“EduKation demenz® Nursing” in the acute hospital setting

Evaluation of a dementia training program: a pilot study

„EduKation demenz® Pflege“ im Akutkrankenhaus

Evaluation eines Demenz-Schulungsprogramms: eine Pilotstudie

Abstract

Background

An increasing number of people with dementia (PwD) are being hospitalized due to acute conditions. The surrounding conditions and procedures in acute hospitals are not oriented to the special needs of this vulnerable patient group. The behavior of PwD poses particular challenges and burdens for nursing staff.

Objective

The aim of this pilot study was to evaluate the effectiveness of a 2-day dementia training program with a self-reflection component compared to a standard 1.5‑h training of nursing staff caring for PwD in acute hospitals.

Methods

A nonrandomized pretest-posttest study with a control group was conducted in three German acute hospitals. Through a questionnaire, nursing staff caring for PwD were examined for potential changes in attitude, strain and confidence levels. The intervention group (n = 32) received a 2-day training program, “EduKation demenz® Nursing”, the control group (n = 36) participated in a short,1.5‑h dementia training.

Results

Compared to the control group, the intervention group demonstrated statistically significant improvement in perceived strain (p = 0.007) and in confidence in caring for PwD (p < 0.001). There were positive but not significant changes in attitude (p = 0.176).

Conclusion

“EduKation demenz® Nursing”, a 2-day training program with a self-reflection component, could provide more effective support for nursing staff in acute hospitals caring for PwD than a 1.5‑h training. Results indicate, however, that general conditions in acute hospitals should be changed to allow nursing staff to apply the knowledge gained.

Zusammenfassung

Hintergrund

Immer mehr Menschen mit Demenz (PwD) werden aufgrund einer akuten Erkrankung ins Krankenhaus eingeliefert. Die Rahmenbedingungen und Abläufe in Akutkrankenhäusern sind jedoch nicht auf die besonderen Bedürfnisse dieser vulnerablen Patientengruppe ausgerichtet. Das Verhalten von PwD stellt insbesondere Pflegekräfte vor besondere Herausforderungen und Belastungen.

Ziel

Das Ziel dieser Studie war es, die Auswirkungen eines zweitägigen Demenz-Schulungsprogramms mit einer Komponente der Selbstreflexion im Vergleich zu einer 1,5-stündigen Schulung, wie sie für Pflegekräfte im Akutkrankenhaus eher üblich ist, zu untersuchen.

Methode

Die Studie wurde als explorative Pilotstudie unter Verwendung eines Prä- und Posttestdesigns mit einer Interventionsgruppe und einer Kontrollgruppe in drei deutschen Akutkrankenhäusern durchgeführt. Mittels einer schriftlichen Befragung wurden mögliche Veränderungen in der Einstellung, der Belastung und der Handlungssicherheit der Pflegekräfte im Umgang von PwD untersucht. Die Intervention bestand aus dem zweitägigen Trainingsprogramm „EduKation demenz® Pflege“ im Akutkrankenhaus (n = 32) und einer 1,5-stündigen Fortbildung zum Thema Demenz der Kontrollgruppe (n = 36).

Ergebnisse

Im Vergleich zur Kontrollgruppe zeigte die Interventionsgruppe eine statistisch signifikante Verbesserung der wahrgenommenen Belastung (p = 0,007) und der Handlungssicherheit in der Betreuung von PwD (p < 0,001). Auch die Einstellung veränderte sich positiv, war aber im Verglich zur Kontrollgruppe nicht signifikant (p = 0,176).

Schlussfolgerung

Das zweitägige Trainingsprogramm „EduKation demenz® Pflege“ im Akutkrankenhaus mit einer Komponente der Selbstreflexion ist eine effektivere Unterstützung für Pflegekräfte im Umgang mit PwD als eine 1,5-stündige Schulung. Darüber hinaus müssen die Rahmenbedingungen in Akutkrankenhäusern verändert werden, damit Pflegekräfte die gewonnenen Erkenntnisse in der täglichen Arbeit anwenden können.

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References

  1. 1.

    Algase DL, Beck C, Kolanowski A et al (2016) Need-driven dementia-compromised behavior. An alternative view of disruptive behavior. Journal 11:10–19. https://doi.org/10.1177/153331759601100603

    Article  Google Scholar 

  2. 2.

