Education Program for Care Home Staff

Effects of a Competency-based Education Program on Care Home Staff's Sense of Competence Related to Dementia Care in Mainland China: A Mixed-methods Approach

The competence of care home staff in dementia care is highly influential to the quality of care that adversely affects both people living with dementia and staff and in Mainland China where knowledge on dementia among care home staff was generally poor and this area is under-researched. This study aims at developing a competency-based culturally-sensitive education program on dementia care for care home staff through literature review, qualitative study. And then a quasi-experiment design without random assignment will be conducted to evaluate the effects of this program on care home staff's sense of competence, knowledge, attitudes, and care approach related to dementia care and staff satisfaction with the intervention. Focus group interviews will be conducted to understand participants' experience about the education program after the intervention. This study is expected to provide an effective way to improve care homes staff's competence in dementia care thereby improve the quality of care.

The education will be delivered weekly with 60-90 minutes per lecture for eight lectures. Multiple teaching methods will be used, including lectures, structured handouts, video, role play, case study and discussion. During the study period, the research team will provide ongoing support and consultation through electronic communication and bimonthly field visits.

The intervention is a competency-based education program for care home staff who provide dementia care in Mainland China.

The educational materials will be delivered to the participants in the control group for their self-study.

Sense of competence in dementia care will be measured by Sense of Competence in dementia care scale.The total score is 17-68 by adding up the score of each item. Higher scores mean higher level of sense of confidence.

Sense of competence in dementia care changes from baseline to immediately after intervention (2 months).

Sense of competence in dementia care will be measured by Sense of Competence in dementia care scale.The total score is 17-68 by adding up the score of each item. Higher scores mean higher level of sense of confidence.

Sense of competence in dementia care changes from immediately after intervention to three months after intervention.

Knowledge on dementia will be assessed by using Dementia Knowledge Assessment Scale. The total score is 0 to 50 by adding up the scores of all items. Higher score means better knowledge on dementia.

Knowledge on dementia will be assessed by using Dementia Knowledge Assessment Scale. The total score is 0 to 50 by adding up the scores of all items. Higher score means better knowledge on dementia.

Knowledge on dementia changes from immediately after intervention to three months after intervention.

Attitude towards dementia care will be assessed by using Approaches to Dementia Questionnaire. The total score is 19-95 with higher score indicating the more positive attitudes.

Attitude towards dementia care will be assessed by using Approaches to Dementia Questionnaire. The total score is 19-95 with higher score indicating the more positive attitudes.

Attitude towards dementia care changes from immediately after intervention to three months after intervention.

Person-centred care approach will be assessed by Person-centred care assessment tools. The total score ranges from 15 to 75 with higher score indicating higher degree of person-centred care provision in the institutions.

Person-centred care approach will be assessed by Person-centred care assessment tools. The total score ranges from 15 to 75 with higher score indicating higher degree of person-centred care provision in the institutions.

Person-centred care approach changes from immediately after intervention to three months after intervention.

Change of severity of behavioural and psychological symptoms of dementia (BPSD) of residents with dementia

Severity of BPSD of residents with dementia will be assessed by Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). The frequency × severity of each item yielded a composite symptom, and total severity scores which ranges from 1 to 36 reflecting the sum of each item score. Higher scores indicate more severe symptoms. The total score of caregiver distress range from 12 to 60, with higher score indicating more severe distress.

Severity of BPSD of residents with dementia changes from baseline to immediately after intervention (2 months).

Change of severity of behavioural and psychological symptoms of dementia (BPSD) of residents with dementia

Severity of BPSD of residents with dementia will be assessed by Neuropsychiatric Inventory - Nursing Home Version (NPI-NH). The frequency × severity of each item yielded a composite symptom, and total severity scores which ranges from 1 to 36 reflecting the sum of each item score. Higher scores indicate more severe symptoms. The total score of caregiver distress range from 12 to 60, with higher score indicating more severe distress.

Severity of BPSD of residents with dementia changes from immediately after intervention to three months after intervention.

Care staff's satisfaction will be measured with a self-developed, five-point Likert, five-item scale including satisfaction with educational content, teaching form, provider, usefulness and overall evaluation. The total score ranges from 5 to 25, with higher score representing more dissatisfaction on the training.

Focus group interviews which will last around 40-60 minutes will be conducted to understand care home staff's experience and their perceptions towards the program.

Inclusion Criteria: Care homes: having at least 10 people with dementia living in; with at least 10 care staff working for people with dementia; which do not have any educational activities for staff in dementia three months before the study and staff training plan during the whole study period; whose management level agrees to participate. Care staff: working for people with dementia; speaking and reading Chinese; being willing to participate in the study. Exclusion Criteria: having any educational activities in dementia three months before the study; having a training plan during the whole study period.