A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.
A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.
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DOI：
10.1371/journal.pone.0028155
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Almeida OP
中科院分区：
文献类型：
--
作者：
Beer C;Horner B;Flicker L;Scherer S;Lautenschlager NT;Bretland N;Flett P;Schaper F;Almeida OP
住院护理中的痴呆症：教育干预试验(DIRECT)旨在确定提供旨在满足全科医生和护理人员感知需求的教育是否改善居住在住宿护理中的痴呆症参与者的生活质量。这项整群随机对照试验在西澳大利亚州珀斯大都市区的39家老年护理机构中进行。351名年龄在65岁及以上的护理机构居民参加了简易精神状态检查≤24，他们的全科医生和机构工作人员参与其中。为满足学习者的感知需求而设计的灵活教育被提供给干预小组中的全科医生和护理机构工作人员。研究的主要结果是对痴呆症参与者的生活质量进行自我评估，在干预结束后4周和6个月使用QOL-阿尔茨海默病量表(QOL-AD)进行测量。采用多水平回归分析对聚类的影响进行分析。全科医生或护理机构工作人员的教育对4周或6个月的主要结果没有影响。在一项不包括不到50%的工作人员参加教育课程的设施的事后分析中，在随机分配给教育干预的设施中，四周随访中，居民的自评QOL-AD得分高出6.14分(调整后95%可信区间为1.14，11.15)。针对护理机构或全科医生的教育干预并没有改善痴呆症参与者作为一个群体的生活质量评级。这可能是因为对干预方案的遵守程度较低，因为痴呆症患者生活在工作人员至少最少参与的设施中似乎受益最少。ANZCTR.org.au ACTRN12607000417482
The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. ANZCTR.org.au ACTRN12607000417482
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