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针对老年医学保健提供者的虐待老人问题(REAGERA)教育干预措施:一项非随机阶梯式楔形试验。

Responding to Elder Abuse in GERiAtric care (REAGERA) educational intervention for healthcare providers: a non-randomised stepped wedge trial.

机构信息

Department of Psychiatry, and Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden.

Department of Acute Internal Medicine and Geriatrics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden.

出版信息

BMJ Open. 2022 May 4;12(5):e060314. doi: 10.1136/bmjopen-2021-060314.

Abstract

INTRODUCTION

Elder abuse is prevalent and associated with different forms of ill health. Despite this, healthcare providers are often unaware of abusive experiences among older patients and many lack training about elder abuse. The overall aim of this study is to determine the effectiveness of an educational intervention on healthcare providers' propensity to ask older patients questions about abusive experiences.

METHODS AND ANALYSIS

Healthcare providers at hospital clinics and primary healthcare centres in Sweden will undergo full-day education about elder abuse between the fall of 2021 and spring of 2023. The education consists of (1) theory and group discussions; (2) forum theatre, a form of interactive theatre in which participants are given the opportunity to practise how to manage difficult patient encounters; and (3) post-training reflection on changing practices.The design is a non-randomised cluster, stepped wedge trial in which all participants (n=750) gradually transit from control group to intervention group with 6-month interval, starting fall 2021. Data are collected using the Responding to Elder Abuse in GERiAtric care-Provider questionnaire which was distributed to all clusters at baseline. All participants will also be asked to answer the questionnaire in conjunction with participating in the education as well as at 6-month and 12-month follow-up. Main outcome is changes in self-reported propensity to ask older patients questions about abuse post-intervention compared with pre-intervention. Linear mixed models including cluster as a random effect will be used to statistically evaluate the outcome.

ETHICS AND DISSEMINATION

The study has been approved by the Swedish Ethical Review Authority. The results will be published in peer-reviewed journals and conference proceedings. If the intervention is successful, a manual of the course content will be published so that the education can be disseminated to other clinics.

TRIAL REGISTRATION NUMBER

NCT05065281.

摘要

简介

虐待老年人现象普遍存在,并与多种健康问题有关。尽管如此,医疗保健提供者往往没有意识到老年患者中存在虐待经历,许多人缺乏虐待老年人方面的培训。本研究的总体目标是确定针对医疗保健提供者询问老年患者虐待经历倾向的教育干预措施的效果。

方法与分析

瑞典医院诊所和初级保健中心的医疗保健提供者将在 2021 年秋季至 2023 年春季接受为期一天的有关虐待老年人问题的教育。该教育包括(1)理论和小组讨论;(2)论坛剧场,一种互动戏剧形式,参与者有机会练习如何处理困难的医患接触;以及(3)培训后对改变实践的反思。该设计是一项非随机群组、逐步楔形试验,其中所有参与者(n=750)从 2021 年秋季开始,以 6 个月为间隔,逐渐从对照组过渡到干预组。数据收集使用“在老年护理提供者中回应虐待老年人-问卷”,该问卷在基线时分发给所有群组。所有参与者还将被要求在参加教育以及 6 个月和 12 个月的随访时回答问卷。主要结果是干预后与干预前相比,自我报告询问老年患者虐待问题倾向的变化。将使用包括群组作为随机效应的线性混合模型对结果进行统计学评估。

伦理与传播

该研究已获得瑞典伦理审查局的批准。研究结果将发表在同行评议的期刊和会议论文集中。如果干预措施成功,将出版课程内容手册,以便将教育传播到其他诊所。

注册号

NCT05065281。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00a4/9073413/04505fff6598/bmjopen-2021-060314f01.jpg

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