Ageing
Conditions
Keywords
Palliative care, Frail elderly, Comorbidity, Staff Development, Nursing Homes
Brief summary
The research on ageing during the last couple of decades has increasingly focused on questions regarding the quality of life and life satisfaction of the old people. Yet the research indicates that when it comes to the final stage of life, the end includes unnecessary suffering and the quality of life drops. Palliative care has traditionally been provided successfully to younger persons dying from incurable illnesses while older people dying of multiple morbidities or old age has received far less of this type of care. However, sixty percent of all people who died in Sweden in 2010 were at least 80 years old and it is well known that dying among older people often is a prolonged period of suffering. One reason might be that it is more difficult to identify when the final stages of life begins for older persons. The purpose of this project is to implement and evaluate how a knowledge-based model for palliative care in nursing homes affects the quality of life and the participation in the care process for older persons in nursing homes and their next of kin. A second aim is to explore the staff's implementation process of palliative care and the role of the leadership. The final aim is to investigate which factors (barriers and facilitators) that affect the implementation process of this model.
Detailed description
The project was planned to be conducted using a cross-over design in two counties in south of Sweden based on a feasibility/pilot study that was conducted during fall 2014 co-created palliative care educational intervention through seminars for professionals in nursing homes. Due to a more significant amount of drop-outs compared with expected (and for not receiving the total amount of applied foundation), the plan needed to be revised. The knowledge-based palliative care intervention was conducted as a non-blinded control trial, implemented over a six-month period in 30 nursing homes in two different counties in the south of Sweden (County A and County B). The data collection was made in two sequential periods in each county. First, the intervention was implemented in ten nursing homes in County A (Kronoberg County from April 2015), while ten nursing homes in County B served as a control group. Then, County B implemented the intervention (Skåne county from April 2016), and ten new nursing homes in County A, which had not received the intervention, were chosen as a control group. After the two sequential time periods were data from one intervention and one control group analysed. The selection through voluntary participation resulted in a mixture of both larger and smaller nursing homes in the two counties, as well as both from urban and rural areas. Every seminar group met once a month and included different professions (unit manager, district nurse, assistant nurse, and other staff i.e. occupational therapist and physiotherapist). There were 5 meetings in each nursing home during a period of 6 months.
Interventions
BEHAVIORALEducational Intervention
The seminar groups will be led by two experienced clinical nurses and researchers from the field of palliative care and geriatric care. The educational material consist of six themes; values in palliative care, symptom relief, dignity and a dignified death, collaborative co-creating care, support to next of kin and dialogue with older persons and next of kin about death and dying. The content of the different themes will have a common core for each nursing home but will be adjusted based on the expressed needs of each nursing home. New themes can be created related to the needs of the unique nursing home. The participants in the seminar groups will reflect together over the content of the developed binder of educational material and will relate it to their own work in order to identify areas suitable for changes and/or development.
