Dementia Mental and Behavioural Disorders
Conditions
Interventions
A dementia communication skills training course for healthcare practitioners working with patients with dementia in the acute hospital (the VOICE2 course). A dementia communications skill ‘train the t
Sponsors
University of Nottingham
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Clinical Educators: 1. Employed by the site NHS Trust or an associated trust (for example the mental health trust providing liaison psychiatry services), with a role to provide dementia education to HCPs 2. Able and willing to attend the VOICE2 ‘train the trainers’ course and to deliver the training to healthcare practitioners in the participating NHS Trust 3. Aged over 18 years old Healthcare Practitioners: 1. A healthcare practitioner working on one of the designated wards 2. Willing and able to complete all follow-up questionnaires and be interviewed and/or observed 3. Aged over 18 years old Ward Managers: 1. A ward manager or deputy manager of a participating ward 2. Willing and able to be interviewed 3. Aged over 18 years old Patients: 1. A diagnosis of dementia recorded in the medical notes 2. Admitted to a participating healthcare of the older person ward 3. Prone to distress as confirmed by the clinical team 4. Capacity to give informed consent or consultee willing to give agreement on whether the person with dementia would wish to take part 5. Willing to be interviewed and/or observed
Exclusion criteria
Exclusion criteria: Clinical Educators: Unwilling or unable to attend the train the trainer's course dates and to complete all parts of the evaluation Healthcare Practitioners: Unable or unwilling to attend training dates and complete all parts of the course Unable or unwilling to be interviewed and observed delivering care Patients: Likely to die within the next week (on an end-of-life pathway) or judged by the clinical team to be too unwell to participate Lacking the capacity to give informed consent and unable to find someone willing to act as a consultee
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Reaction to training is measured using a post-course evaluation questionnaire on satisfaction and usefulness of the VOICE2 course. Learning: assessing knowledge, attitudes, and confidence are measured using pre- and post-course questionnaires: 1.1. A communication knowledge in dementia test 1.2. The Confidence in Dementia Scale (9-item scale assessing self-efficacy, measured on a 5-point Likert scale) 2. Behaviour and demonstration of taught communication skills are measured using the validated 23-item ‘Influences on Patient Safety Behaviours Questionnaire’ adapted to the VOICE2 training (the ‘Putting VOICE2 dementia communication skills learning into practice questionnaire’). The researchers will collect data pre-training and 1-3 months post-training on the perceived barriers and facilitators for Health Care Practitioners putting their learning into practice. This questionnaire is based on the Theoretical Domains Framework of behaviour change, an evidence-based framework drawn from implementation science. Health Care Practitioners will be asked to indicate their agreement with each statement on a 5-point Likert scale from Strongly Agree to Strongly Disagree. 3. Training impact is measured using the Cohen-Mansfield Agitation Inventory, observational version (CMAI-O), and the Pittsburgh Agitation Scale during the direct ward observation periods and observed interactions. The CMAI-O consists of 29 items forming 4 sub-scales: physically aggressive behaviour (e.g., hitting others), physically non-aggressive behaviour (e.g., pacing), verbally aggressive (e.g., swearing) and verbally non-aggressive behaviours (e.g., repetitive sentences). The CMAI-O incorporates both the frequency and severity of behaviours associated with agitation and allows the quantification of agitated behaviours into a continuous measure. The Pittsburgh Agitation Scale measures intensity of agitation on four domains; aberrant vocaliz | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Clinical educator’s experiences of the ‘train-the-trainer’ course, (how well it prepared them to deliver, their plans for and actual delivery of training within the hospital, adaptions to how materials have been delivered and any barriers and facilitators), are evaluated using semi-structured interviews with all the clinical educators after they attend the ‘train the trainers’ course and again 3 months later. Interviews will be conducted either face-to-face or remotely via Microsoft Teams. Interviews are expected to last 30 minutes each. They will be video or audio-recorded and transcribed verbatim. 2. Perceptions of the accessibility of training, staff ability to implement learning into practice and the impact this has had on staff communication are evaluated using interviews with the ward managers from each participating wards (up to 12). Interviews will last approximately 30 minutes. 3. For 1 month before, and 1 month after, training, the researchers will make available on the wards, and invite completion of, survey cards for patients with dementia and visiting family members or friends. These cards will be modelled on the NHS Family and Friends Test and invite the participant to respond to each of the four questions on 6-point Likert scales, and to make free text comments. The cards take 2 minutes to complete. It will be made clear on the card that by completing the card, the patient, family member or friend is consenting to their responses being included in the research. Patients and carers completing the survey cards will be asked if they would like a 10-minute ‘chat’ about their views on care quality. This will be either face-to-face on the ward or via telephone. 4. Quality of care and management of distress, during the observation periods before and after training, are evaluated using 10-minute unstructured conversational interviews with patient participants or family members, friends and informal carers of | — |
Countries
England, United Kingdom
Contacts
Public ContactRowan Harwood
Outcome results
None listed