Process evaluation of the context, reach and recruitment of participants and delivery of dementia-specific case conferences (WELCOME-IdA) in nursing homes (FallDem): a mixed-methods study

Autor: Sven Reuther, Martina Roes, Daniela Holle, René Müller-Widmer, Margareta Halek, Rabea Graf, Ute Rosier-Segschneider
Rok vydání: 2018
Předmět:
Health Knowledge
Attitudes
Practice
Inservice Training
Medicine (miscellaneous)
psychology [Nursing Staff]
nursing [Dementia]
0302 clinical medicine
Germany
Medicine
Homes for the Aged
Pharmacology (medical)
030212 general & internal medicine
Education
Nursing
Qualitative Research
Mixed-methods study
lcsh:R5-920
Nursing home
education [Nursing Staff]
Attendance
Dementia-specific case conference
Outcome and Process Assessment
Health Care
Treatment Outcome
lcsh:Medicine (General)
WELCOME-IdA
psychology [Dementia]
Attitude of Health Personnel
Sample (statistics)
Context (language use)
Process evaluation
Interviews as Topic
03 medical and health sciences
Nursing
Intervention (counseling)
Humans
ddc:610
Protocol (science)
Patient Care Team
Descriptive statistics
business.industry
Patient Selection
Research
diagnosis [Dementia]
Nursing Homes
Content analysis
Sample size determination
Behavioural and psychological symptoms
Dementia
Interdisciplinary Communication
Nursing Staff
business
Delivery of Health Care
030217 neurology & neurosurgery
Zdroj: Trials
Trials, Vol 20, Iss 1, Pp 1-14 (2019)
Trials 20(1), 45 (2019). doi:10.1186/s13063-018-3147-9
ISSN: 1745-6215
DOI: 10.1186/s13063-018-3147-9
Popis: Background A system of dementia-specific case conferences (WELCOME-IdA) was evaluated using a stepped-wedge design in six nursing homes (NHs) to enable nursing staff to analyse properly the behavioural and psychological symptoms (BPSD) of residents with dementia. A process evaluation of the context, the recruitment and target populations reached (residents and nursing staff) and the delivery of the intervention and implementation strategy was carried out to explore the lack of effectiveness of WELCOME-IdA on the residents’ prevalence of BPSD. Methods This study was part of a larger process evaluation using a mixed-methods design. Standardised questionnaires, semi-structured interviews, attendance lists, standardised protocols and written self-reports were used to collect the data. The quantitative data were analysed by calculating descriptive statistics. The qualitative interviews were analysed using deductive content analysis and the self-reports were analysed using a documentary analysis. Results None of the NHs had prior experience with dementia-specific case conferences on a specific concept related to BPSD. The number of residents for whom a dementia-specific case conference was held was lower than expected. The number of nursing staff reached was high, although as defined in the study protocol, core nursing teams continuously participating in all components of the intervention were not established throughout the study. An analysis of the delivery of the intervention showed a reduction in the frequency of dementia-specific case conferences and deviations in the process structure and role structure of WELCOME-IdA. The strategy used to facilitate the implementation of WELCOME-IdA was mostly followed. An analysis of the recruitment of residents indicated that the variation in which residents were included in the study sample was high and that the intended sample size required to achieve a power >80% was not reached. Conclusion An analysis of the process evaluation data indicated that there were inaccuracies in the implementation of WELCOME-IdA and there were methodological limitations within the design of the effectiveness trial, both of which could explain the lack of effectiveness of WELCOME-IdA. To optimise the process structure of WELCOME-IdA, an assessment of BPSD and a pre-selection of possible domains for the behavioural analysis could be conducted prior to a dementia-specific case conference. Trial registration ISRCTN20203855. Registered on 10 July 2013.
Databáze: OpenAIRE
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