Sponsors
Lund University
Linnaeus University
The Swedish Research Council
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
The knowledge-based palliative care intervention was conducted as a non-randomized control trial.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Older persons living in the participating nursing homes * Next of kin to older persons living in the participating nursing homes * Staff working at the participating nursing homes * Managers working at the participating nursing homes * The participating nursing homes must be located in either Kronoberg County or Skåne County in Sweden
Exclusion criteria
* Not being cognitive able to participate in interviews or answering the questionnaires
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | 9 months | World Health Organization Quality of Life-BREF (WHOQOL-BREF) measure quality of life for next of kin to older persons in nursing homes. Five-point Likert-scale. Higher values mean better outcomes. Min 26. Max 130. he range for the sub scale Overall Quality of Life; Min 1 Max 5 The range for the sub scale General health; Min 1 Max 5 The range for the sub scale Physical Health; Min 7 Max 35 The range for the sub scale Psychological; Min 6 Max 30 The range for the sub scale Social relationships; Min 3 Max 15 The range for the sub scale Environment; Min 8 Max 40 |
| Person-Centred Climate Questionnaire (PCQ Patient Version) | 9 months | Person-Centred Climate Questionnaire (PCQ patient version) measure person-centred care for older persons living in nursing homes. Six point Likert-scale. Higher score means better outcome. Min 17. Max. 102. The range for the sub scale Safety; Min 10 Max 60 The range for the sub scale Everydayness; Min 4 Max 24 The range for the sub scale Hospitality; Min 3 Max 18 |
| Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | 9 months | Next-of-Kin Participation in Care (NoK-PiC) measure participation for next of kin to older persons in nursing homes. The study includes both intervention and control groups. The two scales are 1) Communication and Trust (CaT); and 2) Collaboration in Care (CiC). The scales contains nine items each and items are scored from 0 to 4 (agree not at all (=0); agree to a low degree (=1); agree partly (=2); agree to a high degree (=3); and agree totally (=4). The possible score range from 0 to 36 in each of the two scales, and from 0-72 in the total scale. Higher score means better outcomes. This results are based upon a recently published psychometric evaluation by Westergren et al (2020). |
| World Health Organization Quality of Life-BREF (WHOQOL-BREF) | 9 months | World Health Organization Quality of Life-BREF (WHOQOL-BREF) measure quality of life for older persons' at the end of life living in nursing homes. Five-point Likert-scale. Higher values mean better outcomes. Total score Min 26. Max 130. The range for the sub scale Overall Quality of Life; Min 1 Max 5 The range for the sub scale General health; Min 1 Max 5 The range for the sub scale Physical Health; Min 7 Max 35 The range for the sub scale Psychological; Min 6 Max 30 The range for the sub scale Social relationships; Min 3 Max 15 The range for the sub scale Environment; Min 8 Max 40 |
| World Health Organization Quality of Life-OLD (WHOQOL-OLD) | 9 months | World Health Organization Quality of Life-OLD (WHOQOL-OLD) measure quality of life for older persons living in nursing homes. Five point Likert-scale. Higher value means better outcome. Min 24. Max. 120. The range for the all the sub scales are; Min 1 Max 20 |
| Person-centred Care Assessment Tool (P-CAT)(Patient Version) | 9 months | Person-centred Care Assessment Tool (P-CAT) (patient version) measure person-centred care for older persons living in nursing homes. Five point Likert-scale. Higher score means better outcomes. Min 13. Max. 65. The range for the sub scale Extent of personalizing care; Min 8 Max 40 The range for the sub scale Amount of organizational and environmental support; Min 5 Max 25 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Person-Centred Climate Questionnaire (PCQ-S) | 6 months | Person-Centred Climate Questionnaire (PCQ-S) measure person-centred care for staff working in nursing homes. Six-point Likert-scale. Higher values mean better outcomes. Min 14. Max 84. The range for the sub scale Safety; Min 5 Max 30 The range for the sub scale Everydayness; Min 5 Max 30 The range for the sub scale Community; Min 4 Max 24 |
