高齢者施設ケアスタッフに対する Advance Care Planning 実践教育プログラムの効果評価

目的】Advance Care Planning（以下 ACP）の専門職者に対する教育機会はまだ少ない．よって本研究は，高齢者施設における ACP 実践教育プログラムの開発と効果評価を目的とする．【方法】A 高齢者施設のケア従事者 25 名を研究対象者とした 1 群の事前・事後テストデザインである．介入前・全プログラム直後・3 ヶ月後に質問紙調査を行った．AD 態度尺度，死生観尺度等の変化を分析し , 自由記述は質的記述的に分析した．【結果】AD 態度尺度では，介入前から 3 ヶ月後では AD に前向きな態度が上昇した（p ＜ .001）．死生観尺度においては，「死への恐怖」において介入前から 3 ヶ月後に有意に低下した（p=.02）．“改めて利用者の希望を確認していく”といったカテゴリーが導きだされた．【結論】ACP 教育プログラム参加により，AD への態度や「死への恐怖」意識の低下など本プログラムによる一定の効果が示唆された．

Purpose: The present study aimed to examine the effects of an ACP educational program in nursing home. Method: The design was a single-arm study to evaluate staff attitudes pre- and post-program. A 90-minute intervention program was three times during the 3 month, along with self-directed study. The study outcomes included attitudes towards Advance Directives（AD）, the Death Attitude Inventory （DAI）, and the Frommelt Attitude Toward Care of Dying scale（FATCOD- Form B-J）. We used Wilcoxon signed-rank test and Friedman test the data of baseline, immediately after, and after 3 months. Statistical analysis was performed using IBM SPSS Statistics 20. As a program evaluation, comments on participant?s questionnaires from two questions were categorized and evaluated. Result: Participants of this study was 25 care staffs.（Average age was 36 years old）. The most common occupational description was care worker （n=17）.“Attitudes towards AD score”was increased from 9.0 to 10.0, which statistically significant（p=.00）. The score for 'Death anxiety' in the DAI decreased from 21.0 to 16.5, which statistically significant（p = .02）. As a program evaluation, comments on participant's questionnaires were categorized and evaluated. They thought that “Will check the clients wish, again”. Conclusion: These results suggest that the present ACP educational program was effective at improving staff attitudes towards the end of life care of patients.

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Advance Directive

End of Life Care

Education Program

Advance Care Planning

Advance Directive

End of Life Care

Education Program

identifier:HO001800011775