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Teaching staff to respond effectively to cognitively impaired residents who display self-protective behaviors

Ruth Sherman Centre for Research and Education, Shalom Village; McMaster University School of Nursing, Hamilton, Ontario, Canada

Pat Morden, RN, BScN, MEd

Shalom Village; McMaster University School of Nursing, Hamilton, Ontario, Canada

Gertrude Cetinski, MScN

Alzheimer Society for Hamilton and Halton, Ontario, Canada

Naomi Lasky, MSW

Community Centre, Shalom Village, Hamilton, Ontario, Canada

Cathy McDowell, RN

Shalom Village, Hamilton, Ontario, Canada

Jacqueline Roberts, BScN, MSc

Systems-Linked Research Unit, McMaster University, School of Nursing, Hamilton, Ontario, Canada

A randomized controlled trial (RCT) was implementedto evaluate the effectiveness of a 7¹/2 hour educational program designed to provide staff with the knowledge, skill, and confidence to manage physical self-protective behaviors of cognitively impaired long-term care residents. This RCT using a pretest/post-test design was conducted using consenting staff members (n = 40) who were randomly allocated to either a control or experimental group. The main outcome measure was a skills lab that evaluated participants’ responses to simulated patients. Both groups participated in the skills lab prior to training, and six weeks after the experimental group completed the program. Pre-and post-training and skills lab observational field notes were subjected to thematic content analysis. Twenty-eight staff members completed both pre-and post-training assessment measurements. Descriptive statistics and paired t-test analyses yielded statistically significant differences in change scores for performance indicators in three simulation scenarios. Analysis of the qualitative data support the finding that, once trained, staff felt better prepared to manage selfprotective behaviors. The results suggest that an initiative to educate staff will enhance knowledge, improve performance, and provide the confidence necessary for staff to respond positively to overt physical behaviors in cognitively impaired elders.

Key Words: cognitively impaired • long-term care • staff education • self-protective behaviors

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 18, No. 5, 273-281 (2003)
DOI: 10.1177/153331750301800510


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