| Person-centred Care Assessment Tool (P-CAT) (Staff Version) | 6 months | Person-centred Care Assessment Tool (P-CAT)(staff version) measure person-centred care for staff working in nursing homes. Five-point Likert-scale. Higher values mean better outcomes. Min 13. Max 65. The range for the sub scale Extent of personalizing care; Min 8 Max 40 The range for the sub scale Amount of organizational and environmental support; Min 5 Max 25 |
Countries
Sweden
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Intervention Group Older People Older persons: The inclusion criteria for the older persons were ≥ 65 years without dementia and with enough energy to manage a structured interview during up to one hour. | 42 |
| Control Group Older People Older persons: The inclusion criteria for the older persons were ≥ 65 years without dementia and with enough energy to manage a structured interview during up to one hour. | 40 |
| Intervention Group Next-of-Kin The next of kin: The inclusion criterion was someone who had a relation to one of the older persons living at the participating nursing homes but not necessarily family members or relatives. | 152 |
| Control Group Next-of-kin The next of kin: The inclusion criterion was someone who had a relation to one of the older persons living at the participating nursing homes but not necessarily family members or relatives. | 156 |
| Intervention Group Staff Staff: The inclusion criterion was staff at nursing homes (commonly assistant nurses, nurses, occupational therapists and physiotherapists). | 363 |
| Control Group Staff Staff: The inclusion criterion was staff at nursing homes (commonly assistant nurses, nurses, occupational therapists and physiotherapists). | 330 |
| Intervention Group Managers Managers: Managers at different levels with responsibility for the care and social service at the included nursing homes. | 20 |
| Intervention Focus Groups Staff The focus groups took place at the intervention nursing homes and included 40 staff divided into six groups. | 48 |
| Total | 1,151 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 |
|---|---|---|---|---|---|---|---|---|---|
| Overall Study | Death | 20 | 19 | 0 | 0 | 1 | 0 | 0 | 0 |
| Overall Study | Unknown reason, missing data | 0 | 0 | 62 | 51 | 195 | 132 | 0 | 0 |
Baseline characteristics
| Characteristic | Intervention Group Older People | Control Group Older People | Intervention Group Next-of-Kin | Control Group Next-of-kin | Intervention Group Staff | Control Group Staff | Intervention Group Managers | Intervention Focus Groups Staff | Total |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized Age | 87.51 years | 87.22 years | 65 years | 64 years | 47 years | 47 years | 53.77 years | 47 years | 53 years |
| Race and Ethnicity Not Collected | — | — | — | — | — | — | — | — | 0 Participants |
| Sex: Female, Male Female | 28 Participants | 24 Participants | 112 Participants | 124 Participants | 333 Participants | 320 Participants | 20 Participants | 44 Participants | 1005 Participants |
| Sex: Female, Male Male | 14 Participants | 16 Participants | 40 Participants | 32 Participants | 24 Participants | 10 Participants | 0 Participants | 4 Participants | 140 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk |
|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 20 / 42 | 19 / 40 | 0 / 152 | 0 / 156 | 1 / 363 | 0 / 330 | 0 / 20 | 0 / 48 |
| other Total, other adverse events | 0 / 42 | 0 / 40 | 62 / 152 | 51 / 156 | 195 / 363 | 132 / 330 | 0 / 20 | 0 / 48 |
| serious Total, serious adverse events | 20 / 42 | 19 / 40 | 0 / 152 | 0 / 156 | 1 / 363 | 0 / 330 | 0 / 20 | 0 / 48 |
Outcome results
Primary
Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation
Next-of-Kin Participation in Care (NoK-PiC) measure participation for next of kin to older persons in nursing homes. The study includes both intervention and control groups. The two scales are 1) Communication and Trust (CaT); and 2) Collaboration in Care (CiC). The scales contains nine items each and items are scored from 0 to 4 (agree not at all (=0); agree to a low degree (=1); agree partly (=2); agree to a high degree (=3); and agree totally (=4). The possible score range from 0 to 36 in each of the two scales, and from 0-72 in the total scale. Higher score means better outcomes. This results are based upon a recently published psychometric evaluation by Westergren et al (2020).
