A Delphi Study for Developing a Person-centered Dementia Care Online Education Program in Long-term Care Facilities

PURPOSE: There has been a growing recognition that person-centered care enhances the quality of life of nursing home residents with dementia. This study was conducted to develop a person-centered dementia care online education program for direct care staff in long-term care facilities. METHODS: Delphi method with expert group was used to validate contents. We developed 61 draft items based on literature review. Twenty experts participated in consecutive three round surveys including 5-point Likert scale questions and open-ended questions. Based on experts' opinions, the content validity ratio for content validity and the coefficient of variation for stability were calculated. RESULTS: Three-round Delphi surveys and additional feedback from the expert panel established a consensus of core contents: 1) dementia (7 categories), 2) person-centered care (6 categories), 3) communication (8 categories), and 4) behavioral and psychological symptoms of dementia (6 categories). Specific sub-categories in each category were differentiated according to the job qualifications (65 sub-categories for registered nurses, 64 sub-categories for nursing aids, and 41 sub-categories for personal care workers). CONCLUSION: This delphi study identified person-centered dementia education curricula, in which the person-centered approach should be a key policy priority in Korean long-term care system. Now it is urgently needed to develop education programs utilizing online platforms that enable efficient and continuous learning for long-term care staff, which can contribute to behavior changes in the person-centered dementia care approach and improvement of care quality in long-term care facilities.

A Systematic Review of Studies Using Video-recording to Capture Interactions between Staff and Persons with Dementia in Long-term Care Facilities

PURPOSE: The use of video-recording offers important advantages in observing and assessing the relationship between specific behaviors in health care settings. The purpose of this systematic review is to investigate and synthesize the methodological characteristics of studies using video-technology for measuring interactions with the older persons with dementia and staff in long-term care facilities.METHODS: We searched Medline, Embase and CINHAL databases for published articles in English using a video-recording method for both staff and the residents with dementia. Quantitative research design studies (e.g., descriptive or experimental studies) were included.RESULTS: Among 5,605 searched papers, a total of 20 studies were selected for this review. Situations of video-recording were providing personal care (n=12), mealtime (n=6), and conversation (n=3). Concepts measured by video-recording were classified into two groups: 1) Staff [care practice by staff (n=13) and communication by staff (n=11)] and 2) residents [communication by resident (n=4), activities of daily life function of resident (n=8), and behavioral and psychological symptoms of dementia (n=10)].CONCLUSION: This review demonstrates that video technologies are actively used to evaluate the relationship between quality of care and health outcomes of the elderly with dementia in many international nursing studies. This study provides the foundation for a future research using video-recording technologies to examine the interactions and relationships between staff and the residents in Korean long-term care settings.

Person-centered Care and Nursing Service Quality of Nurses in Long-term Care Hospitals

PURPOSE: This study investigated the correlation between person-centered care (PCC) and nursing service quality of nurses in long-term care hospitals. METHODS: The subjects were 114 nurses working in 8 long-term care hospitals. Instruments for evaluating PCC and nursing service quality were used. The data were analyzed by descriptive statistics, two samples-test, one-way ANOVA, Pearson's correlation and Multiple regression. RESULTS: The mean of PCC was 3.25±0.45 out of 5 and the nursing service quality was 3.87±0.40. There were significant differences in PCC in terms of age and income satisfaction, the application of their opinions, the satisfaction of hospital managers, administrators and nurse managers. There were significant differences in nursing service quality according to age, position, the satisfaction of hospital managers, administrators and nurse managers. Nurses' PCC showed a significant positive correlation with nursing service quality. Factors influencing nursing service quality included PCC, their position and age and the most influencing one was PCC. CONCLUSION: This study suggests that the PCC is the strongest affecting element to the quality of nursing service in long-term care hospitals. Therefore, the strategies to improve the practice of person-centered care should be carried out to enhance the quality of nursing service.