None listed
Conditions
Brief summary
The purpose of the study is to pilot test the feasibility, acceptability, and efficacy of the HALT rehabilitation program among patients and their support persons leaving hospital after delirium. This study will employ a single-arm, pre–post feasibility trial of an education and behaviour change program, consisting of eight modules that cover major topics important for the participant's physical, cognitive, and mental health after delirium. Feasibility is assessed from recruitment and withdrawal rates, module uptake and module completion rates, time to complete the program and reasons for withdrawal. Acceptibility will come from interviews to understanding barriers and enablers to engagement and understanding perspectives of support persons on the program and their burden of care; and efficay will involve determining the effects on physical activity level, activities of daily living, diet quality, sleep quality, loneliness, mood, cognitive function, quality of life, and frailty.
Interventions
Participants who had delirium in hospital recently (and enrolled support people) will complete the HALT rehabilitation program. The HALT program is a series of up to eight modules designed to improve cognitive health and wellbeing through education and behaviour change following delirium. Modules will be selected for participants based on their preferences and an individual needs assessment conducted at baseline. Module topics include delirium education, medications, vision and hearing, cognitiv
Participants who had delirium in hospital recently (and enrolled support people) will complete the HALT rehabilitation program. The HALT program is a series of up to eight modules designed to improve cognitive health and wellbeing through education and behaviour change following delirium. Modules will be selected for participants based on their preferences and an individual needs assessment conducted at baseline. Module topics include delirium education, medications, vision and hearing, cognitive engagement, sleep, wellbeing, nutrition and hydration, and physical functioning. Each module includes a minimum of 2, and up to 8 sessions, which will occur approximately weekly. A ninth module will be provided to the participant's support person (family, friend, or caregiver) and is specifically intended to offer education and support for caring for a person with delirium. Modules will be delivered remotely via weekly phone calls or telehealth sessions (10–60 minutes) with a facilitator, guided by a printed resource booklet that is sent to participants. The printed resource booklets have been specifically developed for this project, and feedback on the resources will be part of the feasibility testing. All sessions are one-to-one, although support persons can be present with the deliirum patient (1 facilitator, 1 delirium patient, and 1 or more support persons present). Participants will complete the program from their place of residence. Facilitators will be allied health or nurses and trained in motivational interviewing techniques, which will be used to support patient-driven behaviour change. Session phone or video calls will include interactive behaviour change activities and may be supplemented by supportive email and text messages. The intervention will be delivered over approximately 4 weeks to 6 months, depending on the modules selected and participant schedules. For this feasibility trial, the minimum completion requirement for all participants is completion of the first module, delirium education, which comprises two sessions space approximately 1 week apart. Therefore the minimum number of modules a participant can select is 1, and number of sessions is 2. The maximum number of modules a participant can select is 8 modules, and the total session number to complete all modules is 38. We do not anticipate many participants will wish/need to complete all 8 modules, however this will remain an option if desired. To maintain adherence, participants will be sent reminder texts or emails prior to their scheduled sessions, and the number of sessions attended is recorded as a feasibility outcome. The facilitator for this feasiblity trial will be CIA Davis, who completed Motivational Interviewing training in 2020/2021 through a series of 5x3-hour workshops with Prof Jeff Breckon, a world leading expert and member of the Motivational Interviewing Network of Trainers. CIA Davis has helped co-produced the HALT program, module booklets and is writing a facilitator handbook. In future, all facilitators will attend a Motivational Interviewing training course, such as SA Healths Motivational Interviewing Online Module, at a cost of $66 for non-SA Health employees or free for SA Health employees. This course is a 3.5 hour online workshop. In additional they will be supported by the Facilitator Handbook (yet to be written).
Sponsors
Adelaide University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
65 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Delirium patients: - Confirmed delirium during recent hospital stay (ideally within 1 month of starting the program) - Recovered from delirium (don’t have delirium anymore) - Aged 65–90 years (inclusive) - Willing to modify health-related behaviours - Willing to complete study assessments - Able to speak and read conversational English For the participant's support person, they must meet the following criteria: - Aged 18 years or over - A friend or family member who has face-to-face contact with the person who had delirium for at least an hour per week, for the next 12 months - Willing to be a support person for the duration of the program - Willing to complete study assessments - Not diagnosed with clinical dementia (self-reported) - Able to speak and read conversational English - No severe vision or hearing loss
Exclusion criteria
Delirium patient: - Diagnosed with clinical dementia - Presence of active delirium - Diagnosed with terminal illness or receiving palliative care - Does not speak/read English - Severe vision or hearing loss Support person: - Diagnosed clinical dementia (self-reported) - Unable to be a support person for the duration of the program - Terminal illness - Does not speak/read English - Severe vision or hearing loss
Outcome results
None listed