A family carer decision support intervention for people with advanced dementia residing in a nursing home: a study protocol for an international advance care planning intervention (mySupport study).
Advance care planning
Dementia
Implementation
Nursing homes
Palliative care
Training
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
26 10 2022
26 10 2022
Historique:
received:
30
06
2022
accepted:
16
10
2022
entrez:
27
10
2022
pubmed:
28
10
2022
medline:
29
10
2022
Statut:
epublish
Résumé
Where it has been determined that a resident in a nursing home living with dementia loses decisional capacity, nursing home staff must deliver care that is in the person's best interests. Ideally, decisions should be made involving those close to the person, typically a family carer and health and social care providers. The aim of the Family Carer Decisional Support intervention is to inform family carers on end-of-life care options for a person living with advanced dementia and enable them to contribute to advance care planning. This implementation study proposes to; 1) adopt and apply the intervention internationally; and, 2) train nursing home staff to deliver the family carer decision support intervention. This study will employ a multiple case study design to allow an understanding of the implementation process and to identify the factors which determine how well the intervention will work as intended. We will enrol nursing homes from each country (Canada n = 2 Republic of Ireland = 2, three regions in the UK n = 2 each, The Netherlands n = 2, Italy n = 2 and the Czech Republic n = 2) to reflect the range of characteristics in each national and local context. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. Our mixed methods study design has three phases to (1) establish knowledge about the context of implementation, (2) participant baseline information and measures and (3) follow up evaluation. The use of a multiple case study design will enable evaluation of the intervention in different national, regional, cultural, clinical, social and organisational contexts, and we anticipate collecting rich and in-depth data. While it is hoped that the intervention resources will impact on policy and practice in the nursing homes that are recruited to the study, the development of implementation guidelines will ensure impact on wider national policy and practice. It is our aim that the resources will be sustainable beyond the duration of the study and this will enable the resources to have a longstanding relevance for future advance care planning practice for staff, family carers and residents with advanced dementia.
Sections du résumé
BACKGROUND
Where it has been determined that a resident in a nursing home living with dementia loses decisional capacity, nursing home staff must deliver care that is in the person's best interests. Ideally, decisions should be made involving those close to the person, typically a family carer and health and social care providers. The aim of the Family Carer Decisional Support intervention is to inform family carers on end-of-life care options for a person living with advanced dementia and enable them to contribute to advance care planning. This implementation study proposes to; 1) adopt and apply the intervention internationally; and, 2) train nursing home staff to deliver the family carer decision support intervention.
METHODS
This study will employ a multiple case study design to allow an understanding of the implementation process and to identify the factors which determine how well the intervention will work as intended. We will enrol nursing homes from each country (Canada n = 2 Republic of Ireland = 2, three regions in the UK n = 2 each, The Netherlands n = 2, Italy n = 2 and the Czech Republic n = 2) to reflect the range of characteristics in each national and local context. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. Our mixed methods study design has three phases to (1) establish knowledge about the context of implementation, (2) participant baseline information and measures and (3) follow up evaluation.
DISCUSSION
The use of a multiple case study design will enable evaluation of the intervention in different national, regional, cultural, clinical, social and organisational contexts, and we anticipate collecting rich and in-depth data. While it is hoped that the intervention resources will impact on policy and practice in the nursing homes that are recruited to the study, the development of implementation guidelines will ensure impact on wider national policy and practice. It is our aim that the resources will be sustainable beyond the duration of the study and this will enable the resources to have a longstanding relevance for future advance care planning practice for staff, family carers and residents with advanced dementia.
Identifiants
pubmed: 36289458
doi: 10.1186/s12877-022-03533-2
pii: 10.1186/s12877-022-03533-2
pmc: PMC9607827
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
822Investigateurs
Wilco P Achterberg
(WP)
Mandy Visser
(M)
Catherine Buckley
(C)
Serena Fitzgerald
(S)
Tony Foley
(T)
Siobhan Fox
(S)
Alan Connolly
(A)
Ronan O'Caoimh
(R)
Selena O'Connell
(S)
Catherine Sweeney
(C)
Suzanne Timmons
(S)
Christine Brown Wilson
(CB)
Gillian Carter
(G)
Emily Cousins
(E)
Kay De Vries
(K)
Josie Dixon
(J)
Karen Harrison Dening
(K)
Catherine Henderson
(C)
Adrienne McCann
(A)
Informations de copyright
© 2022. The Author(s).
Références
J Gerontol Nurs. 2005 Jun;31(6):38-48
pubmed: 16138529
Patient Educ Couns. 2022 Apr;105(4):965-973
pubmed: 34376304
J Am Med Dir Assoc. 2012 May;13(4):368-75
pubmed: 21450256
Med Decis Making. 1995 Jan-Mar;15(1):25-30
pubmed: 7898294
Nurs Res. 2004 Mar-Apr;53(2):76-86
pubmed: 15084992
BMJ. 2010 Aug 18;341:c4184
pubmed: 20719843
J Palliat Care. 2004 Winter;20(4):297-302
pubmed: 15690832
Palliat Med. 2016 May;30(5):456-70
pubmed: 26396227
Am J Public Health. 1999 Sep;89(9):1322-7
pubmed: 10474547
Aging Ment Health. 2005 Mar;9(2):105-18
pubmed: 15804627
J Appl Gerontol. 2014 Aug;33(5):522-40
pubmed: 24652906
BMC Palliat Care. 2008 Aug 19;7:12
pubmed: 18710576
SAGE Open Nurs. 2019 Jul 26;5:2377960819861854
pubmed: 33415246
Age Ageing. 2007 Jan;36(1):16-22
pubmed: 17175565
BMC Geriatr. 2021 Aug 9;21(1):456
pubmed: 34372794
Palliat Med. 2018 Mar;32(3):603-612
pubmed: 28786323
Patient Educ Couns. 2001 Aug;44(2):119-27
pubmed: 11479052
Gerontologist. 2007 Aug;47(4):504-15
pubmed: 17766671
Int J Palliat Nurs. 2013 Feb;19(2):67-74
pubmed: 23435535
Int J Evid Based Healthc. 2006 Dec;4(4):288-336
pubmed: 21631773
J Gen Intern Med. 2004 Oct;19(10):1057-63
pubmed: 15482560
J Palliat Med. 2011 May;14(5):614-22
pubmed: 21486116
BMC Geriatr. 2022 May 13;22(1):419
pubmed: 35562712
BMJ Open. 2017 Apr 3;7(4):e016651
pubmed: 28373259
J Clin Nurs. 2017 Feb;26(3-4):436-455
pubmed: 27322855