Transcript Document

Communication training for
healthcare assistants supporting
young people with complex
communication needs
Cheryl Hanson
Post-graduate research student
Manchester Metropolitan University
[email protected]
Session objectives
• To share what is involved in using the
Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA)
checklist to carry out a systematic literature
review
• To share the preliminary findings of this
literature review
• To share proposed next steps based on the
findings
Introduction
• Existing communication partner training packages
• Healthcare assistants
• Young people with complex communication
needs
• Part of a PhD project
• Develop a communication training package
• Collaboration
• Communication partners
Rationale
•
•
•
•
Access to training in education settings
Healthcare assistants
Continuing Care funded support
Lack of access to a standardised approach to
training for healthcare assistants is a key issue
in the delivery of high quality care
• Difficulties evidencing the transfer of skills and
knowledge from training accessed to practice
Objectives for this research task
•
•
•
•
•
Systematic literature review
PRISMA checklist
Communication training packages
Facilitate change in communication partners
Young people with profound and multiple
learning disability
Inclusion criteria: Population (P)
Population 1:
• Young people <25yrs with diagnosis of PMLD
or PIMD with other diagnoses e.g. ASC, Downs
Syndrome, CP
Population 2:
• Healthcare assistant, support staff, caregiver,
residential support staff
Inclusion criteria: intervention (I)
• Any training programme that aims to change
behaviour of communication partner of
person with PMLD/PIMD
Inclusion criteria: outcome (O)
• Change in communication partners' behaviour,
interactive style, approach to person with
PMLD/PIMD
• Change in quality of observations made of
person with PMLD/PIMD
• Increased use of strategies to support
communication
• Increased knowledge/understanding of
communication
Inclusion criteria: outcome (cont.)
• Increased levels of attentional response to
person with PMLD/PIMD
• Increased quality of response to person with
PMLD/PIMD
• Increase in responsiveness in person with
PMLD/PIMD
• If outcome is no reported change in behaviour
of communication partner with person with
PMLD/PIMD
Inclusion criteria: type of study
• Some element of control e.g. multiple
baseline across subjects design, experimental
and control group
Information sources
Academic One File:
• Arts, humanities, social sciences, science and
technology
CINAHL:
• Nursing, physical therapy, health education,
occupational therapy, and consumer health
Web of Knowledge:
• Web of Science and Medline
Electronic search strategy:
population 1
child* OR infant OR adolescent OR student OR
(young person) OR (young people) OR (young
adult) OR teen*
AND
(profound and multiple learning disab*) OR
(profound and multiple intellectual disab*) OR
(profound intellectual and multiple dis*) OR
(profound* learning disab*)
Electronic search strategy:
population 2
AND
(health care*) OR healthcare* OR support* OR
(residential support*) OR (informal caregiver)
OR (paid carer) OR care* OR auxiliary* OR
(school nurse assistant) OR (respite support*)
OR personal* OR (direct support worker) OR
paraprofessional
Electronic search strategy:
intervention
AND
(communication partner training) OR (communication
skills training) OR (partner assisted communication) OR
(facilitated communication) OR (aided communication)
OR (communication competenc*) OR (communication
skills) OR (communication strategies) OR (alternative and
augmentative communication) OR (intensive interaction)
OR interaction OR sign* OR Makaton OR (objects of
reference) OR (multi-sensory environment*) OR (multimedia profil*) OR (responsiveness) OR (attentional
responsiveness) OR (eye gaze) OR (communication
passports)
Electronic search strategy:
outcome
AND
change OR improv* OR develop* OR (skills
transfer*) OR (knowledge transfer*) OR modif*
OR adapt* OR facilitat* OR outcome
Exclusion criteria: population
Population 1:
• Adult >25yrs with PMLD/PIMD, any person
with a named disability other than
PMLD/PIMD e.g. ASC, SLD, MLD, SEBD, ADHD,
ADD, CP, Downs Syndrome
Population 2:
• Healthcare assistant, support staff, caregiver,
residential support staff working with noncommunication disabled client group
Exclusion criteria
• Any training programme that promotes
change in individual with PMLD/PIMD e.g.
functional communication skills training
• If change not reported
• No element of experimental control reported
Data collection process
Database: CINAHL
Date data retrieved: 12.09.14
Abstract no.
