gms | German Medical Science

Background and Purpose: Many interventions in nursing care are complex, i.e. consisting of different components that either act independently or inter-dependently. The UK medical research council’s (MRC) framework for developing and evaluating complex interventions offers methodological guidance for health care researchers to come up with innovations that have the potential to change health care practice in a patient- and practice-oriented way. In this symposium, we will present and discuss projects on nursing interventions for older individuals in institutionalized care settings that follow this framework. While presenting independent studies from all four phases described in the MRC framework, a comprehensive picture of challenges and opportunities of researching complex interventions in nursing care can be drawn.

Model/Framework: The symposium focuses on the UK Medical research council framework for developing and evaluating complex interventions in nursing research.

Methods: For each phase of the MRC framework, development, feasibility and piloting, evaluation, long-term implementation, we will present a worked example in the field of nursing. In all presented studies, the methodological challenges described by the MRC framework will be discussed and strategies and solutions to address these challenges will be presented. Different study designs were used in the presented studies, depending on the phase of the research process.

The discussant will reflect on the presented studies and on future directions of complex interventions’ research in nursing. The symposium will be completed by a plenary discussion.

Research Focus and Results: All presented studies will address the quality of care for older people in institutionalized settings; specifically, they aim to support safe mobility and maintain a maximum of social participation and autonomy even in the presence of chronic disabling health conditions.

Conclusions: The studies presented in this symposium show that the MRC framework for developing and evaluating of complex interventions provides useful guidance for nursing research. Adhering to theoretical frameworks can improve the feasibility of interventions. Nursing interventions adequately addressing the complexity of delivering care to older people have the potential to substantially improve the quality of care.

Programme Overview:

The symposium will include the following presentations:

1.

Introduction: The MRC framework in nursing research; Katrin Balzer

2.

Study 1 (Development phase): Development of an intervention to prevent and reduce the use of physical restraints in acute care settings; Jens Abraham

3.

Study 2 (Piloting phase): Piloting a complex intervention to improve social participation in nursing home residents with joint contractures (JointConImprove); Susanne Saal

4.

Study 3 (Evaluation phase): Evaluation of DAIly NURSE: a nursing intervention to change nursing staff behavior towards encouraging residents’ daily activities and independence in the nursing home; Michel Bleijlevens

5.

Study 4 (Implementation phase): Implementation of a complex intervention to prevent physical restraints in nursing home residents – a pragmatic cluster-randomised controlled trial; Ralph Möhler

6.

Discussion: Future directions of complex interventions research in geriatric nursing; Martin Müller