title: Managing problem behaviors in cognitively impaired older people: the competence and preparedness of healthcare providers in long-term care facilities.
abstract: BACKGROUND
  The prevelance of cognitive impairment in older individuals is increasing in Taiwan. Most healthcare providers (HCPs) experience deep frustration while caring for residents of long-term care facilities who are cognitively impaired. Competence and preparedness of HCPs represent key factors in being able to successfully create and maintain a safe environment for elderly wards and are one of the main concerns of cognitive impairment care.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the competence and preparedness of HCPs to manage the problem behaviors of cognitively impaired elders living in long-term care facilities.
  
  
  METHODS
  This study utilized a correlational research design and included 221 participants that were recruited using a stratified random sampling process. Structured and semistructured questionaires on competence and preparedness of caring for cognitively impaired elders were used to collect data. Descriptive statistics and univariate and multivariate analyses were used to analyze the relationship between HCP demographic characteristics and their competence or preparedness in managing cognitive impairment care.
  
  
  RESULTS
  Ninety-five percent of participants were women. The top scoring item in the competence dimension was "preventing problem behaviors from occurring" (M +/- SD = 3.89 +/- 2.89), and the lowest scoring item was "reading related books and articles" (2.91 +/- 0.85). In the preparedness dimension, "modification of environment" (3.22 +/- 1.07) was the highest scoring item, and "resources referral skills" was the lowest scoring item (3.02 +/- 1.03). Results showed supervisors (F = 7.89, p = .001) and college graduates (F = 2.89, p = .047) to have higher levels of competency than other participants. Participant knowledge level in dealing with problem behaviors was significantly and positively correlated with frequency of continuing education participation (F = 28.73, p < .001).
  
  
  CONCLUSIONS
  Results point to the need for continuing education, practicum, counseling, staffing resources, and involvement of other professionals to increase HCP readiness and competence.
authors.affiliation: Department of Nursing, Chang Gung Institute of Technology, Taiwan.
authors.forename: Chia-Hsiu
authors.initials: CH
authors.lastname: Chang
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Yeh
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lin
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000401:mortality / Q000523:psychology*; D006801:Humans; D008134:Long-Term Care; D001523:Mental Disorders / Q000451:nursing*; D011361:Professional Competence; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology