The impact and feasibility of a brief, virtual, educational intervention for home healthcare professionals on Parkinson's Disease and Related Disorders: pilot study of I SEE PD Home.
The impact and feasibility of a brief, virtual, educational intervention for home healthcare professionals on Parkinson's Disease and Related Disorders: pilot study of I SEE PD Home.
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DOI：
10.1186/s12909-022-03430-7
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发表时间：
2022-06-28
影响因子：
3.6
通讯作者：
Fleisher, Jori E.
中科院分区：
文献类型：
--
作者：
Hess, Serena P.;Levin, Melissa;Akram, Faizan;Woo, Katheryn;Andersen, Lauren;Trenkle, Kristie;Brown, Patricia;Ouyang, Bichun;Fleisher, Jori E.
关键词：
患有晚期帕金森病（PD）和帕金森相关疾病（PRD）的个体经常被转诊接受家庭联合治疗和护理，但家庭医疗保健专业人员在PD/PRD方面的培训有限。虽然认识到需要这种护理，但患者和家属报告说，家庭医疗保健专业人员不熟悉这些情况，这可能是由神经恐惧症引起的，可能导致护理不佳和服务提前终止。我们试图确定一个虚拟的，多模式的教育干预对PD知识，信心和同情家庭健康专业人员的可行性和影响。家庭健康护士，职业治疗师，物理治疗师和物理治疗助理，以及语言病理学家参加了为期一天的关于高级PD/PRD的虚拟研讨会，结合了重点讲座，特定学科的分组会议，沉浸式虚拟现实小插曲，以及与患者和家庭的互动面板，以及运动障碍和家庭医疗保健专家。参与者完成了在线研讨会前和研讨会后的调查，包括：人口统计学; PD/PRD知识（可能为0-10分）;同理心（人际反应指数）;和10分量表的信心和对PD/PRD个人的态度，分别。干预前后的变化和效应大小采用配对t检验和Cohen’s d进行评估。我们使用扎根理论方法对研讨会后的自由文本反馈进行了定性分析，以确定参与者改变实践的意图。参与者在PD/PRD知识测试中平均提高了3.1分（p < 0.001，d = 1.97），PD/PRD患者的信心管理有所改善（p = 0.0003，d = 0.36），同理心没有变化。95%的人认为这种互动的虚拟形式是有效的。关于研讨会驱动的实践变化的共同主题包括：跨学科合作;在护理计划中更多地参与和重视患者和护理人员的声音;关注与患者功能相关的访视安排;认识和实际管理PD/PRD突变的原因，包括感染和体位性低血压。一个虚拟的，多模式的，简短的教育试点干预改善PD/PRD的具体知识和家庭护理护士和专职医疗人员的信心。未来的研究有必要更广泛地测试这种干预的短期和长期影响，并调查这种教育对患者和护理人员结果的影响。在线版本包含补充材料，可通过10.1186/s12909-022-03430-7获得。
Individuals with advanced Parkinson’s Disease (PD) and Parkinson-related disorders (PRD) are frequently referred for home allied therapies and nursing care, yet home healthcare professionals have limited training in PD/PRD. While recognizing the need for such care, patients and families report home healthcare professionals are unfamiliar with these conditions, which may be driven by neurophobia and may contribute to suboptimal care and early termination of services. We sought to determine the feasibility and effects of a virtual, multimodal educational intervention on PD knowledge, confidence, and empathy among home health professionals. Home health nurses, occupational therapists, physical therapists and physical therapy assistants, and speech-language pathologists participated in a daylong, virtual symposium on advanced PD/PRD, combining focused lectures, discipline-specific breakout sessions, immersive virtual reality vignettes, and interactive panels with both patients and families, and movement disorders and home healthcare experts. Participants completed online pre- and post-symposium surveys including: demographics; PD/PRD knowledge (0–10 points possible); empathy (Interpersonal Reactivity Index); and 10-point scales of confidence with and attitudes towards individuals with PD/PRD, respectively. Pre-post intervention changes and effect sizes were evaluated with paired t-tests and Cohen’s d. We performed qualitative analyses of post-symposium free-text feedback using a grounded theory approach to identify participants’ intentions to change their practice. Participants had a mean improvement of 3.1 points on the PD/PRD knowledge test (p < 0.001, d = 1.97), and improvement in confidence managing individuals with PD/PRD (p = 0.0003, d = .36), and no change in empathy. The interactive, virtual format was rated as effective by 95%. Common themes regarding symposium-motivated practice change included: interdisciplinary collaboration; greater involvement and weighting of the patient and caregiver voice in care plans; attention to visit scheduling in relation to patient function; recognition and practical management of the causes of sudden change in PD/PRD, including infections and orthostatic hypotension. A virtual, multimodal, brief educational pilot intervention improved PD/PRD-specific knowledge and confidence among home healthcare nurses and allied health professionals. Future studies are necessary to test the short- and long-term effects of this intervention more broadly and to investigate the impact of this education on patient and caregiver outcomes. The online version contains supplementary material available at 10.1186/s12909-022-03430-7.
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