Evaluation of the Interdisciplinary Care Home-bAsed Reablement Program (I-CHARP) for People Living With Cognitive Impairment and Dementia in Care Homes

被引：1

作者：

Jeon, Yun-Hee ^{[1
]}

Hobbs, Anthony ^{[2
]}

Nelson, Karn ^{[3
]}

Fethney, Judith ^{[1
]}

Comans, Tracy ^{[4
]}

Conway, Jane ^{[1
]}

Mowszowski, Loren ^{[5
]}

Hill, Keith ^{[6
]}

Wesson, Jacqueline ^{[7
]}

Hewitt, Jennifer ^{[8
]}

Watson, Karen ^{[1
]}

Togher, Leanne ^{[9
]}

Allman-Farinelli, Margaret ^{[1
]}

O'Connor, Claire ^{[10
]}

Quinn, John ^{[1
]}

Petrie, Glenys ^{[1
]}

O'Leary, Fiona ^{[1
]}

MacAndrew, Margaret ^{[11
]}

Beattie, Elizabeth ^{[11
]}

Stears, Marc ^{[12
]}

Hilmer, Sarah ^{[13
]}

Sykes, David ^{[14
]}

Liddell, Anne ^{[15
]}

Little, Sophia ^{[1
]}

机构：

[1] Univ Sydney, Susan Wakil Sch Nursing & Midwifery, Sydney, Australia

[2] Calvary Hlth Care Kogarah, Sydney, NSW, Australia

[3] Frank Whiddon Masonic Homes New South Wales, Res & Posit Aging, Glenfield, Australia

[4] Univ Queensland, Ctr Hlth Serv Res, Temora, Qld, Australia

[5] Univ Sydney, Sci Brain & Mind Ctr, Sch Psychol, Camperdown, NSW, Australia

[6] Monash Univ, Rehabil Aging & Independent Living Res Ctr RAIL, Rehabil Ageing & Independent Living RAIL Res Ctr, Melbourne, Australia

[7] Univ Sydney, Discipline Occupat Therapy, Sydney, Australia

[8] Univ Sydney, Univ Ctr Rural Hlth, Lismore, Australia

[9] Univ Sydney, Fac Med & Hlth, Sch Hlth Sci, Sydney, Australia

[10] Univ New South Wales, Sch Psychol, Sydney, Australia

[11] Queensland Univ Technol, Sch Nursing, Brisbane, Australia

[12] UCL, Policy Lab, London, England

[13] Northern Sydney Local Hlth Dist & Univ Sydney, Kolling Inst, Sydney, Australia

[14] Dementia Australia, Newtown, ACT, Australia

[15] Ecas4 Australia Pty Ltd, Mile End 5031, Australia

来源：

JOURNAL OF ADVANCED NURSING | 2025年 / 81卷 / 06期

基金：

英国医学研究理事会;

关键词：

action research; care home; cognitive impairment; dementia; implementation research; interdisciplinary teamwork; long-term care; model of care; Reablement; rehabilitation; AGED CARE; CONTROLLED-TRIAL; NURSING-HOMES; HEALTH; DISABILITY; OUTCOMES; RECOMMENDATIONS; CHALLENGES; RESIDENTS; MOBILITY;

D O I：

10.1111/jan.16588

中图分类号：

R47 [护理学];

学科分类号：

1011 ;

摘要：

BackgroundMajor knowledge and practice gaps exist in aged care home services to support independence of older people with dementia. This research evaluates an adaptation of a community-based rehabilitation model for care homes, namely Interdisciplinary Care Home-bAsed Reablement Program (I-CHARP), by examining whether (and, if so, how) I-CHARP produces its intended effects and how this programme can be practicably implemented, sustained and scaled up across care homes in Australia.MethodsI-CHARP is a 4-month bio-behavioural-environmental rehabilitation model of care, integrated in care home services, supported through the deployment of an implementation strategy, the Research Enabled Aged Care Homes (REACH) network. It consists of (1) 8-12 full individual sessions and additional eight brief follow-ups per resident, tailored to the resident's needs, delivered primarily by a team of an occupational therapist, registered nurse and other allied health staff; (2) environmental modifications/assistive devices up to the value of $400 per resident; and (3) engagement of intervention care home staff, managers and regular visitors. An overarching evaluation approach is participatory action research using a cluster quasi-experimental design and mixed methods. It involves testing of the implementation strategy (REACH network and other approaches) while observing/gathering information on the intervention (I-CHARP) and related outcomes in three cycles. Participants include residents (aged >= 60 years with early stages of dementia) and care staff from 16 care homes. Care quality indicators, health care costs, field notes and semi-structured interviews/focus groups with intervention site staff, regular visitors and managers will provide further insights into I-CHARP processes and implementation issues.DiscussionIn the final phase of the project, an Agile Implementation Playbook will be developed for the delivery of reablement care that can be used in routine practice across care homes in Australia. The study findings will also inform future policy development and strategic directions for dementia care in care homes. Trial Registration: Australian New Zealand Clinical Trial Registry, ACTRN12623000885695 Registered 16 August 2023, . Protocol version: 1.0 dated 20 July 2023DiscussionIn the final phase of the project, an Agile Implementation Playbook will be developed for the delivery of reablement care that can be used in routine practice across care homes in Australia. The study findings will also inform future policy development and strategic directions for dementia care in care homes. Trial Registration: Australian New Zealand Clinical Trial Registry, ACTRN12623000885695 Registered 16 August 2023, . Protocol version: 1.0 dated 20 July 2023DiscussionIn the final phase of the project, an Agile Implementation Playbook will be developed for the delivery of reablement care that can be used in routine practice across care homes in Australia. The study findings will also inform future policy development and strategic directions for dementia care in care homes. Trial Registration: Australian New Zealand Clinical Trial Registry, ACTRN12623000885695 Registered 16 August 2023, . Protocol version: 1.0 dated 20 July 2023

引用

页码：3386 / 3399

页数：14

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