dementia in residential care: education intervention trial project team: chris beer (principle...
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Dementia in Residential Care: Education Intervention Trial
Project Team:Chris Beer (Principle Investigator)
Kelly Banz (Study Coordinator)Nada Eltaiba (Social Researcher)
Jenny Tasker (Research Assistant)
Design Overview of DIRECT
Outcome: Quality of Life (primary)
Outcome: Quality of Care (Secondary)
Input: Educational Program
Clinicians…. (GPs and RACF staff)
Residents
Who is involved in the project?
• People With Dementia
• Carers
• RACF staff (managers, nurses, nurse aides)
• General Practitioners
About the educational program
• The content of the program will be aspects of high quality dementia care
• Will be delivered to GPs who have patients in RCF, and RCF staff (for example, Nurses, Nurse aides, nursing managers)
• Intervention takes place over 12 months• Possible delivery methods include
multimedia or workshops
More about the educational program
• The development of the educational package is through Action Research
• Stakeholder participation increases “buy-in”
• Our program aims to be cost effective and time effective, NOT resource intensive
• We think it will result in changed actions and attitudes
About the Primary Outcome
• Measure quality of life of PWD, probably using ADRQL and brief structured environmental observations
• Also measure cognitive impairment, medication, etc
• Do these at baseline, 6mo, and 12 mo
About the Secondary Outcome
• Measure GPs’ and RCF staff’s satisfaction with their ability to delivery high quality dementia care at baseline and 12 months
Study design
• There are three intervention groups and one control group
RACF
GP+ -
+ Patients whose GPs and RACF staff do receive educational
package
Patients whose GP do but whose RACF staff
do not receive educational package
- Patients whose GPs do not but whose
RACF staff do receive educational package
Patients whose GPs and RACF staff do not
receive educational package
Study timelineRecruitment
Education
Assessment
now +6 months +12 months +18 months +24 months
Qualitative research Qualitative research follow-up
Quantitative Research
What does this study NOT address?
• Factors other than quality of care that affect quality of life
• Community based care
• Specialists (Geriatricians, etc)
• Non-dementia residents (eg, mild cognitive impairment)
What is the project about?(Why are we doing it?)
• We want to improve the quality of life of dementia patients by translating high quality care in an Australian setting
• Our aim is to deliver education which addresses needs that have been directly identified by those who will receive it
What is special about this research project compared to others?
• By using quality of life as the end-point, we ensure that the educational program has a measurable impact on something important and sustainable.
• A qualitative research process– gathering information from survey and focus group respondents BEFORE designing the package– has not been used in Australian dementia education before.
What are the potential benefits to RCFs and GPs of participation?
• Long term training for improving quality of care
• Increased quality of life for patients
• Quantitative data for presentation to government and advocacy bodies for funding and other purposes
What are the potential benefits? (cont’d)
• The action research/qualitative process ensures the education meets identified needs
• Because of the “toolbox” nature, education can be further tailored to each doctor’s/facility’s needs
• This is an “intention-to-treat” protocol, in other words, deals with the “real world”
• So, if our educational program is NOT easy to use and thus results in a small outcome, that is still useful data
The role of GPs and RCFs in the study
• The role is three-fold
• Participation in the trial (50:50 chance)
• Recruitment of patients
• Participation in the educational program development (optional but beneficial!)
RCF and GP involvement in the qualitative research process
• Three kinds of involvement:
• Focus Groups
• Interviews
• Surveys