1
2
3
4
5
6
7
8
9
Population 1: young person 025yrs with PIMD
Y
y
U
Y
N
Y
Y
Y
Y
N
N
Y
N
N
N
N
N
N
N
N
Y
N
N
N
N
N
N
N
N
Y
N
N
N
N
N
N
N
N
U
N
N
N
Y
N
N
N
N
U
N
N
N
N
N
N
Population 2: HCA
Intervention: training
Outcome: change in
communication partner
Type of study: some element of
control
ACTION
ACTION RATIONALE
Y = YES: FITS CRITERIA, N = NO:DOES NOT MEET CRITERIA, U = UNSURE: READ PAPER
Summary of data collected
Academic
OneFile
35 hits
CINAHL
9 hits
Web of
Knowledge
74 hits
Stage 1 : title
and abstract
8
110 articles excluded
based on selection
criteria
Stage 2: full text
4
4 articles excluded
based on selection
criteria
Stage 3:
reference
+2
2 further articles
identified from
reference search
Studies selected and retrieved: 1
Reference
Population
1
Population
2
Intervention Outcome
Type of
study
Damen, Kef,
Worm,
Janssen &
Schuengel
1 participant
aged 13yrs
of 5
participants
in total with
PIMD age
range 1354yrs (M =
35yrs) from
total smaple
of 12
1 male
6 female
Mean age
= 32
Mean no.
years
working in
group home
=3
Mean no.
working hrs
= 14
Contact
programme:
identify
target,
interaction
analysis,
coaching
(group
session to
discuss
analysis and
four video
feedback
sessions),
evaluation
AB-design
across
subjects
with two
baseline and
three
intervention
observations
General
pattern of
improved
interaction
with person
with PIMD
across
support
team on
average in
comparison
to baseline
Studies selected and retrieved: 2
Reference
Population
1
Population
2
Croghan
1 participant Hospice
aged 13yrs
staff
Intervention Outcome
How to use
the Affective
Communicat
ion
Assessment
Type of
study
Improved
Case study
understand
ing of
young
person’s
communica
tion
behaviours
Studies selected and retrieved: 3
Reference
Population
1
Munde,
People with
Vlaskamp,
PIMD
Ruijssenaars
& Nakken
Population
2
Intervention Outcome
Direct
10 studies
support staff identified as
making
reference to
staff training
Type of
study
Improveme Systematic
nts in staff literature
interactions review
with people
with PIMD
and thus
their
alertness
Studies selected and yet to be
retrieved: 4
Reference
Population
1
Population
2
Intervention Outcome
Type of
study
Samuel,
Nind &
Vollans
Four women
with
profound
intellectual
disabilities
living in
supported
housing
service
Staff
supporting
the women
in this
service
Training re
intensive
interaction
principles
Quasiexperimental
interrupted
time-series
multiple
baseline
design
Staff
learned to
use
mirroring
and
contingent
responding
with people
with PIMD
Summary of evidence
• Training can have a positive impact on how staff
interact with young people with profound and
multiple disabilities
• Current evidence base is limited
• Difficult to comment on quality of data as so
limited
• Further analysis is needed e.g. exploration of
reference lists, Critical Appraisal Skills Programme
forms, expand search to other databases
Limitations
• Potential study bias
• Potential publisher bias that may need
investigating further
• Potential selection bias, particularly as
working alone
Conclusions
• Significantly under researched area so current
PhD project continues to be justified
particularly in light of recent government
reports and policy
Conclusions (cont.)
• However, wealth of evidence in:
- Assessment of interactions between young
person with profound and multiple disabilities
and the people who support them
- Interventions targeting change in the
behaviour of young people with profound and
multiple disabilities with growth in types of
AAC e.g. micro-switching, symbols, VOCAs
References
• http://prisma-statement.org/statement.htm
• Report of the Mid Staffordshire NHS
Foundation Trust Public Inquiry (2013) Chaired
by Robert Francis QC
• The Cavendish Review: An independent
review into healthcare assistants and support
workers in the NHS and social care settings
(2013) Crown copyright
References (cont.)
• S. Damen, M.J. Janssen, S. Kef, C. Schuengel, and M. Worm (2011) Effects
of video-feedback interaction training for professional caregivers of
children and adults with visual and intellectual disabilities. Journal of
Intellectual Disability Research. 55.(6) p581 .
• Croghan, P. (2009) The therapeutic effects of hand massage: using a case
study, Peter Croghan shows how learning to give a hand massage can help
staff to communicate with patients who cannot speak. Learning Disability
Practice. 12.(5) p29 .
• Munde , V. S., Vlaskamp, C., Ruijssenaars, A.J.J.M. & Nakken H.(2009)
Alertness in individuals with profound intellectual and multiple disabilities:
A literature review. Research In Developmental Disabilities Volume: 30 (3)
p462-480
• Samuel, J., Nind, M., Volans, A., et al.(2008) An evaluation of Intensive
Interaction in community living settings for adults with profound
intellectual disabilities. Journal of intellectual disabilities : Journal of
Intellectual Disability 12 (2) p111-26