期刊论文详细信息
Trials
Maintenance Cognitive Stimulation Therapy (CST) in practice: study protocol for a randomized controlled trial
Martin Orrell4  Ian Russell2  Robert Woods3  Zoe Hoare1  Juanita Hoe4  Elisa Aguirre4  Aimee Spector4  Amy Streater4 
[1] IMSCaR, room 105, Y Wern, Bangor University, Bangor, UK;Bangor University, Brigantia Building, Lon Penrallt, Bangor, UK;DSDC Wales, 45 College Road, Bangor University, Bangor, UK;North East London Foundation Trust, Goodmayes Hospital, Ilford, London, UK
关键词: Training;    Staff;    Dementia;    Cognitive stimulation;   
Others  :  1095516
DOI  :  10.1186/1745-6215-13-91
 received in 2012-04-02, accepted in 2012-06-26,  发布年份 2012
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【 摘 要 】

Background

Cognitive Stimulation Therapy (CST) is a psychosocial evidence-based group intervention for people with dementia recommended by the UK NICE guidelines. In clinical trials, CST has been shown to improve cognition and quality of life, but little is known about the best way of ensuring implementation of CST in practice settings. A recent pilot study found that a third of people who attend CST training go on to run CST in practice, but staff identified a lack of support as a key reason for the lack of implementation.

Methods/design

There are three projects in this study: The first is a pragmatic multi-centre, randomised controlled trial (RCT) of staff training, comparing CST training and outreach support with CST training only; the second, the monitoring and outreach trial, is a phase IV trial that evaluates implementation of CST in practice by staff members who have previously had the CST manual or attended training. Centres will be randomised to receive outreach support. The primary outcome measure for both of these trials is the number of CST sessions run for people with dementia. Secondary outcomes include the number of attenders at sessions, job satisfaction, dementia knowledge and attitudes, competency, barriers to change, approach to learning and a controllability of beliefs and the level of adherence. Focus groups will assess staff members’ perceptions of running CST groups and receiving outreach support. The third study involves monitoring centres running groups in their usual practice and looking at basic outcomes of cognition and quality of life for the person with dementia.

Discussion

These studies assess the effects of outreach support on putting CST into practice and running groups effectively in a variety of care settings with people with dementia; evaluate the effectiveness of CST in standard clinical practice; and identify key factors promoting or impeding the successful running of groups.

Trial registration

Clinical trial ISRCTN28793457.

