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Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol.

https://arctichealth.org/en/permalink/ahliterature295158
Source
BMC Palliat Care. 2018 Mar 22; 17(1):52
Publication Type
Clinical Trial
Journal Article
Date
Mar-22-2018
Author
Gerd Ahlström
Per Nilsen
Eva Benzein
Lina Behm
Birgitta Wallerstedt
Magnus Persson
Anna Sandgren
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, PO Box 157, SE-221 00, Lund, Sweden. gerd.ahlstrom@med.lu.se.
Source
BMC Palliat Care. 2018 Mar 22; 17(1):52
Date
Mar-22-2018
Language
English
Publication Type
Clinical Trial
Journal Article
Keywords
Aging
Cross-Over Studies
Education, Nursing, Continuing - methods - standards
Humans
Nursing Homes - manpower - organization & administration
Palliative Care - methods - standards
Psychometrics - instrumentation - methods
Sweden
Abstract
The demography of the world is changing as the population is ageing. Because of this change to a higher proportion of older people, the WHO has called for improved palliative care for older persons. A large number of all deaths in the industrialised world occur while older people are living in nursing homes and therefore a key question becomes how the principles of palliative care can be implemented in that context. The aims of this study are: a) to describe a model of an educational intervention with the goal of implementing knowledge-based palliative care in nursing homes, and b) to describe the design of the evaluation of the effectiveness regarding the implementation of knowledge-based palliative care.
A complex intervention is evaluated by means of a cross-over design. An educational intervention concerning palliative care consisting of five seminars during 6 months for staff and managers has been developed and conducted in 20 nursing homes in two counties. Before the intervention started, the feasibility was tested in a pilot study conducted in nursing homes not included in the main study. The intervention is evaluated through a non-randomized experimental design with intervention and control groups and pre- and post-assessments. The evaluation includes older persons living in nursing homes, next-of-kin, staff and managers. Data collection consists of quantitative methods such as questionnaires and register data and qualitative methods in the form of individual interviews, focus-group interviews and participant observations.
The research will contribute to new knowledge about how to implement knowledge-based palliative care in a nursing home setting. A strength of this project is that the Medical Research Council framework of complex intervention is applied. The four recommended stages, Development, Feasibility and piloting, Evaluation and Implementation, are combined for the educational intervention, which functions as a strategy to achieve knowledge-based palliative care in the nursing homes. Implementation is always a question of change and a good theoretical understanding is needed for drawing valid conclusions about the causal mechanisms of change. The topic is highly relevant considering the world's ageing population. The data collection is completed and the analysis is ongoing.
NCT02708498 .
Notes
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PubMed ID
29566688 View in PubMed
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A non-randomised pragmatic trial of a school-based group cognitive-behavioural programme for preventing depression in girls.

https://arctichealth.org/en/permalink/ahliterature294714
Source
Int J Circumpolar Health. 2017; 76(1):1396146
Publication Type
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Date
2017
Author
Heléne Zetterström Dahlqvist
Evelina Landstedt
Ylva B Almqvist
Katja Gillander Gådin
Author Affiliation
a Department of Health Sciences , Mid Sweden University , Sundsvall , Sweden.
Source
Int J Circumpolar Health. 2017; 76(1):1396146
Date
2017
Language
English
Publication Type
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adaptation, Psychological
Adolescent
Arctic Regions
Crime Victims - psychology
Depression - prevention & control - psychology
Female
Health Education - organization & administration
Humans
Program Evaluation
Sexual Harassment - psychology
Socioeconomic Factors
Stress, Psychological - therapy
Sweden
Abstract
The aim of this study was to investigate the effectiveness of the DISA-programme in preventing depressive symptoms (DS) in adolescent girls, as implemented in a real-world school setting, accounting for baseline socioeconomic and psychosocial factors, and to investigate whether the effects of these baseline variables on DS differed between intervention participants and non-participants. In this non-randomised pragmatic trial, an electronic questionnaire was disseminated in 2011 (baseline) and 2012 (follow-up) in schools in one municipality in northern Sweden. Pupils (total n=275; intervention participants identified in the questionnaire: n=53; non-participants: n=222) were 14-15 years old at baseline. The groups were compared by means of SEM. DISA could not predict differences in DS at follow-up in this real-life setting. In the overall sample, sexual harassment victimisation (SH) at baseline was associated with DS at follow-up and the estimate for SH increased in the DISA-participants compared to the overall sample.
Notes
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PubMed ID
29108508 View in PubMed
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