Collaborative knowledge sharing in developing and evaluating a training programme for health professionals to implement a social intervention in dementia research

Purpose: This study aims to explore the utility of collaborative knowledge sharing with stakeholders in developing and evaluating a training programme for health professionals to implement a social intervention in dementia research. Design/methodology/approach: The programme consisted of two phases: 1) development phase guided by the Buckley and Caple’s training model and 2) evaluation phase drew on the Kirkpatrick’s evaluation model. Survey and interview data was collected from health professionals, people with dementia and their supporters who attended the training programme, delivered or participated in the intervention. Qualitative data was analysed using the framework analysis. Findings: Seven health professionals participated in consultations in the development phase. In the evaluation phase, 20 intervention facilitators completed the post one-day training evaluations and three took part in the intervention interviews. Eight people with dementia and their supporters from the promoting independence in dementia feasibility study participated in focus groups interviews. The findings show that intervention facilitators were satisfied with the training programme. They learnt new knowledge and skills through an interactive learning environment and demonstrated competencies in motivating people with dementia to engage in the intervention. As a result, this training programme was feasible to train intervention facilitators. Practical implications: The findings could be implemented in other research training contexts where those delivering research interventions have professional skills but do not have knowledge of the theories and protocols of a research intervention. Originality/value: This study provided insights into the value of collaborative knowledge sharing between academic researchers and multiple non-academic stakeholders that generated knowledge and maximised power through building new capacities and alliances

Following the Francis report: investigating patient experience of mental health in-patient care

BACKGROUND: The Francis report highlights perceptions of care that are affected by different factors including ward structures. AIMS: To assess patient and staff perceptions of psychiatric in-patient wards over time. METHOD: Patient and staff perceptions of in-patient psychiatric wards were assessed over 18 months. We also investigated whether the type of ward or service structure affected these perceptions. We included triage and routine care. The goal was to include at least 50% of eligible patients and staff. RESULTS: The most dramatic change was a significant deterioration in all experiences over the courseof the study. Systems of care or specific wards did not affect patient experience but staff were more dissatisfied in the triage system. CONCLUSIONS: This is the first report of deterioration in perceptions of the therapeutic in-patient environment that has been captured in a rigorous way. It may reflect contemporaneous experiences across the National Health Service of budget reductions and increased throughput. The ward systems we investigated did not improve patient experience and triage may have been detrimental to staff

Promoting independence in dementia: protocol for a feasibility trial of the PRIDE intervention for living well with dementia

Background: Dementia can lead to social exclusion, loss of identity and independence, due to deterioration in cognition and activities of daily living. The aim of the study is to investigate the feasibility of the Promoting Independence in Dementia (PRIDE) intervention, designed to facilitate independence in people with mild dementia. Methods and Results: This is a mixed-methods feasibility trial of the PRIDE, in preparation for a future randomised controlled trial. Up to 50 people with dementia will be recruited. Dementia advisors will deliver the three session intervention. Quantitative outcomes will be taken at baseline and up to three months post baseline. Fidelity checklists will assess fidelity to the intervention. Qualitative implementation data will be gathered in a series of post-intervention semi-structured interviews with staff and participants. This will include data to examine participant experiences of and engagement with the intervention, and other aspects of delivery such as recruitment of DAWs, fidelity and experiences of receiving and delivering the intervention. This study aims to: 1) establish and field test the PRIDE intervention; 2) determine the recruitment rate of sites, providers and participants; 3) assess fidelity in delivery of the intervention and engagement with people with dementia; 4) assess the feasibility and acceptability of outcome measure data and 5) assess the acceptability of the intervention by stakeholders. Discussion: There has been increased need for non-pharmacological interventions for mild dementia. The results of this feasibility study will allow us to plan for a definitive RCT of a three session dementia advisor led intervention for mild dementia

ICT-based applications to improve social health and social participation in older adults with dementia. A systematic literature review

