Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
BMC Palliat Care. 2013 Aug 7;12(1):29. doi: 10.1186/1472-684X-12-29.
End-of-life care in dementia in nursing homes is often found to be suboptimal. The Feedback on End-of-Life care in dementia (FOLlow-up) project tests the effectiveness of audit- and feedback to improve the quality of end-of-life care in dementia.
METHODS/DESIGN: Nursing homes systematically invite the family after death of a resident with dementia to provide feedback using the End-of-Life in Dementia (EOLD) - instruments. Two audit- and feedback strategies are designed and tested in a three-armed Randomized Controlled Trial (RCT): a generic feedback strategy using cumulative EOLD-scores of a group of patients and a patient specific feedback strategy using EOLD-scores on a patient level. A total of 18 nursing homes, three groups of six homes matched on size, geographic location, religious affiliation and availability of a palliative care unit were randomly assigned to an intervention group or the control group. The effect on quality of care and quality of dying and the barriers and facilitators of audit- and feedback in the nursing home setting are evaluated using mixed-method analyses.
The FOLlow-up project is the first study to assess and compare the effect of two audit- and feedback strategies to improve quality of care and quality of dying in dementia. The results contribute to the development of practice guidelines for nursing homes to monitor and improve care outcomes in the realm of end-of-life care in dementia.
The Netherlands National Trial Register (NTR).
NTR3942.
在养老院中，痴呆患者的临终关怀往往不尽如人意。“痴呆患者临终关怀反馈（FOLlow-up）”项目旨在测试审核和反馈对改善痴呆患者临终关怀质量的有效性。
方法/设计：养老院系统地在痴呆症患者去世后邀请家属提供反馈，使用《痴呆患者临终评估工具（EOLD）》。设计并测试了两种审核和反馈策略：一种是使用一组患者的累积 EOLD 评分的通用反馈策略，另一种是使用患者个体 EOLD 评分的患者特异性反馈策略。共有 18 家养老院，按照规模、地理位置、宗教信仰和姑息治疗单位的可用性分为三组，每组 6 家，随机分配到干预组或对照组。使用混合方法分析评估对护理质量和临终质量的影响，以及审核和反馈在养老院环境中的障碍和促进因素。
“FOLlow-up”项目是第一项评估和比较两种审核和反馈策略以改善痴呆症患者护理质量和临终质量的研究。研究结果有助于为养老院制定实践指南，以监测和改善痴呆患者临终关怀领域的护理结果。
荷兰国家试验注册处（NTR）。
NTR3942。
