Process evaluation of a complex intervention to promote advance care planning in community-dwelling older persons (the STADPLAN study)—study protocol
Autor: | Almuth Berg, Änne Kirchner, Henriette Langner, Sascha Köpke, Rieke Schnakenberg, Falk Hoffmann, Juliane Köberlein-Neu, Gabriele Meyer, Katharina Silies |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Advance care planning
Mixed methods Nurses Medicine (miscellaneous) Context (language use) Nursing Process evaluation law.invention Home care setting Advance Care Planning 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Complex intervention law Intervention (counseling) Study protocol Humans Medicine Pharmacology (medical) Generalizability theory 030212 general & internal medicine Aged Randomized Controlled Trials as Topic Aged 80 and over lcsh:R5-920 business.industry Ambulatory setting Home Care Services Focus group humanities Clinical trial Logic model 030220 oncology & carcinogenesis Independent Living business lcsh:Medicine (General) Educational program |
Zdroj: | Trials, Vol 21, Iss 1, Pp 1-12 (2020) Trials |
ISSN: | 1745-6215 |
Popis: | Background Process evaluation addresses the implementation, mechanisms of impact, and context of participants in complex interventions. The STADPLAN study assesses the effects of conversations on advance care planning (ACP) led by trained nurse facilitators. The complex intervention consists of several components that may lead to various changes in attitude and behavior regarding personal ACP activities. With the process evaluation, we aim to assess how changes were achieved in the STADPLAN intervention. Methods The planned process evaluation study will be conducted alongside a cluster-randomized controlled trial on ACP in home care services (HCS). Trained nurse facilitators will deliver the ACP intervention consisting of an information brochure and two ACP conversations. A logic model depicts the assumed change processes of the intervention: the educational program enables nurses to conduct ACP conversations with patients and their caregivers. Patients gain knowledge and reflect upon and engage in their own ACP. Caregivers better understand patients’ wishes and feel reassured in their role as surrogates. Designation of a surrogate and communication on ACP are facilitated. We will assess the effects of the educational program with questionnaires and a focus group including all participating nurses. We will measure ACP engagement, and prevalence of advance directives in patients, and ask for their experiences with the intervention. We will conduct semi-structured interviews with caregivers about their expectations and experiences regarding ACP in general and the intervention. We will address context factors, e.g., basic characteristics of the HCS (such as ownership, number of clients, staff and qualification). Analysis will be based upon the logic model, integrating qualitative and quantitative data. Discussion The comprehensive process evaluation will provide essential information on the feasibility of implementation strategies and the clinical relevance of a nurse-led ACP intervention in home care recipients and its generalizability and transferability to other settings. Trial registration German Clinical Trials Register: DRKS00016886. Registered retrospectively on June 4, 2019, first participant included on May 29, 2019. |
Databáze: | OpenAIRE |
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