Objectives: Information and communication technologies (ICT) developers, together with dementia experts have created several technological solutions to improve and facilitate social health and social participation and quality of life of older adults living with dementia. However, there is a need to carry out a systematic literature review that focuses on the validity and efficacy of these new technologies assessing their utility to promote ‘social health’ and ‘active ageing’ in people with dementia. Method: Searches in electronic databases identified 3824 articles of which 6 met the inclusion criteria and were coded according to their methodological approach, sample sizes, type of outcomes and results. Results: Six papers were identified reporting the use of 10 different interventions with people with dementia. Qualitative studies (four) showed a benefit of the use of technologies to foster social participation in people with dementia. At the same time, barriers to a widespread use of these technologies in this population were identified. A quantitative study and a mixed-method study with quantitative outcomes showed that ICT-based interventions promote more social behaviours than non-technology-based interventions. Conclusions: In the last years, several technological devices for living independently and fostering social health and social participation in people with dementia have been developed. However, specific outcome measures to assess social health and social participation are needed. Even though the analysed studies provided some evidence-base for the use of technology in this field, there is an urge to develop high quality studies and specific outcome measures

Changing nurses' views of the therapeutic environment: randomised controlled trial

BACKGROUND: Although patients value evidence-based therapeutic activities, little is known about nurses' perceptions.AimsTo investigate whether implementing an activities training programme would positively alter staff perceptions of the ward or be detrimental through the increased workload (trial registration: ISRCTN 06545047). METHOD: We conducted a stepped wedge cluster randomised trial involving 16 wards with psychology-led nurse training as the intervention. The main outcome was a staff self-report measure of perceptions of the ward (VOTE) and secondary outcomes measuring potential deterioration were the Index of Work Satisfaction (IWS) and the Maslach Burnout Inventory (MBI). Data were analysed using mixed-effects regression models, with repeated assessments from staff over time. RESULTS: There were 1075 valid outcome measurements from 539 nursing staff. VOTE scores did not change over time (standardised effect size 0.04, 95% CI -0.09 to 0.18, P = 0.54), neither did IWS or MBI scores (IWS, standardised effect size 0.02, 95% CI -0.11 to 0.16, P = 0.74; MBI standardised effect size -0.09, 95% CI -0.24 to 0.06, P = 0.24). There was a mean increase of 1.5 activities per ward (95% CI -0.4 to 3.4, P = 0.12) and on average 6.3 more patients attended groups (95% CI -4.1 to 16.6, P = 0.23) following training. Staff feedback on training was positive. CONCLUSIONS: Our training programme did not change nurses' perceptions of the ward, job satisfaction or burnout. During the study period many service changes occurred, most having a negative impact through increased pressure on staffing, patient mix and management so it is perhaps unsurprising that we found no benefits or reduction in staff skill.Declaration of interestNone

A 21. századi kompetenciák digitális technológiával támogatott fejlesztésének képessége: - pilot kutatás a TPACK21 skála adaptálásáról

