None listed
Conditions
Brief summary
Background: Malnutrition among older people with dementia in Chinese Nursing homes (CNHs) is a growing concern, with inadequate mealtime support from nursing staff being a contributing factor. Online education offers a practical solution to improve staff competencies in this area. Objective: This study aims to assess the effectiveness of an online training program, underpinned by Knowledge, Attitudes, and Practices (KAP) framework, in improving nursing staff’s knowledge, attitudes, and practices related to mealtime support for older people with dementia, and its impact on older people with dementias' eating behaviours and nutritional status. Methods: A cluster-randomised controlled trial with a single-blind design will be conducted across selected 10 CNHs. Nursing staff will be randomised to either an intervention group receiving online education training or a control group receiving usual training. Outcomes will be measured at baseline(T0), post-intervention(T1), 3-month(T3), and 6-month(T6) follow-ups. Nursing staff’s knowledge and attitudes will be assessed via questionnaires; practices will be evaluated using structured observation checklist. Outcome measures for older people with dementia outcomes include nutritional status (MNA-SF), food consummation, and feeding difficulty index (FDI). Discussion: This study addresses a critical gap in dementia care by evaluating a scalable, flexible intervention tailored to frontline staff. If effective, online training could enhance workforce capabilities and resident outcomes in CNHs, supporting broader implementation across similar settings in China. Findings will inform future dementia care policy, training models, and quality improvement initiatives focused on person-centred mealtime support.
Interventions
Participants allocated to the intervention group will receive a structured person-centred mealtime care intervention in addition to usual nursing home care. The intervention will be delivered during routine mealtimes over a 12-week study period. For outcome observation and intervention monitoring, one routine meal will be observed for each participating resident at each assessment time point. The observed meal may be breakfast, lunch, or dinner, depending on the resident’s usual mealtime schedul
Participants allocated to the intervention group will receive a structured person-centred mealtime care intervention in addition to usual nursing home care. The intervention will be delivered during routine mealtimes over a 12-week study period. For outcome observation and intervention monitoring, one routine meal will be observed for each participating resident at each assessment time point. The observed meal may be breakfast, lunch, or dinner, depending on the resident’s usual mealtime schedule and facility arrangements. The estimated duration of direct participant contact will depend on the resident’s usual meal duration, typically approximately 10–30 minutes per observed meal. The intervention will include assessment of eating difficulties, individualized mealtime care planning, tailored feeding assistance, communication strategies, environmental strategies, and monitoring of mealtime duration and food intake during the observed meal. Feeding assistance may include verbal prompting, cueing, pacing, encouragement, positioning support, hand-over-hand assistance where appropriate, and assistance with utensils or food presentation. Communication strategies may include simple instructions, eye contact, reassurance, and allowing sufficient time for responses. Environmental strategies may include reducing distractions, ensuring comfortable seating, maintaining a calm mealtime environment, and presenting food clearly and accessibly. The intervention will be delivered by trained nursing staff and/or care workers during routine meals under the supervision of the research team. Training will be provided before the intervention commences by members of the research team. The training will consist of one session of approximately two hours, delivered face-to-face or online depending on facility arrangements. Training will cover person-centred mealtime care, dementia-related eating difficulties, feeding assistance techniques, communication strategies, environmental modification, and documentation of intervention delivery. Adherence will be monitored using study records, including mealtime observation checklists, staff documentation, and regular review by the research team to assess whether individualized mealtime care plans are being followed and intervention components are delivered as intended.
Sponsors
western Sydney university
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria for nursing staff: 1. Aged 18 years or older. 2. Full-time, frontline clinical nursing staff who are actively engaged in assisting older people with dementia during mealtimes in Chinese nursing homes (CNHs). 3. Have access to a smart device, such as a computer, mobile phone, or tablet, with internet access to online platforms. 4. Proficient in Chinese. Exclusion criteria for nursing staff: 1. Aged under 18 years. 2. Part-time, temporary, agency, or casual nursing staff. 3. Nursing staff who are not frontline clinical staff or are not actively involved in assisting older people with dementia during mealtimes. 4. Do not have access to a smart device, such as a computer, mobile phone, or tablet, with internet connectivity. 5. Not proficient in Chinese.
Exclusion criteria
Exclusion criteria for nursing staff: Aged under 18 years. Part-time, temporary, agency, or casual nursing staff. Not frontline clinical nursing staff or not actively engaged in assisting older people with dementia during mealtimes. No access to a smart device, such as a computer, mobile phone, or tablet, with internet connectivity. Not proficient in Chinese. Unable to participate in the intervention or outcome assessments during the study period due to extended leave, rotation, placement, or other reasons. Exclusion criteria for older people with dementia: Aged 60 years or younger. Have resided in the nursing home for less than two weeks. Do not have a formal diagnosis of dementia documented in medical records and have a Mini-Mental State Examination score above 23/30. Have a feeding tube in place. Do not take food orally. Are able to eat independently without requiring verbal cues or physical assistance from others during mealtimes.
Outcome results
None listed