An Education Intervention to Enhance Staff Self-Efficacy to Provide Dementia Care in an Acute Care Hospital in Canada

Martin, Lori Schindel; Gillies, Leslie; Coker, Esther; Pizzacalla, Anne; Montemuro, Maureen; Suva, Grace; McLelland, Victoria

doi:10.1177/1533317516668574

Cited by 41 publications

(89 citation statements)

References 59 publications

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“…Gentle Persuasive Approach Education Programme: One non‐RCT evaluated this intervention . This intervention was associated with a statistically significant improvement in self‐efficacy in managing behaviours (SBMSE).…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

Feast

White

Candy

et al. 2020

Int J Geriat Psychiatry

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Background People with dementia are at greater risk of being admitted to hospital where care may not be tailored to their needs. Interventions improving care and management are vital. Aim Assess the effectiveness of interventions designed to improve the care and management of people with dementia in hospital. Method Six medical and trial registry, and grey literature databases were searched (1999‐1998/2018). Search terms included “Dementia,” “Hospital,” and “Intervention” and limited to experimental designs. Interventions designed to improve the care and management of people with dementia in the general hospital setting were examined. Outcomes included behavioural and psychological symptoms of dementia (BPSD), psychosocial, clinical, staff knowledge, and length of hospital stay. The CASP tools, Cochrane risk of bias tool, and GRADE system assessed methodological quality and certainty of evidence. Results 9003 unique citations were identified; 24 studies were included. Studies were limited in study design and their conduct was at a risk of bias. There is very low‐quality evidence that multisensory behaviour therapy reduces BPSD. There is low‐quality evidence that a multidisciplinary programme reduces postoperative complications and that robot‐assisted therapy, music therapy, multimodal‐comprehensive care, person‐centred care, and family‐centred function‐focused care interventions improved staff knowledge, competence, efficacy, and communication. No studies reported reduced length of stay. Conclusions Whilst we found that these interventions improved the care and management of people with dementia in hospital, it was low‐ to very low‐quality evidence. New clinical recommendations cannot be made based on current evidence, and robust trial designs are necessary to inform evidence‐based care.

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Section: Resultsmentioning

confidence: 99%

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

Feast

White

Candy

et al. 2020

Int J Geriat Psychiatry

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“…Most of the interventional studies had a before-after design [22][23][24][25][26][27][28][29][30][31] (n = 10). One was a cluster-randomised controlled trial [32], and two were controlled clinical trials [33,34]. Seven of the studies were systematic reviews [15,16,[35][36][37][38][39].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of interventions to improve acute hospital care for people with dementia

Karrer

Schnelli

Zeller

et al. 2020

Preprint

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Background: People with dementia are confronted with negative consequences due to hospital stays. When developing new interventions to improve care for people with dementia in acute care hospitals (by intervention we understand organisational strategies, programmes, and/or treatments and actions performed by healthcare professionals), it is crucial to have a comprehensive overview of previous interventions tested in this field and to know the outcomes.Methods: We conducted a systematic review to provide an overview of interventions targeting the care situation of patients with dementia in acute care hospitals. We included trials with interventional study designs and systematic reviews without restrictions regarding the outcomes. We searched five electronic databases, conducted a hand search of journals and performed forward and backward citation tracking of included studies. For risk of bias assessment, we used the Cochrane Collaboration’s tool for assessing risk of bias in randomised trials, ROBANS (for non-randomised controlled trials) and AMSTAR (for systematic reviews). We provide tabular and narrative summaries of the findings. Results: Twenty studies met the inclusion criteria. The findings indicated a broad range of interventions and outcomes. We categorised the interventions into eight intervention types: educational programmes, special non-pharmacological interventions, delirium management programmes, inpatient rehabilitation interventions, family-/person-centred programmes, use of specially trained nurses, volunteer programmes and special care units. Staff outcomes were investigated in most of the studies, followed by patient outcomes. Outcomes concerning relatives were reported in four studies. Educational programmes were the most commonly reported intervention type and resulted in improved staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were effective in improving patient-related outcomes, e.g. delirium severity and functional performance. Rehabilitation interventions after hip fractures and special care units for people with dementia hardly showed any significant effects. Conclusions: Although the included interventional studies reported improved outcomes concerning patients, relatives and staff, the evidence is insufficient to declare which interventions are effective in improving care for people with dementia in acute care hospitals. Future research should focus on relevant patient and family caregiver outcomes. Thereby, it is necessary to consider the complexity of the interventions. Interventions addressing relatives, interprofessional collaboration and the entire practice culture are needed. Trial registration: PROSPERO: CRD42018111032.

