Evaluation of the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) programme: a protocol of a cluster randomised control trial.

Autor:	Kaasalainen S; School of Nursing, McMaster University, Hamilton, Ontario, Canada.; Gladys Sharpe Chair in Nursing, School of Nursing, McMaster University, Hamilton, Ontario, Canada., Wickson-Griffiths A; Faculty of Nursing, University of Regina, Regina, Saskatchewan, Canada., Hunter P; St Thomas More College, Saskatoon, Saskatchewan, Canada., Thompson G; College of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada., Kruizinga J; School of Nursing, McMaster University, Hamilton, Ontario, Canada kruizij@mcmaster.ca., McCleary L; Department of Nursing, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada., Sussman T; School of Social Work, McGill University, Montreal, Québec, Canada., Venturato L; Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada., Shaw S; School of Nursing, McMaster University, Hamilton, Ontario, Canada., Boamah SA; School of Nursing, McMaster University, Hamilton, Ontario, Canada., Bourgeois-Guérin V; Université du Québec à Montréal, Montreal, Québec, Canada., Hadjistavropoulos T; Department of Psychology, University of Regina, Regina, Saskatchewan, Canada., Macdonald M; Dalhousie University, Halifax, Nova Scotia, Canada., Martin-Misener R; Dalhousie University, Halifax, Nova Scotia, Canada., McClement S; College of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada., Parker D; Aged Care, University of Technology Sydney Faculty of Health, Sydney, New South Wales, Australia., Penner J; College of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada., Ploeg J; School of Nursing, McMaster University, Hamilton, Ontario, Canada., Sinclair S; Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada., Fisher K; School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Oct 25; Vol. 13 (10), pp. e073585. Date of Electronic Publication: 2023 Oct 25.
DOI:	10.1136/bmjopen-2023-073585
Abstrakt:	Introduction: Despite the high mortality rates in long-term care (LTC) homes, most do not have a formalised palliative programme. Hence, our research team has developed the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) programme. The goal of the proposed study is to examine the implementation and effectiveness of the SPA-LTC programme. Methods and Analysis: A cross-jurisdictional, effectiveness-implementation type II hybrid cluster randomised control trial design will be used to assess the SPA-LTC programme for 18 LTC homes (six homes within each of three provinces). Randomisation will occur at the level of the LTC home within each province, using a 1:1 ratio (three homes in the intervention and control groups). Baseline staff surveys will take place over a 3-month period at the beginning for both the intervention and control groups. The intervention group will then receive facilitated training and education for staff, and residents and their family members will participate in the SPA-LTC programme. Postintervention data collection will be conducted in a similar manner as in the baseline period for both groups. The overall target sample size will be 594 (297 per arm, 33 resident/family member participants per home, 18 homes). Data collection and analysis will involve organisational, staff, resident and family measures. The primary outcome will be a binary measure capturing any emergency department use in the last 6 months of life (resident); with secondary outcomes including location of death (resident), satisfaction and decisional conflict (family), knowledge and confidence implementing a palliative approach (staff), along with implementation outcomes (ie, feasibility, reach, fidelity and perceived sustainability of the SPA-LTC programme). The primary outcome will be analysed via multivariable logistic regression using generalised estimating equations. Intention-to-treat principles will be used in the analysis. Ethics and Dissemination: The study has received ethical approval. Results will be disseminated at various presentations and feedback sessions; at provincial, national and international conferences, and in a series of manuscripts that will be submitted to peer-reviewed, open access journals. Trial Registration Number: NCT039359. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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