scholarly journals Impact of a stepwise protocol for treating pain on pain intensity in nursing home patients with dementia: A cluster randomized trial

2014 ◽  
Vol 18 (10) ◽  
pp. 1490-1500 ◽  
Author(s):  
R.K. Sandvik ◽  
G. Selbaek ◽  
R. Seifert ◽  
D. Aarsland ◽  
C. Ballard ◽  
...  
Keyword(s):  
Nursing Home ◽  
Randomized Trial ◽  
Pain Intensity ◽  
Cluster Randomized Trial ◽  
Nursing Home Patients ◽  
Cluster Randomized

scholarly journals Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial

Trials ◽  
2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Matthias Hoben ◽  
Peter G. Norton ◽  
Liane R. Ginsburg ◽  
Ruth A. Anderson ◽  
Greta G. Cummings ◽  
...  
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Performance Data ◽  
Nursing Home Care ◽  
Cluster Randomized

scholarly journals A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain—a secondary outcome analysis

2020 ◽  
Author(s):  
Venerina Johnston ◽  
Xiaoqi Chen ◽  
Alyssa Welch ◽  
Gisela Sjøgaard ◽  
Tracy A Comans ◽  
...  
Keyword(s):  
Health Promotion ◽  
Exercise Training ◽  
Neck Pain ◽  
Randomized Trial ◽  
Pain Intensity ◽  
Cluster Randomized Trial ◽  
Office Workers ◽  
Group Differences ◽  
Specific Exercise ◽  
Cluster Randomized

Abstract Background: Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the general office workers and a subgroup of office workers with neck pain at baseline. Methods: A prospective 12-month cluster-randomized trial was conducted in 14 public and private organisations. Participants were office workers, aged ≥18 years working ≥30 hours per week (n=740). All participants received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0-9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n=367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders (demographic, health or work-related). Subgroup analysis was performed on participants symptomatic at baseline (neck cases) (n=96).Results: The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for both the general office workers (EET: b=-0.53 points 95%CI: -0.84– -0.22 [36%] and EHP: b=-0.17 points 95%CI: -0.47–0.13 [10.5%], p-value=0.02) and neck cases subgroup (EET: b=-2.32 points 95%CI: -3.09– -1.56 [53%] and EHP: b=-1.75 points 95%CI: -2.35– -1.16 [36%], p=0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in either the general office workers (EET: b=-0.18, 95%CI: -0.53–0.16 and EHP: b=-0.14 points 95%CI: -0.49–0.21, p=0.53) or neck cases subgroup, although in both groups an overall reduction was found (EET: b= -1.61 points 95%CI: -2.36– -0.89 and EHP: b=-1.9 points 95%CI: -2.59– -1.20, p=0.26). Conclusion: EET was more effective and clinically meaningful than EHP in reducing neck pain intensity in both general office workers and those with neck pain immediately following the intervention period (12 weeks) but not at 12 months follow-up. Findings suggest the need for continuation of exercise to maintain benefits in the longer term.Clinical trial registration: ACTRN12612001154897 Date of Registration: 31/10/2012

scholarly journals Sustained effects of the INFORM cluster randomized trial: an observational post-intervention study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Matthias Hoben ◽  
Liane R. Ginsburg ◽  
Peter G. Norton ◽  
Malcolm B. Doupe ◽  
Whitney B. Berta ◽  
...  
Keyword(s):  
Nursing Home ◽  
Randomized Trial ◽  
Associated Factors ◽  
Organizational Context ◽  
Cluster Randomized Trial ◽  
Post Intervention ◽  
Resident Care ◽  
Care Aides ◽  
Cluster Randomized ◽  
Simple Feedback

Abstract Background Numerous studies have examined the efficacy and effectiveness of health services interventions. However, much less research is available on the sustainability of study outcomes. The purpose of this study was to assess the lasting benefits of INFORM (Improving Nursing Home Care Through Feedback On perfoRMance data) and associated factors 2.5 years after removal of study supports. INFORM was a complex, theory-based, three-arm, parallel cluster-randomized trial. In 2015–2016, we successfully implemented two theory-based feedback strategies (compared to a simple feedback approach) to increase nursing home (NH) care aides’ involvement in formal communications about resident care. Methods Sustainability analyses included 51 Western Canadian NHs that had been randomly allocated to a simple and two assisted feedback interventions in INFORM. We measured care aide involvement in formal interactions (e.g., resident rounds, family conferences) and other study outcomes at baseline (T1, 09/2014-05/2015), post-intervention (T2, 01/2017-12/2017), and long-term follow-up (T3, 06/2019–03/2020). Using repeated measures, hierarchical mixed models, adjusted for care aide, care unit, and facility variables, we assess sustainability and associated factors: organizational context (leadership, culture, evaluation) and fidelity of the original INFORM intervention. Results We analyzed data from 18 NHs (46 units, 529 care aides) in simple feedback, 19 NHs (60 units, 731 care aides) in basic assisted feedback, and 14 homes (41 units, 537 care aides) in enhanced assisted feedback. T2 (post-intervention) scores remained stable at T3 in the two enhanced feedback arms, indicating sustainability. In the simple feedback group, where scores were had remained lower than in the enhanced groups during the intervention, T3 scores rose to the level of the two enhanced feedback groups. Better culture (β = 0.099, 95% confidence interval [CI] 0.005; 0.192), evaluation (β = 0.273, 95% CI 0.196; 0.351), and fidelity enactment (β = 0.290, 95% CI 0.196; 0.384) increased care aide involvement in formal interactions at T3. Conclusions Theory-informed feedback provides long-lasting improvement in care aides’ involvement in formal communications about resident care. Greater intervention intensity neither implies greater effectiveness nor sustainability. Modifiable context elements and fidelity enactment during the intervention period may facilitate sustained improvement, warranting further study—as does possible post-intervention spread of our intervention to simple feedback homes.