Time frame: 9 months
Population: The inclusion criterion was someone who had a relation to one of the older persons living at the participating nursing homes but not necessarily family members or relatives.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Intervention Group Older People | Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | Next-of-Kin Participation in Care | 48.9 score on a scale | Standard Deviation 14.9 |
| Intervention Group Older People | Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | Communication and Trust | 27.6 score on a scale | Standard Deviation 7.2 |
| Intervention Group Older People | Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | Collaboration in Care | 21.4 score on a scale | Standard Deviation 8.6 |
| Control Group Older People | Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | Next-of-Kin Participation in Care | 48.6 score on a scale | Standard Deviation 14.1 |
| Control Group Older People | Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | Communication and Trust | 27.9 score on a scale | Standard Deviation 6.6 |
| Control Group Older People | Next-of-Kin Participation in Care (NoK-PiC); Psychometric Evaluation | Collaboration in Care | 20.7 score on a scale | Standard Deviation 8.8 |
Primary
Person-centred Care Assessment Tool (P-CAT)(Patient Version)
Person-centred Care Assessment Tool (P-CAT) (patient version) measure person-centred care for older persons living in nursing homes. Five point Likert-scale. Higher score means better outcomes. Min 13. Max. 65. The range for the sub scale Extent of personalizing care; Min 8 Max 40 The range for the sub scale Amount of organizational and environmental support; Min 5 Max 25
Time frame: 9 months
Population: In total, 90 older persons, (65 years or older) were included in the study based on the inclusion criteria of being Swedish speaking, not having dementia and with enough energy to manage a structured interview lasting up to one hour.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Intervention Group Older People | Person-centred Care Assessment Tool (P-CAT)(Patient Version) | Extent of personalizing care | 25.0 score on a scale |
| Intervention Group Older People | Person-centred Care Assessment Tool (P-CAT)(Patient Version) | Amount of organizational and environmental support | 11.0 score on a scale |
| Control Group Older People | Person-centred Care Assessment Tool (P-CAT)(Patient Version) | Extent of personalizing care | 27 score on a scale |
| Control Group Older People | Person-centred Care Assessment Tool (P-CAT)(Patient Version) | Amount of organizational and environmental support | 11.0 score on a scale |
Primary
Person-Centred Climate Questionnaire (PCQ Patient Version)
Person-Centred Climate Questionnaire (PCQ patient version) measure person-centred care for older persons living in nursing homes. Six point Likert-scale. Higher score means better outcome. Min 17. Max. 102. The range for the sub scale Safety; Min 10 Max 60 The range for the sub scale Everydayness; Min 4 Max 24 The range for the sub scale Hospitality; Min 3 Max 18
Time frame: 9 months
Population: In total, 90 older persons, (65 years or older) were included in the study based on the inclusion criteria of being Swedish speaking, not having dementia and with enough energy to manage a structured interview lasting up to one hour.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ Patient Version) | Safety | 51.5 score on a scale |
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ Patient Version) | Everydayness | 19.5 score on a scale |
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ Patient Version) | Hospitality | 15.0 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ Patient Version) | Safety | 53.0 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ Patient Version) | Everydayness | 19.5 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ Patient Version) | Hospitality | 15.5 score on a scale |
Primary
World Health Organization Quality of Life-BREF (WHOQOL-BREF)
World Health Organization Quality of Life-BREF (WHOQOL-BREF) measure quality of life for older persons' at the end of life living in nursing homes. Five-point Likert-scale. Higher values mean better outcomes. Total score Min 26. Max 130. The range for the sub scale Overall Quality of Life; Min 1 Max 5 The range for the sub scale General health; Min 1 Max 5 The range for the sub scale Physical Health; Min 7 Max 35 The range for the sub scale Psychological; Min 6 Max 30 The range for the sub scale Social relationships; Min 3 Max 15 The range for the sub scale Environment; Min 8 Max 40
Time frame: 9 months
Population: The inclusion criteria for the older persons were that they were 65 years or older, spoke Swedish, did not have dementia and had enough energy to participate in a structured interview for up to one hour.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Total score | 86 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Overall Quality of Life | 3 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | General health | 3 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Physical Health | 21 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Psychological | 21 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Social relationships | 8 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Environment | 28 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Total score | 82 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Psychological | 20 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Overall Quality of Life | 3 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Environment | 29 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | General health | 3 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Social relationships | 8 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) | Physical Health | 20 score on a scale |
Primary
World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin
