Effects of a feeding skills training program on knowledge, attitude, perceived behavior control, intention, and behavior of formal caregivers toward feeding dementia patients in Taiwan nursing homes (China)

The purposes of this study were (1) to explore the feeding difficulties among dementia patients in Taiwan; and (2) to examine the effects of a feeding skills training program on knowledge, attitude, perceived behavior control, intention, and behaviors of formal caregivers toward feeding dementia patients in nursing homes. Theory of Planned Behavior guided this study. Sixty-seven nursing assistants (treatment 31; control 36) were enrolled. The repeated measures ANOVA with two groups and three time points were used. A feeding skills training program, attitude and knowledge questionnaires, perceived behavior control and intention scale, and an observation checklist were developed by the researcher. The treatment group received a feeding skills training program that included three hours of in-service classes and one hour of hands-on training. The content included the purpose of program, overview of dementia, etiology and behaviors of feeding problems, and protocol for feeding dementia patients. Cronbach's alpha for knowledge, attitude, and behavioral checklist were 0.7, 0.6 and 0.7. Test-retest reliability of perceived behavior control and intention scale was reported by the Pearson Correlation at 0.5, 0.6, and 0.5. All questionnaires were back translated from English to Chinese to English and were subjected to expert reviews.; (1) The treatment group had significantly more knowledge, greater intention, and better behaviors than the control group after the intervention. (2) There were no significant differences between the groups on attitude and perceived behavior control. (3) Hierarchical regression revealed that there were significant behavior changes between the treatment and control groups after the intervention. (4) Slope analysis showed that the two groups had significantly different change patterns on knowledge and attitudes from Time 1 to Time 2 and from Time 1 to Time 3. (5) There were no significantly different change patterns for perceived behavior control between the two groups. (6) There were significant pattern changes on intention from Time 1 to Time 3.; This feeding skills training program can be utilized for nursing assistant on-the-job training. The study instruments along with ethical and cultural considerations should be included in future training programs. Furthermore, family members, volunteers, and other health workers should assist patients with eating during mealtimes.