Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Giảm bớt căng thẳng cho nhân viên trong các nhà dưỡng lão cho người bị chứng mất trí: giao thức cho thử nghiệm ngẫu nhiên phân cụm theo từng bước để đánh giá khóa học Giảm căng thẳng thông qua Chánh niệm trên web
Tóm tắt
Có sự thay đổi liên tục về bản chất của các nhà dưỡng lão ở Vương quốc Anh khi hiện có tới 80% cư dân sống với một dạng chứng mất trí nhớ hoặc vấn đề về trí nhớ. Khi chăm sóc trong môi trường này có thể phức tạp, đầy thách thức và căng thẳng cho nhân viên; điều này có thể ảnh hưởng đến chất lượng chăm sóc mà cư dân nhận được, dẫn đến áp lực và kiệt sức cho nhân viên, và làm tăng tỷ lệ bệnh, vắng mặt và tỷ lệ nghỉ việc. Do đó, cần phải tìm ra các can thiệp nhằm tăng cường sự an lành cho nhân viên, không chỉ mang lại lợi ích cho chính họ mà còn cho cư dân và các nhà cung cấp dịch vụ chăm sóc. Huấn luyện chánh niệm được biết đến là có hiệu quả trong việc điều trị nhiều tình trạng sức khỏe thể chất và tinh thần. Nghiên cứu này sử dụng phương pháp hỗn hợp dựa trên thử nghiệm ngẫu nhiên phân cụm theo từng bước. Ba mươi nhà dưỡng lão ở xứ Wales đang triển khai một khóa huấn luyện chánh niệm trực tuyến ngắn hạn, bắt đầu theo trình tự ngẫu nhiên. Từ bốn đến mười nhân viên đồng ý từ mỗi cơ sở sẽ tham gia khóa học và hoàn thành các bảng hỏi đã được xác thực tại thời điểm cơ bản và sau tám và 20 tuần. Chúng tôi cũng sẽ phỏng vấn một mẫu phân tầng gồm mười nhân viên đã qua đào tạo và phân tích các bản ghi theo chủ đề. Kết quả chính là sự căng thẳng; các kết quả thứ cấp bao gồm sự hài lòng trong công việc, thái độ đối với cư dân và tỷ lệ vắng mặt do ốm. Với số lượng gia tăng người sống với chứng mất trí trong các nhà dưỡng lão và gây căng thẳng cho những người chăm sóc họ, điều quan trọng là phải đánh giá các chiến lược hỗ trợ cho nhân viên. Các liệu pháp dựa trên chánh niệm có thể có lợi và cần được xem xét chi tiết. ISRCTN registry.
ISRCTN80487202
. Đăng ký ngày 24 tháng 7 năm 2013.
Từ khóa
#nhà dưỡng lão #chứng mất trí #căng thẳng nhân viên #huấn luyện chánh niệm #chăm sóc sức khỏeTài liệu tham khảo
Jennings B. A life greater than the sum of its sensations: ethics, dementia and quality of life. In: Albert SM, Logsdon RG, editors. Assessing quality of life in Alzheimer’s disease. New York: Springer Publishing Company; 2000. p. 165–78.
Society A’s. Dementia 2014: opportunity for change. London: Alzheimer’s Society; 2014. http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2317. Accessed 3 Aug 2015.
Society A’s. Low expectations: attitudes on choice, care and community for people with dementia in care homes. London: Alzheimer’s Society; 2013. http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=1628. Accessed 9 Jan 2015.
Prince M, Prina M, Guerchet M. World Alzheimer Report 2013: journey of caring – analysis of long-term care for dementia. London: Alzheimer’s Disease International; 2014. http://www.alz.co.uk/research/world-report-2013. Accessed 4 Aug 2015.
Lievesley N, Crosby G, Bowman C, Midwinter E. The changing role of care homes. London: BUPA and Centre for Policy on Ageing; 2011. http://www.cpa.org.uk/information/reviews/changingroleofcarehomes.pdf. Accessed 12 March 2015.
Cavendish C. The Cavendish review: an independent review into healthcare assistants and support workers in the NHS and social care settings. London: DH; 2013. https://www.gov.uk/government/publications/review-of-healthcare-assistants-and-support-workers-in-nhs-and-social-care. Accessed 19 Jan 2015.
Department of Health. Living well with dementia: a National Dementia Strategy. London: DH; 2009. https://www.gov.uk/government/publications/living-well-with-dementia-a-national-dementia-strategy. Accessed 19 Jan 2015.
