A Cluster-Randomised Trial of Staff Education to Improve the Quality of Life of People with Dementia Living in Residential Care: The DIRECT Study

被引：28

作者：

Beer, Christopher ^{[1
,2
]}

Horner, Barbara ^{[3
]}

Flicker, Leon ^{[1
,2
]}

Scherer, Samuel ^{[5
,6
]}

Lautenschlager, Nicola T. ^{[1
,4
,7
]}

Bretland, Nick ^{[8
]}

Flett, Penelope ^{[9
]}

Schaper, Frank ^{[10
]}

Almeida, Osvaldo P. ^{[1
,4
,11
]}

机构：

[1] WA Ctr Hlth & Ageing, Med Res Ctr, Perth, WA, Australia

[2] Univ Western Australia, Sch Med & Pharmacol, Perth, WA 6009, Australia

[3] Curtin Univ Technol, Ctr Res Ageing, Perth, WA, Australia

[4] Univ Western Australia, Sch Psychiat & Neurosci, Perth, WA 6009, Australia

[5] Royal Freemasons, Victoria, Australia

[6] Univ Melbourne, Dept Med, Melbourne, Vic, Australia

[7] Univ Melbourne, Dept Psychiat, Acad Unit Psychiat Old Age, Melbourne, Vic, Australia

[8] Rowethorpe Med Ctr, Bentley, WA, Australia

[9] Brightwater Care, Perth, WA, Australia

[10] Alzheimers Australia WA Ltd, Perth, WA, Australia

[11] Royal Perth Hosp, Dept Psychiat, Perth, WA, Australia

来源：

PLOS ONE | 2011年 / 6卷 / 11期

基金：

英国医学研究理事会;

关键词：

OLDER-PEOPLE; HOME;

D O I：

10.1371/journal.pone.0028155

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. Methodology/Principal Findings: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination <= 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. Conclusion: The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit.

引用

页数：11

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