Training in dementia care: a cluster-randomized controlled trial of a training program for nursing home staff in Germany.
BACKGROUND
This study examines the effectiveness of a nursing home staff training program designed to improve the interaction between residents with dementia and their caregivers.


METHODS
A three-arm cluster-randomized and controlled population of 96 caregivers and 210 residents was used. Caregivers of the intervention group (IG) received a three-month training program in dementia care. Data were gathered at baseline, immediately after the training and at a six-month follow-up-assessment. Short- and long-term effects of the training program were assessed in comparison with another intervention referred to as the relaxation group (RG) and a wait-list control group (CG).


RESULTS
Results indicated significant positive effects of the training program on caregivers' knowledge immediately after the training and on the use of physical restraints at the six-month follow-up. Caregivers' overall competence increased significantly both in the IG and in the RG. No intervention effects were found on caregivers' level of burnout, their health complaints or on the use of sedative drugs. Relaxation training was more successful in the reduction of caregivers' health complaints.


CONCLUSIONS
Results of the study indicate both the effectiveness and the limitations of a general training program in dementia care. The complexity of the nursing home setting potentially needs more complex interventions. Ongoing and continued support of the caregivers, as well as changes in organization and environment, are more likely to be helpful in the long-term improvement in the quality of care. Future research should focus on studies of specific interventions, such as the interesting effects of relaxation training on the caregivers' state of health.
Kuske
Bettina
B
Department of Psychiatry, University of Leipzig, Public Mental Health Research Unit, Leipzig, Germany.
Luck
Tobias
T
Hanns
Stephanie
S
Matschinger
Herbert
H
Angermeyer
Matthias C
MC
Behrens
Johann
J
Riedel-Heller
Steffi G
SG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002055:Burnout, Professional / Q000453:epidemiology / Q000517:prevention & control; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006707:Homes for the Aged; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009735:Nursing Homes; D009740:Nursing Staff / Q000193:education*; D012064:Relaxation Therapy; D012149:Restraint, Physical / Q000706:statistics & numerical data; D012931:Social Environment
D006993:Hypnotics and Sedatives