Journal
INTERNATIONAL PSYCHOGERIATRICS
Volume 33, Issue 10, Pages 1069-1081Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1041610220001647
Keywords
dementia; palliative care; nursing home; feasibility study; agitation
Funding
- UK Economic and Social Research Council
- National Institute of Health Research [NIHR/ESRC ES/L001780/1]
- Marie Curie core grant [MCCC-FCO-16-U]
- National Institute for Health Research (NIHR) University College London Hospital Biomedical Research Centre
- NIHR Collaborations for Leadership in Applied Health Research and Care North Thames at Barts Health National Health Service (NHS) Trust
- ESRC [ES/L001780/1] Funding Source: UKRI
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The staff training intervention for agitation in people with severe dementia in nursing homes was found to be feasible and acceptable in a study, indicating the potential for a larger trial to evaluate its effectiveness.
Objectives: To develop a staff training intervention for agitation in people with severe dementia, reaching end-of-life, residing in nursing homes (NHs), test feasibility, acceptability, and whether a trial is warranted. Design: Feasibility study with pre- and post-intervention data collection, qualitative interviews, and focus groups. Setting: Three NHs in South East England with dementia units, diverse in terms of size, ownership status, and location. Participants: Residents with a dementia diagnosis or scoring >= 2 on the Noticeable Problems Checklist, rated as severe on Clinical Dementia Rating Scale, family carers, and staff (healthcare assistants and nurses). Intervention: Manualized training, delivered by nonclinical psychology graduates focusing on agitation in severe dementia, underpinned by a palliative care framework. Measurements: Main outcomes were feasibility of recruitment, data collection, follow-up, and intervention acceptability. We collected resident, family carer, and staff demographics. Staff provided data on resident's agitation, pain, quality of life, and service receipt. Staff reported their sense of competence in dementia care. Family carers reported on satisfaction with end-of-life care. In qualitative interviews, we explored staff and family carers' views on the intervention. Results: The target three NHs participated: 28 (49%) residents, 53 (74%) staff, and 11 (85%) family carers who were eligible to participate consented. Eight-four percent of staff attended >= 3 sessions, and we achieved 93% follow-up. We were able to complete quantitative interviews. Staff and family carers reported the intervention and delivery were acceptable and helpful. Conclusions: The intervention was feasible and acceptable indicating a larger trial for effectiveness may be warranted.
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