Nursing assistants' behaviour during morning care: effects of the implementation of snoezelen, integrated in 24-hour dementia care.
OBJECTIVE
This paper reports an investigation of the effects of the implementation of snoezelen, or multisensory stimulation, on the quality of nursing assistants' behaviour during morning care.


BACKGROUND
Nursing assistants in long-term dementia care are often unaware of the impact of their behaviour on patient functioning. Snoezelen is a psychosocial intervention that might improve the quality of caregiver behaviour by combining a person-centred approach with the integration of sensory stimuli.


METHODS
A quasi-experimental pre- and post-test design was implemented in 12 wards for older mentally infirm patients at six nursing homes. The experimental group intervention was a 4-day in-house 'snoezelen' training, stimulus preference screening and supervision meetings. The control group received usual nursing home care. The effectiveness of the intervention was studied by analysing 250 video recordings, which were assessed by independent observers using a 4-point measurement scale developed for this study and based on Kitwood's Dialectical Framework.


RESULTS
The results showed a statistically significant increase in 'Positive Person Work' and decrease in 'Malignant Social Psychology' (total scores) after the implementation of snoezelen. Nursing assistants in the experimental group also improved by statistically significant amounts on all subitems of 'Positive Person Work'. The mean number of sensory stimuli, offered explicitly, increased.


CONCLUSIONS
The implementation of snoezelen succeeded in effecting a change to a more person-centred approach during morning care. The results indicate that nursing assistants' behaviour can be positively changed provided that the new care model has been successfully implemented.
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. j.vanweert@nivel.nl
Julia C M
JC
van Weert
Bienke M
BM
Janssen
Alexandra M
AM
van Dulmen
Peter M M
PM
Spreeuwenberg
Jozien M
JM
Bensing
Miel W
MW
Ribbe
D000328:Adult; D001291:Attitude of Health Personnel; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009728:Nursing Assistants; D018802:Patient-Centered Care; D010812:Physical Stimulation / Q000379:methods*; D016896:Treatment Outcome