【 授权许可】

   
2012 Streater et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Lutz W, Sanderson W, Scherbov S: The coming acceleration of global population ageing. Nature 2008, 451:716-719.
  • [2]Romanow RJ: Building on values, In The future of health care in Canada-Final report (electronic version). National Library of Canada, Ottawa, ON; 2002.
  • [3]Murdoch P: How might a crisis in long-term care of people with dementia be averted. Age Ageing 2007, 36(1):6-7.
  • [4]Living well with dementia: A National Dementia Strategy DH/SCLG&CP/SCPI/SR. 2009.
  • [5]Spector A, Thorgrimsen L, Woods B, Royan L, Davies S, Butterworth M, Orrell M: A randomised controlled trial investigating the effectiveness of an evidence-based cognitive stimulation therapy programme for people with dementia. Br J Psychiatry 2003, 183:248-254.
  • [6]Spector A, Davies S, Woods B, Orrell M: Reality orientation for dementia: a systematic review of the evidence of effectiveness from Randomized Controlled Trials. Gerontologist 2000, 40(2):206-212.
  • [7]Medical Research Council: A framework for the development and evaluation of RCT’s for complex interventions to improve health, Medical Research Council. 2000. [http://www.mrc.ac.uk/Utilities/Documentrecord/index.htm? webcite]d=MRC003372
  • [8]Knapp M, Thorgrimsen L, Patel A, Spector A, Hallam A, Woods B: Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis. Br J Psychiatry 2006, 188:574-580.
  • [9]Woods B, Aguirre E, Spector AE, Orrell M: Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012, 1:CD005562.
  • [10]National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (NICE-SCIE): Dementia: supporting people with dementia and their carers in health and social care, Clinical Guideline 42. NICE-SCIE, London; 2006.
  • [11]Orrell M, Spector A, Thorgrimsen L, Woods B: A pilot study examining the effectiveness of Maintenance Cognitive Stimulation Therapy (MCST) for people with dementia. Int J Geriatr Psychiatry 2005, 20:446-451.
  • [12]Aguirre E, Spector A, Hoe J, Russell I, Knapp M, Woods R, Orrell M: Maintenance Cognitive Stimulation Therapy (CST) for dementia: a single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia Trials 2010, 11:46.
  • [13]National Audit Office: Improving Services and support for people with dementia. The Stationary office, London, UK; 2007.
  • [14]Spector A, Thorgrimsen L, Woods B, Orrell M: Making a difference: an evidence-based group programme to offer Cognitive Stimulation therapy (CST) to people with dementia. Hawker Publications, UK; 2006.
  • [15]Aguirre E, Spector A, Streater A, Hoe J, Woods B, Orrell M: Making a difference 2. Hawker Publications, UK; 2012.
  • [16]Spector A, Orrell M, Aguirre E: Translating research into practice: a pilot study examining the use of Cognitive Stimulation Therapy (CST) after a one-day training course. Non-pharmacological Therapies in, Dementia; 2010:945-949.
  • [17]Weiss DJ, Dawis RV, England GW, Lofquist LH: Manual for the Minnesota Satisfaction Questionnaire, In Minnesota Studies in Vocational Rehabilitation. 1967. XXII
  • [18]Lintern T, Woods B: Approaches to Dementia Questionnaire. University of Wales, Bangor, UK; 1996.
  • [19]Shanahan N, Schepers A, Spector A, Orrell M: The development and evaluation of the DK20: A knowledge of dementia measure for care staf. in press
  • [20]Schepers A: The Sense of Competence in Dementia Care Questionnaire for Staff (SCID-S): Development, reliability and validity. D. Clin. Psy thesis, University College London; Volume 1; 2010.
  • [21]Holton EF, Bates RA, Ruona WEA: Development of a generalized learning transfer system inventory. Hum Resour Dev Q 2000, 11(4):333-360.
  • [22]Holton EF, Bates R, Leimbach M: In Development and validation of a generalized potential for training transfer climate instrument, In Proceedings of the 1997 Academy of Human Resource Development Annual Meeting. Edited by Torraco R. Atlanta, GA; 1997.
  • [23]Holton EF, Bates R, Seyler DL, Carvalho MB: “Toward construct validation of a transfer climate instrument”. Hum Resour Dev Q 1997, 8(2):95-113.
  • [24]Corrigan PW, Kwartarini WY, Pramana W: Staff perceptions of barriers to behaviour therapy at a psychiatric hospital. Behaviour Modification 1992, 16:132-144.
  • [25]Dagnan D, Grant F, McDonnell A: Understanding challenging behaviour in older people; the development of the controllability Beliefs Scale. Behav Cogn Psychother 2004, 32:501-506.
  • [26]Morris JC: The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993, 43:2412-2414.
  • [27]Folstein MF, Folstein SE, McHugh PR: ‘Mini Mental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12:189-198.
  • [28]Logsdon RG, Gibbons LE, McCurry SM, Teri L: Quality of Life in Alzheimer’s Disease: patient and caregiver reports. Journal of Mental Health Aging 1999, 5:21-32.
  • [29]Thorgrimsen L, Selwood A, Spector A: Whose quality of life is it anyway? The validity and reliability of the Quality of Life – Alzheimer’s Disease (QOL–AD) scale. Alzheimer’s Disease and Associated Disorders 2003. in press
  • [30]Office of Public Sector Information (OPSI): Mental Capacity Act. 2005. http://www.opsi.gov.uk/acts/acts2005/ukpga_20050009_en_11 webcite
  • [31]Spector A, Gadner C, Orrell M: The impact of Cognitive Stimulation Therapy groups on people with dementia: views from participants, their carers and group facilitators. In Aging & Mental Health 2011.
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