World Health Organization Quality of Life-BREF (WHOQOL-BREF) measure quality of life for next of kin to older persons in nursing homes. Five-point Likert-scale. Higher values mean better outcomes. Min 26. Max 130. he range for the sub scale Overall Quality of Life; Min 1 Max 5 The range for the sub scale General health; Min 1 Max 5 The range for the sub scale Physical Health; Min 7 Max 35 The range for the sub scale Psychological; Min 6 Max 30 The range for the sub scale Social relationships; Min 3 Max 15 The range for the sub scale Environment; Min 8 Max 40
Time frame: 9 months
Population: The inclusion criteria were a next of kin who had a relation to an older person living in one of the participating nursing homes but was not necessarily a family member or a relative \[14\]. The next of kin were recruited consecutively in equal numbers from both the intervention nursing homes and the control nursing homes.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | General health | 4 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Psychological | 16 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Overall Quality of Life | 4 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Social relationships | 4 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Physical Health | 16 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Environment | 16 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Total score | 94 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Environment | 17 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Total score | 103 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Overall Quality of Life | 4 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | General health | 4 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Physical Health | 16 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Psychological | 17 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-BREF (WHOQOL-BREF) for Next of Kin | Social relationships | 4 score on a scale |
Primary
World Health Organization Quality of Life-OLD (WHOQOL-OLD)
World Health Organization Quality of Life-OLD (WHOQOL-OLD) measure quality of life for older persons living in nursing homes. Five point Likert-scale. Higher value means better outcome. Min 24. Max. 120. The range for the all the sub scales are; Min 1 Max 20
Time frame: 9 months
Population: The inclusion criteria for the older persons were that they were 65 years or older, spoke Swedish, did not have dementia and had enough energy to participate in a structured interview for up to one hour.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Intervention Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Sensory Abilities | 15 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Autonomy | 11 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Past, present and future abilities | 14 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Social participation | 12 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Death and Dying | 17 score on a scale |
| Intervention Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Intimacy | 14 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Death and Dying | 18 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Sensory Abilities | 13 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Social participation | 13 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Autonomy | 12 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Intimacy | 14 score on a scale |
| Control Group Older People | World Health Organization Quality of Life-OLD (WHOQOL-OLD) | Past, present and future abilities | 14 score on a scale |
Secondary
Person-centred Care Assessment Tool (P-CAT) (Staff Version)
Person-centred Care Assessment Tool (P-CAT)(staff version) measure person-centred care for staff working in nursing homes. Five-point Likert-scale. Higher values mean better outcomes. Min 13. Max 65. The range for the sub scale Extent of personalizing care; Min 8 Max 40 The range for the sub scale Amount of organizational and environmental support; Min 5 Max 25
Time frame: 6 months
Population: The informants in this study, the staff, were recruited consecutively in equal numbers from both the intervention nursing homes and the control nursing homes.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Intervention Group Older People | Person-centred Care Assessment Tool (P-CAT) (Staff Version) | Total score | 45.0 score on a scale |
| Intervention Group Older People | Person-centred Care Assessment Tool (P-CAT) (Staff Version) | Extent of personalizing care | 34.0 score on a scale |
| Intervention Group Older People | Person-centred Care Assessment Tool (P-CAT) (Staff Version) | Amount of organizational and environmental support | 11.0 score on a scale |
| Control Group Older People | Person-centred Care Assessment Tool (P-CAT) (Staff Version) | Total score | 44.0 score on a scale |
| Control Group Older People | Person-centred Care Assessment Tool (P-CAT) (Staff Version) | Extent of personalizing care | 34.0 score on a scale |
| Control Group Older People | Person-centred Care Assessment Tool (P-CAT) (Staff Version) | Amount of organizational and environmental support | 11.0 score on a scale |
Secondary
Person-Centred Climate Questionnaire (PCQ-S)
Person-Centred Climate Questionnaire (PCQ-S) measure person-centred care for staff working in nursing homes. Six-point Likert-scale. Higher values mean better outcomes. Min 14. Max 84. The range for the sub scale Safety; Min 5 Max 30 The range for the sub scale Everydayness; Min 5 Max 30 The range for the sub scale Community; Min 4 Max 24
Time frame: 6 months
Population: The informants in this study, the staff, were recruited consecutively in equal numbers from both the intervention nursing homes and the control nursing homes.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Total score | 77.0 score on a scale |
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Safety | 27.0 score on a scale |
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Everydayness | 25.0 score on a scale |
| Intervention Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Community | 23.0 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Community | 22.0 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Total score | 74.0 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Everydayness | 25.0 score on a scale |
| Control Group Older People | Person-Centred Climate Questionnaire (PCQ-S) | Safety | 27.0 score on a scale |