社区医学与健康教育

抽象的

Short- and Long-Term Effects of Workshop-Style Educational Program on Long-Term Care Leaders ’ Attitudes toward Facility End-of-Life Care

Yoshihisa Hirakawa, Takaya Kimata and Kazumasa Uemura

Background: Although the proper training of caring staff is required, very few studies have actually focused on the effects of caring staff educational programs on end-of-life care at long-term care facilities. The aim of the present study was to test a pilot caring staff education program emphasizing quality end-of-life care for elderly residents at long-term care facilities. Method: The workshop program was designed by an expert panel made up of long-term care educational leaders from 8 selected long-term care facilities. The topics of the program were: (1) definition of end of life of the elderly, (2) signs and symptoms of imminent death, (3) advanced care planning, (4) issues related to tube feeding, (5) communication with family members of end-of-life residents, (6) communication with bed-ridden elderly, and (7) staff education concerning key elements in the provision of end-of-life care for elderly residents. Study questionnaires were administered to participants both before and after the educational intervention. The questionnaires included two major sets of questions: the Frommelt Attitude toward Care of the Dying scale, Form B, Japanese version and the Death Attitude Inventory. Six months after the intervention, the same questionnaire was mailed to the participants. Result: A total of two hundred and forty seven care leaders participated in the program. Two hundred and forty care leaders completed pre- and post-questionnaires. Out of these, 226 completed a follow-up questionnaire six months after the program. Our six month follow-up data confirms improvements in the participants’ attitudes toward end-of-life care provision at long-term care facilities. Our data also indicates an improved outlook on caring for the dying patient and the maintenance of a positive perception of patient- and family-centered care. Conclusion: Our workshop-style educational program had positive short- and long-term effects on long-term care leaders’ attitudes toward facility end-of-life care.