失智症照顧教育課程對日間照顧中心照顧服務員的照顧知識、態度及能力之成效

The Effects of Educational Program of Dementia Care on the Knowledge, Attitude and Competence among the Nurse Aides in Day Care Centers

背景：日間照顧中心屬於社區式長期照顧之服務模式，為台灣落實在地老化策略之一；照顧服務員為日間照顧中心主要的照顧人力，其多數經照顧服務員培訓課程後任用；然而培訓課程著重於失能者的照顧，較缺乏完整的失智症照顧的培訓。
目的：探討失智症照顧教育課程對於日間照顧中心照顧服務員的照顧知識、態度及能力改善之成效。
方法：本研究採雙組前後測實驗性設計，以配對取樣方式選取中部及南部共24 家日間照顧中心53 位照顧服務員為研究對象。以隨機分組為實驗組(n = 29) 接受12 堂(20 小時) 失智症照顧教育課程；對照組(n = 24) 則未接受教育課程。以結構式問卷進行資料收集，於課程介入的前三天進行前測，及課程結束後的六週進行後測，並以SPSS Version 20.0 進行統計分析。
結果：失智症照顧教育課程可顯著的改善實驗組照顧服務員之失智症照顧知識(t = -2.12 , p =.04)。進一步比較兩組間成效指標之前後測差異，雖然實驗組照顧服務員接受失智症照顧教育課程後的失智症照顧知識、態度及能力比對照組照顧服務員改善，但改善程度未達統計上顯著差異。
結論：失智症照顧教育課程介入雖顯著的增加照顧服務員照顧失智症個案的知識，但課程內容、指導方式及成效評值的時間，將需進一步探討。

Background: Taiwan has a policy of supporting aging in place for its elderly. Day care is one of community-based services of long-term care in Taiwan. Nurse aides provide most of the cares at these day care centers, however, their training focuses on disability care, rather than on dementia care.
Purpose: This study examined the effects of an educational program of dementia care on knowledge, attitude, and competence among nurse aides at 24 day care centers in Taiwan.
Methods: An experimental two group pre-test and post-test research design was used. Participants included 24 matched experimental and comparison groups in Central and Southern Taiwan day care centers. Twenty nine participants in the experimental group participated in a 12-topic (20 hours) threedayeducational program on dementia care. Twenty four participants in the comparison group did not participate in the educational program. All participants were interviewed using three structured questionnaires prior to the intervention. The post-test was conducted 6 weeks after the intervention. The collected data were analyzed using SPSS Window version 20.0.
Results: The research results showed that the educational program improved dementia care on knowledge of dementia among nurse aides in the experimental group (t = -2.12, p = .04). However, there was no significant mean difference on knowledge, attitude, and clinical competence of dementia care between the two groups of nurse aides post-test.
Conclusions: After participating in the dementia care educational program, the nurse aids demonstrated significantly improved dementia care knowledge. However, the lack of a significant difference between the two groups post-test suggests that there is an urgent need for further study regarding course content, use of directional methods and timing of outcome measurements.