.001) and college graduates (F=2.89, p=.047) to have higher levels of competency than other participants. Participant knowledge level in dealing with problem behaviors was significantly and positively correlated with frequency of continuing education participation (F=28.73, p＜001).
Conclusions/Implications for Practice: Results point to the need for continuing education, practicum, counseling, staffing resources, and involvement of other professionals to increase HCP readiness and competence.

關鍵字

處理能力 ； 照顧準備度 ； 問題行為 ； 失智症老人 ； 長期照護機構

並列摘要

Background: The prevelance of cognitive impairment in older individuals is increasing in Taiwan. Most healthcare providers (HCPs) experience deep frustration while caring for residents of long-term care facilities who are cognitively impaired. Competence and preparedness of HCPs represent key factors in being able to successfully create and maintain a safe environment for elderly wards and are one of the main concerns of cognitive impairment care.
Purpose: The purpose of this study was to investigate the competence and preparedness of HCPs to manage the problem behaviors of cognitively impaired elders living in long-term care facilities.
Methods: This study utilized a correlational research design and included 221 participants that were recruited using a stratified random sampling process. Structured and semistructured questionaires on competence and preparedness of caring for cognitively impaired elders were used to collect data. Descriptive statistics and univariate and multivariate analyses were used to analyze the relationship between HCP demographic characteristics and their competence or preparedness in managing cognitive impairment care.
Results: Ninety-five percent of participants were women. The top scoring item in the competence dimension was ”preventing problem behaviors from occurring” (M±SD=3.89±2.89), and the lowest scoring item was ”reading related books and articles” (2.91±0.85). In the preparedness dimension, ”modification of environment” (3.22±1.07) was the highest scoring item, and ”resources referral skills” was the lowest scoring item (3.02±1.03). Results showed supervisors (F=7.89, p=.001) and college graduates (F=2.89, p=.047) to have higher levels of competency than other participants. Participant knowledge level in dealing with problem behaviors was significantly and positively correlated with frequency of continuing education participation (F=28.73, p＜001).
Conclusions/Implications for Practice: Results point to the need for continuing education, practicum, counseling, staffing resources, and involvement of other professionals to increase HCP readiness and competence.

並列關鍵字

competence ； preparedness for caring ； problem behaviors ； cognitively impaired elders ； long-term care facilities

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