Effectiveness of the “Person First – Please” educational intervention for nurses in older people long-term care –protocol for a cluster RCT v1

2022 ◽  
Author(s):  
Mari Pakkonen ◽  
Minna Stolt ◽  
Minna Ylönen ◽  
Miko Pasanen ◽  
Riitta Suhonen
Keyword(s):  
Older People ◽  
Continuing Education ◽  
Educational Intervention ◽  
Long Term Care ◽  
Intervention Group ◽  
Control Group ◽  
Term Care ◽  
Care Protocol ◽  
Collective Competence

Aim. To evaluate effectiveness of “Person First –Please” (PFP) intervention in supporting nurses’ collective competence in Person-centred Care (PCC) in Long-Term Care (LTC) of older people. Design. Cluster randomised controlled trial. Methods. Intervention group comprising nurses working on older people LTC will receive PFP Continuing Education (CE) intervention; control group will work as usual. The primary outcomes are nurses’ individual PCC competence and intervention’s effectiveness for collective competence. Secondary outcomes are PCC climate as perceived by nurses, residents and their families. Measurements are conducted three times (baseline, after PFP intervention and after 6-week follow-up) in both groups. Results. The study will provide evidence of PFP’s effectiveness and its influence on PCC climate of older people LTC. If effective, the educational intervention can be used to improve PCC and quality care for older people. Keywords Person-centred care, older people, long-term care, intervention, continuing education, collective competence

scholarly journals Continuing education interventions about person-centered care targeted for nurses in older people long-term care: a systematic review

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mari Pakkonen ◽  
Minna Stolt ◽  
Andreas Charalambous ◽  
Riitta Suhonen
Keyword(s):  
Older People ◽  
Continuing Education ◽  
Long Term Care ◽  
Educational Interventions ◽  
Term Care ◽  
Person Centered Care ◽  
Centered Care ◽  
Education Interventions

Abstract Background Person-Centered Care is often seen as an indicator of quality of care. However, it is not known whether and to what extent person-centered care can be enhanced by continuing education interventions in older people’s long-term care settings. This systematic review aimed to analyze and synthesize the existing research literature about person-centered care-based continuing educational interventions for nurses working in long-term care settings for older people. Methods Five databases were searched 6/2019 and updated 7/2020; PubMed (Medline), CINAHL, PsycINFO, Cochrane and Eric using the keywords person-centered car* OR person-centred car * OR patient-centered car* OR client-centered car* OR tailored car* OR resident-centered car* OR individualized car* AND older* OR elder* OR old person* AND Long-Term Care OR Nursing home OR 24-h treatment OR long-term treatment. Twenty-seven full texts from 2587 initially retrieved citations were included. Results The continuing educational interventions found were divided into five themes: person-centered interventions focusing on medication; interaction and caring culture; nurses’ job satisfaction; nursing activities; and older people’s quality of life. The perspective of older people and their next of kin about the influence of continuing education interventions were largely absent. The background theories about interventions, the measurements taken, and the clarity around the building blocks of the continuing-care interventions need further empirical verification. The pedagogical methods used were mainly quite behavioristic mostly lectures and seminars. Conclusion Most of person-centered care continuing education interventions are effective. Still more empirical research-based continuing education interventions are needed that include learner-centered pedagogical methods, with measurable outcomes that consider the opinions of older people and their next of kin. Continuing educational interventions for nurses need to be further developed to strengthen nurse’s competence in person-centered care, job satisfaction and for better quality of care.

scholarly journals Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial

2019 ◽  
Author(s):  
Lynne Taylor ◽  
John Parsons ◽  
Denise Taylor ◽  
Elizabeth Binns ◽  
Sue Lord ◽  
...  
Keyword(s):  
Older Adults ◽  
Cost Effectiveness ◽  
Long Term Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Community Dwelling ◽  
Control Group ◽  
Term Care