Specific components of a complex depression care program can affect staff outcomes differently: post-hoc analyses of a stepped-wedge cluster-randomized trial in nursing homes

2020 ◽  
Vol 32 (3) ◽  
pp. 371-380 ◽  
Author(s):  
Ruslan Leontjevas ◽  
Linda Hooijschuur ◽  
Martin Smalbrugge ◽  
Raymond T.C.M. Koopmans ◽  
Debby L. Gerritsen
Keyword(s):  
Job Satisfaction ◽  
Nursing Home ◽  
Randomized Trial ◽  
Complex Interventions ◽  
Job Demands ◽  
Cluster Randomized Trial ◽  
Care Staff ◽  
Stepped Wedge ◽  
Job Outcomes ◽  
Cluster Randomized

ABSTRACTObjective:The Act in case of Depression program showed effects on the quality of life and depression in nursing home (NH) residents. We aimed to explore the effects of this complex multidisciplinary program on job satisfaction, job demands, and autonomy in nursing home staff.Design:Four data points from a stepped-wedge cluster-randomized trial on patient outcomes were used for secondary analyses on staff outcomes.Setting:Sixteen dementia special care and 17 somatic care units in Dutch NHs.Participants were 717 (90.1%) care staff or trainees, 34 (4.3%) paramedical staff, and 45 (5.7%) other staff members.Intervention describes procedures for nursing staff, activity therapists, psychologists, and physicians. It contains evidence-based pathways for depression assessment, treatment, and monitoring treatment results.Results:Mixed models for intention-to-treat analyses showed no significant changes in job demands, job satisfaction, or autonomy. Models corrected for the ratio of unit residents who received, when indicated, a specific program component revealed reduced job demands and improved job satisfaction and autonomy when treatment procedures were used. A better use of assessment procedures was associated with increased job demands, while conducting monitoring procedures was associated with increased job demands and decreased autonomy.Conclusions:Components of complex care programs may affect the staff outcomes in opposite directions and, taken together, produce a zero-sum or a statistically insignificant effect. While implementing treatment protocols affecting patients directly can also improve job outcomes such as satisfaction and autonomy and decrease job demands, it is possible that other procedures of complex programs may have unfavorable effects on job outcomes. It is important to account for specific components of complex interventions when evaluating intervention effects.

Effect of Influenza Vaccination of Nursing Home Staff on Mortality of Residents: A Cluster-Randomized Trial

2009 ◽  
Vol 57 (9) ◽  
pp. 1580-1586 ◽  
Author(s):  
Magali Lemaitre ◽  
Thierry Meret ◽  
Monique Rothan-Tondeur ◽  
Joel Belmin ◽  
Jean-Louis Lejonc ◽  
...  
Keyword(s):  
Nursing Home ◽  
Influenza Vaccination ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Nursing Home Staff ◽  
Cluster Randomized

Interventions to address deficits of pharmacological pain management in nursing home residents - A cluster-randomized trial

2015 ◽  
Vol 19 (9) ◽  
pp. 1331-1341 ◽  
Author(s):  
F. Könner ◽  
A. Budnick ◽  
R. Kuhnert ◽  
I. Wulff ◽  
S. Kalinowski ◽  
...  
Keyword(s):  
Nursing Home ◽  
Pain Management ◽  
Randomized Trial ◽  
Nursing Home Residents ◽  
Cluster Randomized Trial ◽  
Cluster Randomized

scholarly journals A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain – a secondary outcome analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Venerina Johnston ◽  
Xiaoqi Chen ◽  
Alyssa Welch ◽  
Gisela Sjøgaard ◽  
Tracy A. Comans ◽  
...  
Keyword(s):  
Health Promotion ◽  
Exercise Training ◽  
Neck Pain ◽  
Randomized Trial ◽  
Pain Intensity ◽  
Cluster Randomized Trial ◽  
Office Workers ◽  
Group Differences ◽  
Specific Exercise ◽  
Cluster Randomized

Abstract Background Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the All Workers and a subgroup of Neck Pain cases at baseline. Methods A 12-month cluster-randomized trial was conducted in 14 public and private organisations. Office workers aged ≥18 years working ≥30 h per week (n = 740) received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0–9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n = 367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders. Subgroup analysis was performed on neck cases reporting pain ≥3 at baseline (n = 96). Results The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for All Workers (EET: β = − 0.53 points 95% CI: − 0.84– − 0.22 [36%] and EHP: β = − 0.17 points 95% CI: − 0.47–0.13 [10.5%], p-value = 0.02) and the Neck Cases (EET: β = − 2.32 points 95% CI: − 3.09– − 1.56 [53%] and EHP: β = − 1.75 points 95% CI: − 2.35– − 1.16 [36%], p = 0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in All Workers (EET: β = − 0.18, 95% CI: − 0.53–0.16 and EHP: β = − 0.14 points 95% CI: − 0.49–0.21, p = 0.53) or Neck Cases, although in both groups an overall reduction was found (EET: β = − 1.61 points 95% CI: − 2.36– − 0.89 and EHP: β = − 1.9 points 95% CI: − 2.59– − 1.20, p = 0.26). Conclusion EET was more effective than EHP in reducing neck pain intensity in All Workers and Neck Cases immediately following the intervention period (12 weeks) but not at 12 months, with changes at 12 weeks reaching clinically meaningful thresholds for the Neck Cases. Findings suggest the need for continuation of exercise to maintain benefits in the longer term. Clinical trial registration hACTRN12612001154897 Date of Registration: 31/10/2012.

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