Barbora Richardson1, Ginnette Kitchen, Gill Livingston. 1. Camden and Islington NHS Mental Health Trust, Waterlow Unit and Royal Free & University College Medical School, University College London, Department of Psychiatry and Behavioural Sciences, Gower Street Campus, 48 Riding House Street, London W1N 8AA, UK.
Abstract
BACKGROUND:Abuse of older adults may occur to a disproportionate extent in institutions. Lack of familiarity with protocols when managing abuse once it occurs is one of the reasons why it persists. Educational interventions are one of the ways to improve knowledge and management in this area. OBJECTIVE: To compare the effectiveness of attending an educational course (Group 1) to printed educational material (Group 2) in improving management of abuse of older people. To determine if positive attitude and low burnout scores are related to improvement. DESIGN: Randomized controlled trial. SETTING: North London, UK. SUBJECTS: Nurses, care assistants and social workers working with older people. METHODS: Staff answered questionnaires pre- and post-intervention. RESULTS: The study was completed by 64 (81%) of staff. Baseline scores on knowledge and management abusive scenarios were low. Those randomized to Group 1 improved after intervention and Group 2 deteriorated (Group 1=3.7 [standard deviation=8.1], ANOVA F=23.0; P=0.0001 and Group 2=-2.9 [standard deviation=10.0]). There was a ceiling effect with those who knew more learning less. The significant independent variables in regression analysis to predict learning were being randomized to Group 1 (P=0.003; odds ratio=6.8; 95% confidence interval=1.9-24.5) and low baseline knowledge and management score, (P=0.015, odds ratio=4.8, confidence interval=1.4-16.9). Most staff had a positive attitude towards people with dementia; positive attitude score correlated with baseline knowledge, but did not predict learning. CONCLUSION: Identifying, documenting and reporting abuse of older people is not carried out consistently. Whilst an educational course goes some way in improving this, it needs to be targeted to take into account the baseline knowledge.
RCT Entities:
BACKGROUND: Abuse of older adults may occur to a disproportionate extent in institutions. Lack of familiarity with protocols when managing abuse once it occurs is one of the reasons why it persists. Educational interventions are one of the ways to improve knowledge and management in this area. OBJECTIVE: To compare the effectiveness of attending an educational course (Group 1) to printed educational material (Group 2) in improving management of abuse of older people. To determine if positive attitude and low burnout scores are related to improvement. DESIGN: Randomized controlled trial. SETTING: North London, UK. SUBJECTS: Nurses, care assistants and social workers working with older people. METHODS: Staff answered questionnaires pre- and post-intervention. RESULTS: The study was completed by 64 (81%) of staff. Baseline scores on knowledge and management abusive scenarios were low. Those randomized to Group 1 improved after intervention and Group 2 deteriorated (Group 1=3.7 [standard deviation=8.1], ANOVA F=23.0; P=0.0001 and Group 2=-2.9 [standard deviation=10.0]). There was a ceiling effect with those who knew more learning less. The significant independent variables in regression analysis to predict learning were being randomized to Group 1 (P=0.003; odds ratio=6.8; 95% confidence interval=1.9-24.5) and low baseline knowledge and management score, (P=0.015, odds ratio=4.8, confidence interval=1.4-16.9). Most staff had a positive attitude towards people with dementia; positive attitude score correlated with baseline knowledge, but did not predict learning. CONCLUSION: Identifying, documenting and reporting abuse of older people is not carried out consistently. Whilst an educational course goes some way in improving this, it needs to be targeted to take into account the baseline knowledge.
Authors: Anik Giguère; France Légaré; Jeremy Grimshaw; Stéphane Turcotte; Michelle Fiander; Agnes Grudniewicz; Sun Makosso-Kallyth; Fredric M Wolf; Anna P Farmer; Marie-Pierre Gagnon Journal: Cochrane Database Syst Rev Date: 2012-10-17
Authors: Priscilla Harries; Miranda Davies; Ken Gilhooly; Mary Gilhooly; Christopher Tomlinson Journal: BMC Med Educ Date: 2014-02-01 Impact factor: 2.463
Authors: Abbie West; Cara Cawley; Elizabeth Crow; Alexis M Stoner; Natalie M Fadel; Kristi Ford-Scales; Ning Cheng Journal: J Med Educ Curric Dev Date: 2021-06-18