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养老院中痴呆症患者睡眠问题干预措施的过程评估:一项混合方法研究

Process evaluation of an intervention to reduce sleep problems in people living with dementia in nursing homes: a mixed-methods study.

作者信息

Wilfling Denise, Kühn Anja, Lüth Frederike, Berg Almuth, Klatt Thomas, Meyer Gabriele, Dörner Jonas, Halek Margareta, Köpke Sascha, Dichter Martin Nikolaus, Möhler Ralph

机构信息

Institute of Nursing Science, Medical University Graz, Graz, Austria.

Institute of Social Medicine and Epidemiology, Nursing Research Group, University of Lübeck, Lübeck, Germany.

出版信息

Age Ageing. 2025 Mar 3;54(3). doi: 10.1093/ageing/afaf051.

DOI:10.1093/ageing/afaf051
PMID:40037562
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11879320/
Abstract

BACKGROUND

People living with dementia often suffer from sleep disturbances. The MoNoPol-Sleep (multimodal, nonpharmacological intervention for sleep disturbances in people with dementia living in nursing homes) study aimed to develop and evaluate a multimodal, nonpharmacological intervention to prevent and reduce sleep disturbances in people with dementia living in nursing homes.

OBJECTIVES

To investigate implementation fidelity, adoption, barriers and facilitators of the multimodal, nonpharmacological intervention.

DESIGN

Mixed-methods process evaluation alongside an exploratory cluster-randomised controlled trial.

SETTING

Twenty-two nursing homes in three regions in Germany.

SUBJECTS

Nursing staff, nursing home managers, sleep nurses and other target groups of the intervention from the participating nursing homes.

METHODS

Questionnaires, qualitative interviews and documentation of the intervention's implementation.

RESULTS

The intervention was predominately implemented as planned, but implementation fidelity varied between the clusters. The most frequently planned and implemented sleep-promoting interventions were daytime activities. There is some evidence that person-centredness slightly increased in the intervention group. The commitment of nursing home managers, the motivation of nurses and good cooperation with the main contact persons of the research team were identified as facilitating context factors. Identified barriers were financial and time resources and low motivation of the nurses. The results of the cRCT have been published elsewhere.

CONCLUSIONS

For a successful implementation, involvement of nurses from day and night shifts and other stakeholders is crucial. Based on the results of this process evaluation conducted alongside an exploratory trial, the intervention can be adapted and further developed to evaluate its effectiveness in a future full trial.

CLINICAL TRIAL REGISTRATION

ISRCTN No ISRCTN36015309.

摘要

背景

痴呆症患者常受睡眠障碍困扰。MoNoPol-Sleep(针对养老院痴呆症患者睡眠障碍的多模式非药物干预)研究旨在开发并评估一种多模式非药物干预措施,以预防和减少养老院痴呆症患者的睡眠障碍。

目的

调查多模式非药物干预措施的实施保真度、采用情况、障碍和促进因素。

设计

在一项探索性整群随机对照试验的同时进行混合方法过程评估。

设置

德国三个地区的22家养老院。

受试者

参与研究的养老院的护理人员、养老院管理人员、睡眠护士及其他干预目标群体。

方法

问卷调查、定性访谈以及干预实施的记录。

结果

干预措施大多按计划实施,但各群组的实施保真度有所不同。最常计划和实施的促进睡眠干预措施是日间活动。有证据表明干预组的以人为本程度略有提高。养老院管理人员的投入、护士的积极性以及与研究团队主要联系人的良好合作被确定为促进因素。已确定的障碍包括资金和时间资源以及护士积极性不高。整群随机对照试验的结果已在其他地方发表。

结论

要成功实施,白班和夜班护士以及其他利益相关者的参与至关重要。基于在探索性试验同时进行的这一过程评估结果,可对干预措施进行调整和进一步开发,以便在未来的全面试验中评估其有效性。

临床试验注册

ISRCTN编号ISRCTN36015309。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7f1/11879320/1e77ec6cd088/afaf051f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7f1/11879320/1e77ec6cd088/afaf051f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7f1/11879320/1e77ec6cd088/afaf051f1.jpg

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本文引用的文献

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[Structured case conference for sleep disturbances in nursing home residents with cognitive impairment].[针对认知障碍养老院居民睡眠障碍的结构化病例讨论会]
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