Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study
Abstract Background Joint contractures in nursing home residents limit the capacity to perform daily activities and restrict social participation. The purpose of this study was to develop a complex intervention to improve participation in nursing home residents with joint contractures. Methods The d...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-018-0745-z |
| _version_ | 1818991697721294848 |
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| author | Susanne Saal Gabriele Meyer Katrin Beutner Hanna Klingshirn Ralf Strobl Eva Grill Eva Mann Sascha Köpke Michel H. C. Bleijlevens Gabriele Bartoszek Anna-Janina Stephan Julian Hirt Martin Müller |
| author_facet | Susanne Saal Gabriele Meyer Katrin Beutner Hanna Klingshirn Ralf Strobl Eva Grill Eva Mann Sascha Köpke Michel H. C. Bleijlevens Gabriele Bartoszek Anna-Janina Stephan Julian Hirt Martin Müller |
| author_sort | Susanne Saal |
| collection | DOAJ |
| description | Abstract Background Joint contractures in nursing home residents limit the capacity to perform daily activities and restrict social participation. The purpose of this study was to develop a complex intervention to improve participation in nursing home residents with joint contractures. Methods The development followed the UK Medical Research Council framework using a mixed-methods design with re-analysis of existing interview data using a graphic modelling approach, group discussions with nursing home residents, systematic review of intervention studies, structured 2-day workshop with experts in geriatric, nursing, and rehabilitation, and group discussion with professionals in nursing homes. Results Graphic modelling identified restrictions in the use of transportation, walking within buildings, memory functions, and using the hands and arms as the central target points for the intervention. Seven group discussions with 33 residents revealed various aspects related to functioning and disability according the International Classification of Functioning, Disability and Health domains body functions, body structures, activities and participation, environmental factors, and personal factors. The systematic review included 17 studies with 992 participants: 16 randomised controlled trials and one controlled trial. The findings could not demonstrate any evidence in favour of an intervention. The structured 2-day expert workshop resulted in a variety of potential intervention components and implementation strategies. The group discussion with the professionals in nursing homes verified the feasibility of the components and the overall concept. The resulting intervention, Participation Enabling CAre in Nursing (PECAN), will be implemented during a 1-day workshop for nurses, a mentoring approach, and supportive material. The intervention addresses nurses and other staff, residents, their informal caregivers, therapists, and general practitioners. Conclusions In view of the absence of any robust evidence, the decision to use mixed methods and to closely involve both health professionals and residents proved to be an appropriate means to develop a complex intervention to improve participation of and quality of life in nursing home residents. We will now evaluate the PECAN intervention for its impact and feasibility in a pilot study in preparation for an evaluation of its effectiveness in a definitive trial. Trial registration German clinical trials register, reference number DRKS00010037 (12 February 2016). |
| first_indexed | 2024-12-20T20:14:23Z |
| format | Article |
| id | doaj.art-7973e8b1507442419fb4371798527008 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-20T20:14:23Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-7973e8b1507442419fb43717985270082022-12-21T19:27:45ZengBMCBMC Geriatrics1471-23182018-02-0118111010.1186/s12877-018-0745-zDevelopment of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method studySusanne Saal0Gabriele Meyer1Katrin Beutner2Hanna Klingshirn3Ralf Strobl4Eva Grill5Eva Mann6Sascha Köpke7Michel H. C. Bleijlevens8Gabriele Bartoszek9Anna-Janina Stephan10Julian Hirt11Martin Müller12Institute of Health and Nursing Sciences, Medical Faculty, University of Halle-WittenbergInstitute of Health and Nursing Sciences, Medical Faculty, University of Halle-WittenbergInstitute of Health and Nursing Sciences, Medical Faculty, University of Halle-WittenbergInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University MunichInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University MunichInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University MunichInstitute for General, Family and Preventive Medicine, Paracelsus Medical UniversityInstitute of Social Medicine and Epidemiology, Nursing research group, University of LübeckCAPHRI Care and Public Health Research Institute, Department of Health Services Research, Living Lab on Ageing and Long-Term Care, Maastricht UniversityInstitute of Health and Nursing Sciences, Medical Faculty, University of Halle-WittenbergInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University MunichInstitute of Health and Nursing Sciences, Medical Faculty, University of Halle-WittenbergInstitute of Health and Nursing Sciences, Medical Faculty, University of Halle-WittenbergAbstract Background Joint contractures in nursing home residents limit the capacity to perform daily activities and restrict social participation. The purpose of this study was to develop a complex intervention to improve participation in nursing home residents with joint contractures. Methods The development followed the UK Medical Research Council framework using a mixed-methods design with re-analysis of existing interview data using a graphic modelling approach, group discussions with nursing home residents, systematic review of intervention studies, structured 2-day workshop with experts in geriatric, nursing, and rehabilitation, and group discussion with professionals in nursing homes. Results Graphic modelling identified restrictions in the use of transportation, walking within buildings, memory functions, and using the hands and arms as the central target points for the intervention. Seven group discussions with 33 residents revealed various aspects related to functioning and disability according the International Classification of Functioning, Disability and Health domains body functions, body structures, activities and participation, environmental factors, and personal factors. The systematic review included 17 studies with 992 participants: 16 randomised controlled trials and one controlled trial. The findings could not demonstrate any evidence in favour of an intervention. The structured 2-day expert workshop resulted in a variety of potential intervention components and implementation strategies. The group discussion with the professionals in nursing homes verified the feasibility of the components and the overall concept. The resulting intervention, Participation Enabling CAre in Nursing (PECAN), will be implemented during a 1-day workshop for nurses, a mentoring approach, and supportive material. The intervention addresses nurses and other staff, residents, their informal caregivers, therapists, and general practitioners. Conclusions In view of the absence of any robust evidence, the decision to use mixed methods and to closely involve both health professionals and residents proved to be an appropriate means to develop a complex intervention to improve participation of and quality of life in nursing home residents. We will now evaluate the PECAN intervention for its impact and feasibility in a pilot study in preparation for an evaluation of its effectiveness in a definitive trial. Trial registration German clinical trials register, reference number DRKS00010037 (12 February 2016).http://link.springer.com/article/10.1186/s12877-018-0745-zContracturesNursing homesSocial participationInternational classification of functioningDisability and health (ICF)Complex intervention |
| spellingShingle | Susanne Saal Gabriele Meyer Katrin Beutner Hanna Klingshirn Ralf Strobl Eva Grill Eva Mann Sascha Köpke Michel H. C. Bleijlevens Gabriele Bartoszek Anna-Janina Stephan Julian Hirt Martin Müller Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study BMC Geriatrics Contractures Nursing homes Social participation International classification of functioning Disability and health (ICF) Complex intervention |
| title | Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study |
| title_full | Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study |
| title_fullStr | Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study |
| title_full_unstemmed | Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study |
| title_short | Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study |
| title_sort | development of a complex intervention to improve participation of nursing home residents with joint contractures a mixed method study |
| topic | Contractures Nursing homes Social participation International classification of functioning Disability and health (ICF) Complex intervention |
| url | http://link.springer.com/article/10.1186/s12877-018-0745-z |
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