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“…It was not always easy to detect and identify the meanings of behaviours. In GPA, reframing involved understanding the meaning of the person's reaction to the surroundings (Schindel Martin et al., ). Staff members were challenged to change their thinking of aggressive behaviours as responsive and protective.…”

Section: Resultsmentioning

confidence: 99%

“…We used mixed methods, including an immediate posteducation survey (Schindel Martin et al., ) and follow‐up focus groups (Berglund, Gillsjö, & Svanström, ), after a year to gain an in‐depth understanding of participants’ experiences. The study was part of the first author's ( LH's) doctoral research.…”

Section: Methodsmentioning

confidence: 99%

“…Schindel Martin et al. () found significant improvements in staff‐reported self‐efficacy postintervention compared to baseline. Grounded in the philosophy of person‐centred care, GPA focuses on understanding the underlying environmental, physical, interpersonal and social factors that may trigger behavioural symptoms as well as how to minimize them (Schindel Martin et al., ).…”

Section: Introductionmentioning

confidence: 99%

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The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care

Hung

Son

Hung

2018

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Although the seminal work of McCormack et al. (International Practice Development Journal, 2015, 5, 1) and Nolan, Davies, Brown, Keady, and Nolan () provides useful conceptual frameworks in person‐centred care, research is needed to understand how theoretical concepts can be applied into practice to support dementia care. Also, evidence is needed to demonstrate the impacts of implementing person‐centred care and staff experiences. What does this paper add to existing knowledge? This paper adds to the emerging work that is providing a greater understanding of how team education in practice can make a difference in building capacity to improve dementia care. We offer timely evidence and useful insights into how an education programme, Gentle Persuasive Approaches (GPA), was implemented (“what worked” and “how”) in a large Canadian hospital to improve knowledge and skills among staff in dementia care. The GPA education helped hospital staff enact person‐centred care by cultivating shared values and a learning environment to change attitudes, practices and conditions for continuous practice development. What are the implications for practice? Mental health nurses in advance practice are well positioned to lead dementia education and advocate for person‐centred care in hospitals. Hospital leaders are responsible for providing resources to cultivate a supportive environment for continuous learning to ensure the workforce gains the capacity to meet the changing demands and needs of the ageing population. System support is essential for creating conditions to enable person‐centred care. Abstract IntroductionHospital staff lacks knowledge and skills in dementia care. There is a need to understand how person‐centred care theory can be operationalized in staff's practices to improve dementia care. AimsTo describe the staff's experiences of learning and applying the Gentle Persuasive Approaches (GPA) to enact person‐centred care in a hospital. MethodsMixed methods, including posteducation survey and focus groups, were used. Thematic analysis was conducted to identify themes that describe participants’ experiences. ResultsThree hundred and ten staff and leaders in a hospital participated in the GPA education and completed a posteducation survey (n = 297). After 1 year, two follow‐up focus groups were conducted with interdisciplinary staff (n = 24) across medicine and mental health programmes. Our analysis identified three themes to enable person‐centred care: (a) changing attitudes, (b) changing practices and (c) changing conditions. DiscussionThis study contributes to the literature by providing evidence of how an education programme was implemented in a large Canadian hospital to build capacity for dementia care. Joint education for interprofessional staff offers value in enabling person‐centred care. ImplicationMental health nurses are in position to lead dementia education and advocate for person‐centred care in hospitals. Staff need structural support to engage...

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An Education Intervention to Enhance Staff Self-Efficacy to Provide Dementia Care in an Acute Care Hospital in Canada

Cited by 41 publications

References 59 publications

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

A systematic review of interventions to improve acute hospital care for people with dementia

The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care

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