Abstract Background Falls are two to four times more frequent amongst long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesized that a progressive exercise program targeting balance and strength will reduce falls rates when compared to a seated exercise program and do so cost effectively. Methods/Design This is a single blind, parallel-group, randomized controlled trial with blinded assessment of outcome and intention-to-treat analysis. LTC residents (age ≥65 years) will be recruited from LTC facilities in New Zealand. Participants (n= 528 total; with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable to people with dementia, (intervention group) or a seated exercise program (control group). The intervention and control group classes will be delivered for 1 hour twice weekly over 1 year. The primary outcome is rate of falls (per 1000 person years) within the intervention period. Secondary outcomes will be risk of falling (the proportion of fallers per group), falls rate relative to activity exposure, hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and change in physical performance assessed at baseline, 6 and 12 months. Cost effectiveness will be examined using intervention and health service costs. The trial commenced recruitment on 31 November 2018. Discussion This study evaluates the efficacy and cost effectiveness of a progressive strength and balance exercise program for aged-care residents to reduce falls. The outcomes will aid development of evidenced-based exercise programs for this vulnerable population.

scholarly journals 206 Deprescribing in Frail Older People Transitioning to Long-term Care: a Randomized Controlled Trial Using STOPPFrail Criteria

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Denis Curtin ◽  
Emma Jennings ◽  
Ruth Daunt ◽  
Mary Randles ◽  
Paul Gallagher ◽  
...  
Keyword(s):  
Older People ◽  
Intervention Group ◽  
Nursing Home Care ◽  
Control Group ◽  
Frail Older People ◽  
Term Care ◽  
Emergency Hospital ◽  
Significant Difference ◽  
The Mean

Abstract Background Older people with advanced frailty are among the highest consumers of prescription medications. When life expectancy is limited, the use of multiple medications may be unnecessary or burdensome. STOPPFrail criteria were recently developed to assist clinicians with deprescribing decisions in frail older people approaching end-of-life. The aim of this study was to examine whether long-term medications could be safely discontinued in frail older people using STOPPFrail criteria. Methods We recruited hospitalized adults aged ≥75 years with polypharmacy (≥5 long-term medications) that were transitioning to nursing home care. Participants were eligible if their Clinical Frailty Scale score was ≥7 and if their attending physician indicated that he/she “would not be surprised if the patient died in the next 12 months”. Patients were randomized to single time point pre-discharge STOPPFrail-guided deprescribing or routine pharmaceutical care. The primary outcome was change in the number of regular medications at 3 months. Secondary outcomes included emergency hospital transfers, incident falls, fractures and mortality. Results Results are presented for the first 100 enrolled patients. The mean (±standard deviation [SD]) age of study participants was 85.1 (±5.7) and 61% were female. Intervention (n = 49) and control group (n = 51) participants were prescribed a mean (±SD) of 11.5 (±3.0) and 10.9 (±3.5) regular medications, respectively, at baseline. The mean (±SD) change in the number of regular medications at 3 months was -2.7 (±2.8) in the intervention group and -0.6 (±2.6) in the control group (estimated difference 2.1 ±0.6, 95% confidence interval 0.8 -3.3, p=0.001). Ten intervention participants and 14 control participants died within 3 months of randomization (20.4% vs 27.4%, p=0.49). There was no significant difference between groups for emergency hospital transfers, incident falls or fractures. Conclusion STOPPFrail-guided deprescribing significantly reduced medication burden in frail older people without adversely affecting clinical outcomes in the prospective 3 months.

Improving Quality of Work life for Care Providers by Fostering the Emotional well-being of Persons with Dementia: A Cluster-randomized Trial of a Nursing Intervention in German long-term Care Settings

Dementia ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 1286-1309 ◽  
Author(s):  
Charlotte Berendonk ◽  
Roman Kaspar ◽  
Marion Bär ◽  
Matthias Hoben
Keyword(s):  
Long Term Care ◽  
Intervention Group ◽  
Cluster Randomized Trial ◽  
Well Being ◽  
Nursing Intervention ◽  
Control Group ◽  
Care Providers ◽  
Term Care ◽  
Cluster Randomized

We tested the feasibility of a nursing intervention (DEMIAN) in routine care and its effects on care providers’ job satisfaction, motivation, and work strain. This cluster-randomized trial was conducted in 20 German long-term care facilities. We randomly assigned 20 facilities to an intervention group (84 care providers, 42 residents with dementia) or a control group (96 care providers, 42 residents with dementia). Intervention group providers received two training days on the intervention; 68 providers attended both training days. Sixty two providers completed both baseline and follow-up questionnaires. Trained providers created individualized mini-intervention plans for participating residents. Control group residents received ‘usual care’. Intervention group providers stated that the intervention was feasible and helped them improve emotional well-being of residents with dementia. We found significantly decreased time pressure and decreased job dissatisfaction for intervention group providers. DEMIAN is an effective and pragmatic contribution to implementing person-centred care in long-term care, with positive effects on providers’ working conditions.

