Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.
J Nutr Health Aging. 2013 Feb;17(2):173-8. doi: 10.1007/s12603-013-0008-9.
Whilst the number of people living in nursing homes (NH) is expected to rise, research on NH quality is scarce. The purpose of this article is to describe the research protocol of the IQUARE study and to present its baseline data.
IQUARE is a 18-month multicentric individually-tailored controlled trial of education and professional support to NH staff. The main purposes of IQUARE are to improve the quality of the health care provided in NHs and to reduce the risk of functional decline among residents. Data on internal organisation and residents' health for the 175 participating NHs were recorded by NH staff at baseline. NHs were allocated to either a light intervention group (LIG, n = 90 NHs, totalising 3 258 participants) or a strong intervention group (SIG, n = 85 NHs, totalising 3 017 participants). Intervention for LIG consisted at delivering to NH staff descriptive statistics on indicators of quality regarding their NH and the NHs from their sub-region of health and region; whereas for SIG, NH staff received the same information that LIG, but quality indicators were discussed by a cooperative work (two half-day meetings) between a hospital geriatrician and NH staff. Strategies for overcoming NH's weaknesses were then traced; the efficacy of strategies is evaluated at a 6-month period.
Baseline data showed high levels of dependence, comorbidities, psychological disturbances and medication's consumption among NH residents. Large discrepancies among NHs were observed.
IQUARE is one of the largest controlled trials in NHs developed in France. Results from IQUARE may constitute the basis for the development of new work modalities within the French health system, and serve as a model of a feasible research approach in NHs.
随着居住在养老院（NH）的人数预计将增加，对 NH 质量的研究却很少。本文的目的是描述 IQUARE 研究的研究方案，并介绍其基线数据。
IQUARE 是一项为期 18 个月的多中心个体化定制的教育和专业支持 NH 工作人员的对照试验。IQUARE 的主要目的是提高 NH 提供的医疗保健质量，并降低居民功能下降的风险。在基线时，NH 工作人员记录了 175 家参与 NH 的内部组织和居民健康数据。NH 被分配到轻度干预组（LIG，n = 90 NH，共计 3258 名参与者）或强干预组（SIG，n = 85 NH，共计 3017 名参与者）。LIG 的干预措施包括向 NH 工作人员提供有关其 NH 和 NH 所在卫生区和地区的质量指标的描述性统计信息；而对于 SIG，NH 工作人员收到了与 LIG 相同的信息，但质量指标由医院老年病学家与 NH 工作人员之间的合作工作（两次半天会议）进行讨论。然后追踪 NH 弱点的策略；在 6 个月时评估策略的效果。
基线数据显示 NH 居民依赖程度高、合并症多、心理障碍和药物消耗量大。NH 之间存在很大差异。
IQUARE 是法国开展的最大的 NH 对照试验之一。IQUARE 的结果可能为法国卫生系统内新工作模式的发展提供基础，并作为 NH 可行研究方法的典范。