    Asselin ME, Fain JA (2013) Effect of reflective practice education on self-reflection, insight, and reflective thinking among experienced nurses. J Nurses Prof Dev 29:111–119. https://doi.org/10.1097/NND.0b013e318291c0cc

    Article  PubMed  Google Scholar 

  3. 3.

    Bickel H, Hendlmeier I, Heßler JB et al (2018) The prevalence of dementia and cognitive impairment in hospitals. Dtsch Arztebl Int 115:733–740. https://doi.org/10.3238/arztebl.2018.0733

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Cohen J (1988) Statistical power analysis for the behavioral sciences. Taylor and Francis, Hoboken

    Google Scholar 

  5. 5.

    Dahlke S, Hunter KF, Negrin K et al (2019) The educational needs of nursing staff when working with hospitalised older people. J Clin Nurs 28:221–234. https://doi.org/10.1111/jocn.14631

    Article  PubMed  Google Scholar 

  6. 6.

    Deutsche Alzheimer Gesellschaft e. V. (2018) Informationsblatt 1: Die Häufigkeit von Demenzerkrankungen. https://www.alzheimer-bayern.de/images/downloads/demenz/8_Zahlen/DAlzG_Häufigkeit_Stand_Juni_2018.pdf. Accessed 13 May 2020

  7. 7.

    Digby R, Lee S, Williams A (2017) The experience of people with dementia and nurses in hospital. An integrative review. J Clin Nurs 26:1152–1171. https://doi.org/10.1111/jocn.13429

    Article  PubMed  Google Scholar 

  8. 8.

    Elvish R, Burrow S, Cawley R et al (2014) ‘Getting to Know Me’. The development and evaluation of a training programme for enhancing skills in the care of people with dementia in general hospital settings. Aging Ment Health 18:481–488. https://doi.org/10.1080/13607863.2013.856860

    Article  PubMed  Google Scholar 

  9. 9.

    Elvish R, Burrow S, Cawley R et al (2018) ‘Getting to Know Me’. The second phase roll-out of a staff training programme for supporting people with dementia in general hospitals. Dementia 17:96–109. https://doi.org/10.1177/1471301216634926

    Article  PubMed  Google Scholar 

  10. 10.

    Engel S, Reiter-Jäschke A, Hofner B (2016) „EduKation demenz®“. Psychoedukatives Schulungsprogramm für Angehörige von Menschen mit Demenz. Z Gerontol Geriat 49:187–195. https://doi.org/10.1007/s00391-016-1034-0

    Article  Google Scholar 

  11. 11.

    Galvin JE, Kuntemeier B, Al-Hammadi N et al (2010) “Dementia-friendly hospitals. Care not crisis”: an educational program designed to improve the care of the hospitalized patient with dementia. Alzheimer disease and associated. disorders, vol 24, pp 372–379 https://doi.org/10.1097/WAD.0b013e3181e9f829

    Book  Google Scholar 

  12. 12.

    Handley M, Bunn F, Goodman C (2017) Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: a realist review. Bmj Open 7:e15257. https://doi.org/10.1136/bmjopen-2016-015257

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Hessler JB, Schäufele M, Hendlmeier I et al (2018) Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care. Results of the General Hospital Study. Epidemiol Psychiatr Sci 27:278–287. https://doi.org/10.1017/S2045796016001098

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Hrncir M (2009) Das Belastungserleben von Pflegepersonen im Umgang mit demenzkranken Patienten im Akutspital im Vergleich zur Situation auf einer Demenzstation. Diplomarbeit, (Diplomarbeit, Wien). https://ubdata.univie.ac.at/AC07796755. Accessed 13 May 2020

    Google Scholar 

  15. 15.

    Hynninen N, Saarnio R, Isola A (2015) The care of older people with dementia in surgical wards from the point of view of the nursing staff and physicians. J Clin Nurs 24:192–201. https://doi.org/10.1111/jocn.12669

    Article  PubMed  Google Scholar 

  16. 16.

    Jensen AM, Pedersen BD, Olsen RB et al (2018) “If only they could understand me!” Acute hospital care experiences of patients with Alzheimer’s disease. Dementia. https://doi.org/10.1177/1471301218820483

    Article  PubMed  Google Scholar 

  17. 17.

