Artikel
Looking inside the processes of the PECAN-intervention for nursing home residents with joint contractures: Results from a pilot cluster-RCT
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Autoren
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Martin Mueller
- Rosenheim University of Applied Sciences
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Hanna Klingshirn
- Rosenheim University of Applied Sciences
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Susanne Saal
- Martin-Luther-University Halle-Wittenberg
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Katrin Beutner
- Martin-Luther-University Halle-Wittenberg
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Gabriele Meyer
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Science
| Veröffentlicht: | 30. April 2018 |
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Gliederung
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Background and Purpose: Joint contractures are frequent conditions in nursing home residents that are associated with limitations in social participation. To address this, we developed the PECAN (Participation Enabling Care in Nursing homes) intervention, a complex intervention using a multipliers’ approach to change professional behaviour of nurses. This study aimed to evaluate the interventions’ processes examining implementation (delivery, response), mechanisms of impact and contextual factors.
Model/Framework: UK Medical Research Council framework for development and implementation of complex interventions; Framework of Grant et al. (2013) for process evaluation of cluster-randomized trials
Methods: We used a mixed-methods approach in parallel to the cluster-randomized pilot study involving 7 nursing homes in Germany. Processes involving clusters and target population were examined. Data collection comprised questionnaires, field notes, individual interviews and group discussions. Quantitative data was analysed using descriptive statistics and qualitative data with direct content analysis.
Results: Fourteen skilled nurses from 4 nursing homes (intervention group) were trained as multipliers. The peer-mentor-visit reached 10 of 14 multipliers; 16 counselling interviews were held. Support of nursing home management, information flow, and implementation of interprofessional round-table discussions were identified as most relevant facilitators. Hindering contextual factors for delivery were staff shortage and less organisational support.
Conclusions: The study provides insight into the implementation of the PECAN-intervention. The intervention was delivered to the multipliers as planned. The intervention was not delivered sufficiently to nurses, health professionals and therefore to residents. This suggest multiple adaptions of the implementation strategy before the conduct of the main trial.
Disclosures: All authors declare that there are no conflicts of interests in the subject matter or material presented.
Funding: The study was funded by the German Federal Ministry of Education and Research (Grant no. 01GY1327A/B).
