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1000 Titel
  • Implementation of a complex intervention to improve participation in older people with joint contractures living in nursing homes: a process evaluation of a cluster-randomised pilot trial
1000 Autor/in
  1. Klingshirn, Hanna |
  2. Müller, Martin |
  3. Beutner, Katrin |
  4. Hirt, Julian |
  5. Strobl, Ralf |
  6. Grill, Eva |
  7. Meyer, Gabriele |
  8. Saal, Susanne |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-08-05
1000 Erschienen in
1000 Quellenangabe
  • 20(1):270
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12877-020-01655-z |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405353/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation.!##!Methods!#!The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis.!##!Results!#!Seven nursing homes (n = 4 intervention groups, n = 3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: 'good'; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers.!##!Conclusion!#!The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial.!##!Trial registration!#!German clinical trials register, DRKS00010037 . Registered 12 February 2016.
1000 Sacherschließung
lokal Aged, 80 and over [MeSH]
lokal Aged [MeSH]
lokal Humans [MeSH]
lokal Cluster-randomised controlled trials
lokal Pilot study
lokal Complex intervention
lokal Nursing Homes [MeSH]
lokal Joint contractures
lokal Contracture [MeSH]
lokal Implementation strategy
lokal Physical functioning, physical health and activity
lokal Quality of Life [MeSH]
lokal Germany [MeSH]
lokal Pilot Projects [MeSH]
lokal Nursing homes
lokal Process evaluation
lokal Homes for the Aged [MeSH]
lokal Research Article
lokal Participation
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/S2xpbmdzaGlybiwgSGFubmE=|https://frl.publisso.de/adhoc/uri/TcO8bGxlciwgTWFydGlu|https://frl.publisso.de/adhoc/uri/QmV1dG5lciwgS2F0cmlu|https://frl.publisso.de/adhoc/uri/SGlydCwgSnVsaWFu|https://frl.publisso.de/adhoc/uri/U3Ryb2JsLCBSYWxm|https://frl.publisso.de/adhoc/uri/R3JpbGwsIEV2YQ==|https://frl.publisso.de/adhoc/uri/TWV5ZXIsIEdhYnJpZWxl|https://orcid.org/0000-0002-2493-601X
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