Unit of Mental Health Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London, UK.
Trials. 2012 Jun 26;13:91. doi: 10.1186/1745-6215-13-91.
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.
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.
Clinical trial ISRCTN28793457.
认知刺激疗法（CST）是一种基于证据的心理社会团体干预措施，适用于痴呆症患者，已被英国 NICE 指南推荐。临床试验表明，CST 可改善认知和生活质量，但对于如何在实践环境中确保 CST 的实施，知之甚少。最近的一项试点研究发现，参加 CST 培训的人中，有三分之一会继续在实践中开展 CST，但工作人员认为缺乏支持是实施不足的一个关键原因。
方法/设计：本研究有三个项目：第一个是一项关于员工培训的实用、多中心、随机对照试验（RCT），比较 CST 培训和外展支持与仅 CST 培训；第二个是监测和外展试验，是一项四期试验，评估了以前接受过 CST 手册或参加过培训的工作人员在实践中实施 CST 的情况。中心将随机接受外展支持。这两项试验的主要结局测量指标都是为痴呆症患者开展的 CST 疗程数。次要结局包括参加者人数、工作满意度、痴呆症知识和态度、能力、变革障碍、学习方法、信念可控性和依从性水平。焦点小组将评估工作人员对开展 CST 小组和接受外展支持的看法。第三个研究涉及监测在常规实践中开展小组的中心，并观察痴呆症患者认知和生活质量的基本结果。
这些研究评估了外展支持对将 CST 付诸实践并在各种护理环境中有效开展小组的影响；评估了 CST 在标准临床实践中的有效性；并确定了促进或阻碍小组成功开展的关键因素。
临床试验 ISRCTN28793457。
