Quality of care for people with mental handicap and challenging behaviour : an investigation of the impact of staff training in goal attainment scaling and behavioural procedures
Year: 1992
Type: article
Study design: Clinical Trial
Abstract: This study examined the contribution to quality of care \nof a goal planning technique called Goal Attainment \nScaling and its impact upon the quality of life of people \nwith severe mental handicaps and challenging behaviour. \nThe study also seeks to establish the utility of \nemploying Goal Attainment Scaling as a means of \nevaluating clinical nursing performance, \nThis study essentially aims to bring about changes in the \ncare practices of nurses using a comprehensive staff \nmanagement procedure. The study was designed as a four \nphase intervention using a multiple baseline design \nacross three wards in a hospital for people with mental \nhandicaps. Staff on three wards (n = 41) were initially \ntrained over three phases in the use of Goal Attainment \nScaling and other procedures. Training was carried out by \na combination of workshops and individual tuition which \nincorporated the use of individualised learning contracts \nfor staff. The fourth phase consisted of establishing \nweekly meetings to set objectives for staff to achieve \nthat were specifically related to material covered in \ntraining. If targets were achieved, staff performance was \nfollowed by letters of recognition from managers and by \nfinancial donations to ward funds. \nDependent measures included frequency of challenging \nbehaviour, quality of staff-resident interaction and \nengagement, ward activity, residents' adaptive behaviour, \nstaff attitudes and goals set by staff. Results indicate \nthat adaptive behaviour increased by small but \nstatistically significant levels. Levels of challenging \ndisplay a mixed pattern of results, as do levels of ward \nactivity and quality of interaction, although encouraging \ntrends may be identified. Despite some increases, \nresidents still spend significant amounts of time \nunoccupied. The number of goals set increased throughout \nthe study, particularly in phase four, data for staff \nattitudes were not used because of the low compliance \nrate and changes indicated below. \nConsiderable problems were encountered with turnover of \nstaff and other organisational changes outwith the \nresearcher's control which compromised both the quality \nof training given to staff and, by virtue of this, the \nfinal results. Statistically significant relationships \nwere found to exist between staff turnover and \ninteraction. \nThe implications of this study are discussed and \nrecommendations made for future research.
Author: J.W. Turnbull
Language: English
Subfield: Developmental and Educational Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W137873088