Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial

BMC Geriatrics

Study Protocol

Aukje Post¹  Eddy MM Adang²  Rogier ART Donders²  Sytse U Zuidema³  Geertje van de Ven³  Irena Draskovic³  Raymond TCM Koopmans³  Myrra JFJ Vernooij-Dassen⁴ 

[1] Dementia-care mapping, The Netherlands, De Friese Wouden, P.O. Box 215, 9250, Burgum, AE, The Netherlands;Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 113 EBH, 6500, Nijmegen, HB, The Netherlands;Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 117 ELG, 6500, Nijmegen, HB, The Netherlands;Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 117 ELG, 6500, Nijmegen, HB, The Netherlands;Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 114 IQ healthcare, 6500, Nijmegen, HB, The Netherlands;Kalorama Foundation, Postbus 85, 6573, Beek-Ubbergen, ZH, The Netherlands;

关键词: Dementia;    Nursing Home;    Neuropsychiatric Symptom;    Dementia Care;    Global Deterioration Scale;   

DOI  :  10.1186/1471-2318-12-1

 received in 2011-05-25, accepted in 2012-01-03,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the staff problems. The main objective of this study is to evaluate the effectiveness and cost-effectiveness of dementia-care mapping in nursing-home dementia care.Methods/DesignThe study is a cluster-randomised controlled trial, with nursing homes grouped in clusters. Studywise minimisation is the allocation method. Nursing homes in the intervention group will receive a dementia-care-mapping intervention, while the control group will receive usual care. The primary outcome measure is resident agitation, to be assessed with the Cohen-Mansfield Agitation Inventory. The secondary outcomes are resident neuropsychiatric symptoms, assessed with the Neuropsychiatric Inventory - Nursing Homes and quality of life, assessed with Qualidem and the EQ-5D. The staff outcomes are stress reactions, job satisfaction and job-stress-related absenteeism, and staff turnover rate, assessed with the Questionnaire about Experience and Assessment of Work, the General Health Questionnaire-12, and the Maastricht Job Satisfaction Scale for Health Care, respectively. We will collect the data from the questionnaires and electronic registration systems. We will employ linear mixed-effect models and cost-effectiveness analyses to evaluate the outcomes. We will use structural equation modelling in the secondary analysis to evaluate the plausibility of a theoretical model regarding the effectiveness of the dementia-care mapping intervention. We will set up process analyses, including focus groups with staff, to determine the relevant facilitators of and barriers to implementing dementia-care mapping broadly.DiscussionA novelty of dementia-care mapping is that it offers an integral person-centred approach to dementia care in nursing homes. The major strengths of the study design are the large sample size, the cluster-randomisation, and the one-year follow-up. The generalisability of the implementation strategies may be questionable because the motivation for person-centred care in both the intervention and control nursing homes is above average. The results of this study may be useful in improving the quality of care and are relevant for policymakers.Trial registrationThe trial is registered in the Netherlands National Trial Register: NTR2314.

【 授权许可】

CC BY   
© van de Ven et al; licensee BioMed Central Ltd. 2012