照顧服務員餵食技巧訓練計畫之成效

Effects of a Feeding Skills Training Program on Nursing Assistants

失智隨著人口的老化逐年增加，而餵食或進食困難是失智老人主要的問題之一，亦是造成其發生營養不良的主要原因。協助進食是長期照護機構中照顧服務員的主要工作之一，良好的餵食技巧可以幫助提供完善的營養照顧。本研究之主要目的為針對照顧失智老人之照顧服務員，發展一套餵食技巧訓練計畫並測試此訓練計畫在改善其知識、態度及行為上之成效。本研究採類實驗性研究方法，以立意取樣方式選擇北台灣兩家失智照護中心為研究地點，並以隨機方式選取實驗或對照組。共67位照顧服務員參與此研究，實驗組參與三小時餵食訓練課程及一小時的臨床指導；對照組則未接受任何訓練。研究結果發現兩組參與訓練前，在知識及行為上均未達50％之正確率並對餵食失智老人具有較負向的態度；另外，兩組間並無差異；但在參與餵食技巧訓練後，實驗組之照顧助理員比對照組呈現顯著較好的知識（F=47.7，p<0.001）、態度（F=15.75，p=0.001）及行為（F=0.89，p<0.001）。此研究不但證實訓練計畫的成效及價值並提醒健康照護人員應重視失智老人之營養照護，以促進老人長期照護之品質。

Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants, and they require better training in order to provide adequate quality of nutritional care. The purposes of this study were to develop a comprehensive feeding skills training program for nursing assistants mid to test the effects of this training program on their knowledge, attitude, and behavior. A quasi-experimental study was conducted. Two convenience-chosen dementia-specialized long-term care facilities in north Taiwan were randomly assigned into either a control or a treatment group. Sixty-seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants arid the same number of dementia patients were observed during mealtime. Treatment group participated in a feeding skills training program including three hours of in-service classes and one hour of hands-on training, whereas the control group did lot receive any training. Both groups had poor knowledge and feeding behaviors and they hold negative attitude toward feeding elderly with dementia before the intervention. However, there were no differences in knowledge, attitudes, and feeding behaviors between two groups before the intervention. The treatment group had significantly more knowledge (F=47.7, p<0.001), more positive attitude (F=15.75, p=0.001), and better behaviors (F=0.89, p<0.001) than the control group after the intervention. This feeding skills training program has been found to change nursing assistants' knowledge, attitude, and behavior This study raises attention regarding oil-the-job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.