Department of Health, Social Services and Public Safety. Improving Dementia Services in Northern Ireland: A Regional Strategy. Belfast: DHSSPS; 2011. https://www.dhsspsni.gov.uk/publications/improving-dementia-services-northern-ireland-regional-strategy. Accessed 19 Jan 2015.
Scottish Government. Scotland’s National Dementia Strategy 2013-16. Edinburgh: SG; 2011. http://www.scotland.gov.uk/Resource/0042/00423472.pdf. Accessed 19 Jan 2015.
Welsh Assembly Government. National Dementia Vision for Wales: Dementia Supportive Communities. Cardiff: WAG; 2011. http://gov.wales/docs/dhss/publications/110302dementiaen.pdf. Accessed 19 Jan 2015.
Health and Safety Executive. Stress-related and psychological disorders in Great Britain 2014. London: HSE; 2015. http://www.hse.gov.uk/statistics/causdis/stress/. Accessed 19 Jan 2015.
Selye H. The stress of life. New York: McGraw-Hill; 1956.
Albrecht TL. What job stress means for the staff nurse. Nurs Adm Q. 1982;7:1–11.
Lambert VA, Lambert CE. Literature review of role stress/strain on nurses: an international perspective. Nurs Health Sci. 2001;3:161–72.
Lim J, Bogossian F, Ahem K. Stress and coping in Australian nurses: a systematic review. Int Nurs Rev. 2010;57:22–31.
Wilson J, Kirshbaum M. Effects of patient death. Br J Nurs. 2011;20:559–63.
Lewis R, Yarker J, Donaldson-Feilder E, Flaxman P, Munir F. Using a competency-based approach to identify the management behaviours required to manage workplace stress in nursing: a critical incident study. Int J Nurs Stud. 2010;47:307–13.
Corey S, Mackenzie CS, Poulin PA, Seidman-Carlson R. A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Appl Nurs Res. 2006;19:105–9.
Hussein S. Estimating probabilities and numbers of direct care workers paid under the National Minimum Wage in the UK: a Bayesian approach. Social Care Workforce Periodical Issue 16. London: Social Care Workforce Research Unit, King’s College; 2011.
Unison. Zeroing in on zero-hours contracts. London: Unison; 2014. http://www.unison.org.uk/zeroing-in-on-zero-hours-contracts Accessed 19 Jan 2015.
Bowers B, Fibich B, Jacobson N. The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides. J Nurs Care Qual. 2000;14:55–64.
Zimmerman S, Williams CS, Reed PS, Boustani M, Preisser JS, Heck E, et al. Attitudes, stress and satisfaction of staff who care for residents with dementia. Gerontologist. 2005;45:96–105.
Kleinman L, Frank L, Ciesla G, Rupnow M, Brodaty H. Psychometric performance of an assessment scale for strain in nursing care: The M-NCAS. Health Qual Life Outcomes. 2004;2:1–10.
Brodaty H, Draper B, Low LF. Nursing home staff attitudes towards residents with dementia: strain and satisfaction with work. J Adv Nurs. 2003;44:583–90.
Lann-Wolcott H, Medvene L. Measuring the person-centredness of caregivers working with nursing home residents with dementia. Behav Ther. 2011;42:89–99.
Mackenzie CS, Peragine G. Measuring and enhancing self-efficacy among professional caregivers of individuals with dementia. Am J Alz Dis Other Dement. 2003;18:291–8.
Talerico K, Evans L, Strumpf N. Mental health correlates of aggression in nursing home residents with dementia. Gerontologist. 2002;42:169–77.
Edberg A, Bird M, Richards DA, Woods R, Keeley P, Davis-Quarrell V. Strain in nursing care of people with dementia: nurses’ experience in Australia, Sweden and United Kingdom. Aging Ment Health. 2008;12:236–43.
Todd SJ, Watts SC. Staff responses to challenging behaviour shown by people with dementia: application of an attributional-emotional model of helping behaviour. Aging Ment Health. 2005;9:71–81.
Health and Safety Executive. http://www.hse.gov.uk/stress/furtheradvice/whatisstress.htm. Accessed 19 Jan 2015.
Karasek R. The stress-disequilibrium theory: chronic disease development, low social control, and psychological de-regulation. Med Lav. 2006;97:258–71.
Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1:27–41.
Cooper C, Dewe P, O’Driscoll MP. Organizational stress: a review and critique of theory, research and applications. London: Sage; 2001.
Schaufeli WB, Buunk BP. Burnout: an overview of 25 years of research and theorizing. In: Schabracq MJ, Winnubst JAM, Cooper CL, editors. The handbook of work and health psychology. Chichester: Wiley; 2003. p. 383–425.
