Aims and objectives. The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. Background. Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. Design methods. A quasi-experimental study was conducted. Two convenience-chosen dementia-specialized long-term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty-seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in-service classes and one hour of hands-on training, whereas the control group did not receive any training. Results. The treatment group had significantly more knowledge (F = 47.7, P <0.001), more positive attitude (F = 15.75, P = 0.001) and better behaviours (t = 6.0, P <0.001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2.7, P <0.05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2.1, P <0.05) than the control group. There was no significant difference on food intake between the two groups (t = 0.8, P = 0.49). Conclusion. This feeding skills training programme has been found to change nursing assistants' knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. Relevance to clinical practice. This study raises attention regarding on-the-job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.
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