Multi-Sensory Stimulation in 24-hour Dementia Care - Nivel

The fifth objective was to find out whether the implementation of snoezelen had a
positive effect on the quality of working life of CNAs who apply snoezel care,
compared to CNAs who apply usual care.
In particular, it was hypothesized that the intervention would lead to measurable,
positive changes in
Workload: the activities that someone has to carry out in a particular
environment, classified in job characteristics (skill variety, learning opportunities,
autonomy, having a say) and working conditions (time pressure, role ambiguity).
Positive effects of the implementation of
snoezelen were especially assumed on working conditions.
Psychological outcomes of CNAs : the subjective experience of the actual
workload, operationalised in perceived problems, stress reactions, job satisfaction
and burnout.
Design of the study
A quasi-experimental pre-test and post-test design was carried out. The study was
performed in twelve psycho-geriatric wards of six Dutch nursing homes. The six
experimental wards received a training ‘snoezelen for caregivers’ to implement
snoezelen in 24-h care. In the six control wards, usual care was continued.
Randomisation took place at ward level by way of an independent person drawing
lots drawn from a sealed container. Nursing units were randomised within each
nursing home (every nursing home delivered an experimental and a control ward)
instead of randomising entire nursing homes. Therefore, the experimental and the
control group were considered to be comparable in terms of admission policy,
capacity for psychogeriatric residents, population of psychogeriatric residents on the
ward, composition of nursing staff, staff-client ratio, used care model at baseline,
system of resident-allocation, service types and degree of care innovation. By
interviews with staff members, these aspects were verified. In case of allocation to
the control group, the ward had to refrain from snoezelen training or implementation
of elements from the snoezel care model during the study period. Commitment to this
and other inclusion criteria (see chapter 6) were laid down in a co-operative
agreement. Control for contamination on the control wards was done by
interviewing the head nurses. Control on the intervention in the experimental wards
was done by participating observations in five of the six experimental wards (Janssen,
2001; Vruggink, 2004).
Measurements were performed at baseline and after 18 months in the period
between January 2001 and February 2003. The nursing homes were consecutively
included between January (home 1) and August 2001 (home 6), in order to spread
the activities with regard to the pre-test and post-test and the intervention. The
Introduction 21