    Kirchen Peters S, Krupp E (2019) Demenzsensibilität in Akutkrankenhäusern. Z Gerontol Geriat 52:291–296. https://doi.org/10.1007/s00391-019-01631-2

    Article  Google Scholar 

  18. 18.

    Kleinman L, Frank L, Ciesla G et al (2004) Psychometric performance of an assessment scale for strain in nursing care. The M‑NCAS. Health Qual Life Outcomes 2:62. https://doi.org/10.1186/1477-7525-2-62

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Lehmann J, Michalowsky B, Kaczynski A et al (2018) The impact of hospitalization on readmission, institutionalization, and mortality of people with dementia. A systematic review and meta-analysis. Journal of Alzheimer’s disease 64:735–749. https://doi.org/10.3233/JAD-171128

    Article  PubMed  Google Scholar 

  20. 20.

    Löhr M, Baumeister M, Meißnest B et al (2015) Deutsche Version der Lern von mir! Schulungsmaterialien. https://www.fh-diakonie.de/.cms/menschen_mit_demenz/trainingsmaterialien/416. Accessed 20 Apr 2020

  21. 21.

    Miraglia R, Asselin ME (2015) Reflection as an educational strategy in nursing professional development. An integrative review. J Nurses Prof Dev 31:62–72. https://doi.org/10.1097/NND.0000000000000151 (quiz E6)

    Article  PubMed  Google Scholar 

  22. 22.

    Pinkert C, Holle B (2012) People with dementia in acute hospitals. Literature review of prevalence and reasons for hospital admission. Z Gerontol Geriat 45:728–734. https://doi.org/10.1007/s00391-012-0319-1

    CAS  Article  Google Scholar 

  23. 23.

    Rao A, Suliman A, Vuik S et al (2016) Outcomes of dementia. Systematic review and meta-analysis of hospital administrative database studies. Arch Gerontol Geriatr 66:198–204. https://doi.org/10.1016/j.archger.2016.06.008

    Article  PubMed  Google Scholar 

  24. 24.

    Smythe A, Jenkins C, Harries M et al (2014) Evaluation of dementia training for staff in acute hospital settings. Nurs Older People 26:18–24. https://doi.org/10.7748/nop2014.02.26.2.18.e527

    Article  PubMed  Google Scholar 

  25. 25.

    Surr CA, Gates C (2017) What works in delivering dementia education or training to hospital staff? A critical synthesis of the evidence. Int J Nurs Stud 75:172–188. https://doi.org/10.1016/j.ijnurstu.2017.08.002

    Article  PubMed  Google Scholar 

  26. 26.

    Tropea J, LoGiudice D, Liew D et al (2017) Caring for people with dementia in hospital. Findings from a survey to identify barriers and facilitators to implementing best practice dementia care. Int Psychogeriatrics 29:467–474. https://doi.org/10.1017/S104161021600185X

    Article  Google Scholar 

  27. 27.

    Turner A, Eccles FJR, Elvish R et al (2017) The experience of caring for patients with dementia within a general hospital setting. A meta-synthesis of the qualitative literature. Aging Ment Health 21:66–76. https://doi.org/10.1080/13607863.2015.1109057

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank the participating acute hospitals for supporting this study and Ashley Basse-Lüsebrink for tidying up English grammar and expression in this manuscript.

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Correspondence to Thomas Johann Gehr.

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Conflict of interest

T.J. Gehr, C.C. Sieber, E. Freiberger and S.A. Engel declare that they have no competing interests.

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 and its later amendments. Written informed consent was obtained from all individual participants included in the study prior to data collection.

Additional information

This paper is submitted in partial fulfilment of the requirements for obtaining the degree Dr. rer. biol. hum. (PhD in human biology) for the primary author.

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Gehr, T.J., Sieber, C.C., Freiberger, E. et al. “EduKation demenz® Nursing” in the acute hospital setting. Z Gerontol Geriat (2021). https://doi.org/10.1007/s00391-020-01838-8

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Keywords

  • Dementia-sensitive care
  • Qualification
  • Intervention
  • Strain
  • Self-reflection

Schlüsselwörter

  • Demenzsensible Pflege
  • Qualifizierung
  • Intervention
  • Belastung
  • Selbstreflexion