养老院中以人为主导并促进活力的干预措施——U-Age养老院多中心、非等效对照组前后对照试验的研究方案
A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial.
作者信息
Edvardsson David, Sjögren Karin, Lood Qarin, Bergland Ådel, Kirkevold Marit, Sandman Per-Olof
机构信息
The Medical Faculty, Department of Nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, SE-90187, Umeå, Sweden.
College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg, 3084, VIC, Australia.
出版信息
BMC Geriatr. 2017 Jan 17;17(1):22. doi: 10.1186/s12877-016-0404-1.
BACKGROUND
The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this.
METHODS
The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents' thriving, relatives' satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives' experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention.
DISCUSSION
The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care.
TRIAL REGISTRATION
The trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452 .
背景
文献表明，以人为主的护理有助于提高养老院居民、亲属和工作人员的生活质量和幸福感。然而，关于如何在实践中实施和推行以人为主的护理，以及它在多大程度上能促进幸福感和满意度，研究证据稀少。因此，启动了U-Age养老院研究，以加深对如何将以人为主的护理融入日常实践的理解，并探索其效果和意义。
方法
该研究旨在通过多中心、非等效对照组前后试验设计，评估养老院中以人为主且促进蓬勃发展的干预措施的效果和意义。三个国际地点的三家养老院被分配到以人为主且促进蓬勃发展的干预组，另外三家养老院被分配到惰性对照组。干预地点的工作人员将参加一个为期12个月的互动教育项目，该项目从三个维度实施促进蓬勃发展和以人为主的护理：1）多做一点，2）营造关怀环境，3）评估并满足高度优先的心理社会需求。一个教学框架将指导该干预措施。主要研究终点是：居民的蓬勃发展、亲属对护理的满意度和工作人员的工作满意度。次要终点是：居民、亲属和工作人员对关怀环境的体验、亲属探访亲属和养老院的体验，以及工作人员的良心压力和对护理中以人为主程度的认知。将在干预前、干预后和六个月随访时收集关于研究终点的数据。将与亲属和工作人员进行访谈，以探索干预措施的体验和意义。
讨论
该研究预计将提供证据，为关于以人为主的护理是否以及如何改善养老院居民、访客或工作人员的幸福感、蓬勃发展和满意度的进一步研究、政策和实践发展提供参考。定量和定性数据的结合将阐明以人为主且促进蓬勃发展的护理的实施、效果和意义。
试验注册
该试验于2016年3月19日在ClinicalTrials.gov注册，标识符为NCT02714452。
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