scholarly journals Effects of 1 Year of Lifestyle Intervention on Institutionalized Older Adults

2021 ◽  
Vol 18 (14) ◽  
pp. 7612
Author(s):  
Daniele Magistro ◽  
Fabio Carlevaro ◽  
Francesca Magno ◽  
Martina Simon ◽  
Nicola Camp ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Lifestyle Intervention ◽  
Long Term Care ◽  
Social Care ◽  
Care Home ◽  
Intervention Group ◽  
Control Group ◽  
Term Care

The socio-economic and health consequences of our ageing population are well documented, with older adults living in long-term care facilities amongst the frailest possessing specific and significant healthcare and social care needs. These needs may be exacerbated through the sedentary behaviour which is prevalent within care home settings. Reducing sedentary time can reduce the risk of many diseases and improve functional health, implying that improvements in health may be gained by simply helping older adults substitute time spent sitting with time spent standing or in light-intensity ambulation. This study identified the impact of 1 year of lifestyle intervention in a group of older adults living in a long-term care setting in Italy. One hundred and eleven older adults (mean age, 82.37 years; SD = 10.55 years) participated in the study. Sixty-nine older adults were in the intervention group (35 without severe cognitive decline and 34 with dementia) and 42 older adults were in the control group. Data on physical functioning, basic activities of daily living (BADL) and mood were collected 4 times, before, during (every four months) and after the 1 year of intervention. The lifestyle intervention focused on improving the amount of time spent every week in active behaviour and physical activity (minimum 150 min of weekly activities). All participants completed the training program and no adverse events, related to the program, occurred. The intervention group showed steady and significant improvements in physical functioning and a stable situation in BADL and mood following the intervention in older adults with and without dementia, whilst the control group exhibited a significant decline over time. These results suggest that engagement in a physical activity intervention may benefit care home residents with and without dementia both physically and mentally, leading to improved social care and a reduced burden on healthcare services.

scholarly journals The Effects of a Horticulture Activity Program on the Psychological Well-being of Older People in a Long-term Care Facility

2003 ◽  
Vol 13 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Tom Barnicle ◽  
Karen Stoelzle Midden
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Care Facility ◽  
Well Being ◽  
Control Group ◽  
Term Care ◽  
Psychological Well Being ◽  
Long Term Care Facility ◽  
Current Psychological

This study investigated the effects of indoor horticulture activities on the current psychological well-being of older people in two long-term care facilities over a 7-week period. Thirty-one participants at one facility served as the control group. Thirty-one participants at another facility served as the horticulture group. Participants in both facilities continued with their normal daily routine and activities over the 7-week period; however, the horticulture group participated in a 1-hour horticulture activity session once a week over the 7-week period and the control group did not. The control group and horticulture group did not differ significantly in psychological well-being prior to the start of the study. After the 7-week program, the horticulture group had a significant increase in psychological well-being, whereas the control group had a slight decrease in psychological well-being. The results of this study indicate that horticulture activities may have a beneficial effect on the current psychological well-being of older people in a long-term care facility.

Effects of reminiscing about nostalgic smells on the physiological and psychological responses of older people in long-term care facilities

2018 ◽  
Vol 40 (3) ◽  
pp. 501-511
Author(s):  
Sin Rou Fu ◽  
Mei Fen Lee ◽  
Sheng Jung Ou
Keyword(s):  
Older People ◽  
Mixed Methods Research ◽  
Long Term Care ◽  
Control Group ◽  
Depression Symptoms ◽  
Psychological Responses ◽  
Term Care ◽  
Care Facilities ◽  
Experimental Group

AbstractThis study adopted mixed-methods research to explore the effects of reminiscing about nostalgic smells on the physiological and psychological responses of older people in long-term care facilities. A total of 60 participants were randomly divided into two groups and each participant was either interviewed regarding their reminiscence about nostalgic smells (experimental group) or were engaged in daily conversation (control group). The results indicated that anxiety and depression symptoms were more effectively relieved in the experimental group than in the control group. Moreover, most of the nostalgic smells recalled by the experimental group were associated with naturally occurring smells. Regarding heart rate variability, the normalised low-frequency of the experimental group decreased significantly. The results verified the utility of using reminiscence about olfactory memories in reminiscence therapy as this can calm anxiety and lessen depression, which can be very important for older adults living in long-term care facilities.

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