Bamber MR. CBT for occupational stress in health professionals: introducing a schema-focused approach. Hove: Routledge; 2006.
National Institute for Health and Clinical Excellence. Managing long-term sickness and incapacity for work. NICE Guideline PH19. London; NICE: 2009. http://www.nice.org.uk/GUIDANCE/PH19. Accessed 19 January 2015.
National Institute for Health and Clinical Excellence. Promoting mental wellbeing at work. NICE Guideline PH22. London; NICE: 2009. http://www.nice.org.uk/GUIDANCE/PH22. Accessed 19 January 2015.
McCarty EF, Drebing C. Exploring professional caregivers’ perceptions: Balancing self-care with care for patients with Alzheimer’s disease. J Gerontol Nurs. 2003;29:42–8.
Van den Pol-Grevelink A, Jukema JS, Smits CHM. Person-centred care and job satisfaction of caregivers in nursing homes: a systematic review of the impact of different forms of person-centred care on various dimensions of job satisfaction. Int J Geriatr Psychiatry. 2011;27:219–29.
Ruotsalainen JH, Serra C, Marine A, Verbeek JH. Systematic review of interventions for reducing occupational stress in health care workers. Scand J Work Environ Health. 2008;34:169–78.
Edwards D, Burnard P. A systematic review of stress and stress management interventions for mental health nurses. J Adv Nurs. 2003;42:169–200.
Baer RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Pract. 2003;10:125–43.
Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: a meta-analysis. J Psychosom Res. 2004;57:35–43.
Chiesa A, Serretti AJ. Altern Complement Med. 2009;15:593–600.
Cohen-Katz J, Wiley SD, Capuano T, Baker DM, Shapiro S. The effects of mindfulness-based stress reduction on nurse stress and burnout: a quantitative and qualitative study. Holist Nurs Pract. 2004;18:302–8.
Im Choi J, Koh MS. Relations of Job Stress, Burnout, Mindfulness and Job Satisfaction of Clinical Nurses. Int J Biosci Biotechnol 2015; 7:121-8. http://www.sersc.org/journals/IJBSBT/vol7_no3/12.pdf. Accessed Nov 30 2015
Krusche A, Cyhlarova E, Williams JMG. Mindfulness online: an evaluation of the feasibility of a web-based mindfulness course for stress, anxiety and depression. BMJ Open. 2012;2:e000803. doi:10.1136/bmjopen-2011-000803.
Wolever RQ, Bobinet KJ, McCabe K, Mackenzie ER, Fekete E, Kusnick CA, et al. Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial. J Occup Health Psychol. 2012;17:246–58.
Gluck TM, Maercker A. A randomized controlled pilot study of brief web-based mindfulness training. BMC Psychiatry. 2011;11:175.
Brown CA, Lilford RJ. The stepped wedge trial design: a systematic review. BMC Med Res Methodol. 2006;6:54. doi:10.1186/1471-2288-6-54.
Moxon S, Lyne K, Sinclair I, Young P, Kirk C. Mental health in residential homes: a role for care staff. Ageing Soc. 2001;21:71–93.
Be Mindful. Online Mindfulness Course. http://www.bemindfulonline.com/. Accessed Feb 2015.
Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte; 2009.
Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guildford; 2002.
Cohen S, Kamarck TRM. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.
Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.
Schaefer JA, Moos RH. Relationship, tasks, and system stressors in the health care workplace. J Community Appl Soc Psychol. 1993;3:285–98.
Karasek RA. Job demands, job decision latitude and mental strain: implications for job redesign. Adm Sci Q. 1979;24:285–308.
Astrom S, Nilsson M, Norberg A, Sandman P, Winblad B. Staff burnout in dementia care — relations to empathy and attitudes. Int J Nurs Stud. 1991;28:65–75.
Andrews FM, Withey SB. Social indicators of well being. In: Fields DL, editor. Taking the measure of work: a guide to validated scales for organizational research and diagnosis. London: Sage; 2002.
Lintern T, Woods B, Phair L. Training is not enough to change care practice. JDC. 2000;8:15–6.
Koopman C, Pelletier KR, Sharda RN, Berger ML, Turpin RS, Hackleman P, et al. Stanford Presenteeism Scale: health status and employee productivity. J Occup Environ Med. 2002;44:14–20.
Ware JJ, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.
National Institute for Health Research. The ENRICH toolkit: Enabling Research in Care Homes; a simple guide for researchers, care home staff and residents. www.enrich.nihr.ac.uk/. Accessed 16 Jun 2015