Nurses and social workers perception on daily care for Korsakoff's patients
Description
The health problems and care needs of patients with Korsakoff’s syndrome described contains a manifold of problems across various domains: somatic (e.g., cardiovascular diseases), psychiatric (e.g., personality disorders), behavioural (e.g., apathy) and functional (e.g., loneliness). The first aim of the study was to explore what healthcare workers subjectively experience as being the most difficult aspect of providing daily care to patients with Korsakoff’s syndrome in the above-described domains and to find out how competent they feel they are at dealing with them. Secondly, we wanted to establish how the experienced problems were related to their perceived competencies. Thirdly, we were interested in the predictive variables that are associated with the perceived problems and competencies, such as age, professional background, years working in care, years working in Korsakoff care, and the type of specialist facility they are working in. The predictive variables were based on expert opinions. Data was gathered with a multi-centre survey study (see appendix 1). The survey contained 47 items, which were to be scored on a Visual Analogue Scale ranging from 0-100. The results of our study indicate that whilst healthcare workers perceived the presence of the different healthcare problems as being moderately high, they nevertheless felt generally competent when it comes to managing them. On the item level, healthcare workers considered patients neglecting themselves as the most challenging problem in daily care. Observing symptoms of a cerebral vascular accident (CVA) in turn was regarded as the least challenging problem. On the category level, perceived problems by healthcare workers were scored the highest in the functional category, whilst the somatic category received the lowest scores. Regarding competency at the item level, the healthcare workers felt most competent with regards to supporting the daily living activities of their patients. They felt least competent with respect to managing paranoid behaviour. For detailed score information for each category, see Appendix 2. At the category level, the functional category had the highest competence scores whilst the psychiatric/behavioural category received the lowest scores. A weak but nevertheless statistically significant negative correlation was found between perceived problems and competency. Finally, we explored the predictive variables associated with perceived problems and competency. The variables age and social work profession, along with professions that came under the category ‘other,’ were statistically significantly associated with perceived problems. For competence, the variable ‘nurse-assistant’ was statistically significantly associated.
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Staff employed in daily care within all specialist long-term care facilities affiliated with the Dutch Korsakoff Network organisation were invited to participate in the survey. Each facility had a contact person for the Dutch Korsakoff Network organisation. The contact person received an initial email from this Network with an invitation to participate in the study. If they were willing to participate, then they were subsequently invited to attend an online information meeting. After this meeting, they were asked to confirm their participation. Those contact persons who could not attend the information meeting were offered an individual appointment and then asked to confirm that they wished to participate. A reminder was sent three weeks later. After the confirmation had been received, the contact person then received an email providing them with all the details about the study and a link to the survey. The contact persons then forwarded this email to all eligible nurses and social workers within their respective setting. Furthermore, the survey was distributed through different channels. Besides the contact persons recruiting from the Korsakoff Centres, a link to the survey was also spread via the newsletter of the Dutch Korsakoff Network organisation. The inclusie criteria for participants were as follows: Command of the Dutch language; Age > 16; Working in daily care provision for patients with Korsakoff’s syndrome; Working in an institute that is a member of the Dutch Korsakoff Network organisation. Participation in the study was voluntary. Participants were not compensated for their efforts. For this study, a self-designed survey was used. The items ware based on our literature review (van Dam et al., 2020) and categorised accordingly into somatic, psychiatric/ behavioural, and functional categories. The research group discussed the selection of items in several rounds to check the completeness of the questionnaire and to see whether the items were clearly worded. The feasibility of the survey was tested in a pilot study that involved seven nurses in two rounds, using the method of cognitive interviewing (Beatty & Willis, 2007).