Our research is a part of a comprehensive research project focusing on the impact of digital transformation on education, as a pilot project. We investigated the relationship between teachers' technological-pedagogical-content knowledge (TPACK) and their age, the goals and quantity of using digital tools, and their attitudes towards digital education. As part of the pilot research, an online questionnaire for teachers was conducted following a quantitative research strategy in order to test the TPACK21 scale. We translated a version of the scale developed by Valtonen et al. (2017) for measuring TPACK21, the scale for developing 21st century skills. Based on the KIR database, we administered the questionnaire to a randomly selected 5% of all schools (stratified by region and school type). The cleansed database contains 191 respondents. The results do not confirm that younger age is associated with higher TPACK21. However, a significant correlation between TPACK21 score and the set of purposes for using digital tools is found: those with higher TPACK21 scores reported a higher variety of educational purposes in using digital technologies and those with above-average TPACK21 scores have reported the use of digital tools to support individual learning pathways to a higher proportion. Results confirm that the TPACK21 scale is able to measure pedagogically-aware use of digital technologies. Furthermore, the study confirms that feelings of uncertainty and helplessness negatively influence the TPACK21 score, which brings the community aspects of continuous professional development in focus (Phillips, 2017). The results of our study, although limited in drawing generalisable conclusions, may contribute to the success of further research exploring the effects of digital transformation and to the identification of further opportunities.Kutatásunk egy, a digitális transzformáció hatásait vizsgáló átfogó kutatás részeként, annak pilot projektjeként valósult meg. Vizsgálatunk során arra kerestük a választ, milyen összefüggésben áll a pedagógusok technológiai- pedagógiai-szaktárgyi tudása (TPACK) a pályán eltöltött éveik számával, a digitális eszközhasználat céljaival és azok mennyiségével, valamint a digitális eszközökkel támogatott oktatással kapcsolatos attitűdjeikkel. A pilot kutatás keretében kvantitatív kutatási stratégiát követve online kérdőíves vizsgálatot végeztünk pedagógusok körében annak érdekében, hogy az átfogó kutatás számára teszteljük a TPACK21 skála működését. A kérdőívben a TPACK21 mérésére a Valtonen és munkatársai (2017) által kialakított skála 21. századi kompetenciák fejlesztésére irányuló verzióját fordítottuk magyarra. A KIR adatbázis alapján az összes feladatellátási hely (régió és iskolatípus szerint rétegezve) véletlenszerűen kiválasztott 5%-ának juttattuk el a kérdőívünket. A tisztított adatbázisban 191 kitöltő szerepel. Az eredmények alapján nem igazolható, hogy a fiatalabb életkor magasabb TPACK21 értéket jelent. A digitális eszközhasználat céljait tekintve azonban szignifikáns összefüggés állapítható meg a TPACK21 érték és a célok mennyisége között: azok, akik magasabb TPACK21 pontszámmal rendelkeznek, többféle oktatási célra használják a digitális technológiákat, továbbá az átlag feletti TPACK21 értékkel rendelkezők csoportjában kimutathatóan magasabb arányban használnak digitális eszközöket az egyéni tanulási utak támogatására, Az eredmények megerősítik, hogy a TPACK21 skála képes a pedagógiailag tudatos eszközhasználat mérésére. Továbbá a vizsgálat alapján megerősítést nyert, hogy a bizonytalanság és a tehetetlenség érzete negatív mértékben befolyásolja a TPACK21 értékét, ami előtérbe helyezi a folyamatos szakmai fejlődés közösségi aspektusait (Phillips, 2017). Kutatásunk eredményei – bár önmagukban általánosítható következtetés levonására korlátozottan alkalmasak – hozzájárulhatnak a digitális transzformáció hatásait feltáró további kutatások sikerességéhez és további lehetőségek feltérképezéséhez

Feasibility and acceptability evaluation of the Promoting Independence in Dementia (PRIDE) intervention for living well with dementia

OBJECTIVES: Post-diagnostic psychosocial interventions could play an important role in supporting people with mild dementia remain independent. The Promoting Independence in Dementia (PRIDE) intervention was developed to address this. METHOD: The mixed methods non-randomized, pre-post feasibility study occurred across England. Facilitators were recruited from the voluntary sector and memory services. Participants and their supporters took part in the three-session intervention. Outcome measures were collected at baseline and follow-up. To evaluate acceptability, focus groups and interviews were conducted with a subsample of participants and facilitators. RESULTS: Contextual challenges to delivery including national research governance changes, affected recruitment of study sites. Thirty-four dyads consented, with 14 facilitators providing the intervention. Dyads took part in at least two sessions (79%), and 73% in all three. Outcome measures were completed by 79% without difficulty, with minimal missing data. No significant changes were found on pre and post assessments. Post hoc analysis found moderate effect size improvements for self-management (SMAS instrument) in people with dementia (d = 0.41) and quality of life (EQ5D measure) in carers (d = 0.40). Qualitative data indicated that dyads found PRIDE acceptable, as did intervention facilitators. CONCLUSIONS: The three-session intervention was well accepted by participant-dyads and intervention facilitators. A randomized controlled trial of PRIDE would need to carefully consider recruitment potential across geographically varied settings and site stratification according to knowledge of contextual factors, such as the diversity of post-diagnostic services across the country. Letting sites themselves be responsible for identifying suitable intervention facilitators was successful. The self-report measures showed potential to be included in the main trial

Promoting Independence in Dementia (PRIDE): A Feasibility Randomized Controlled Trial

Background: There is a need for interventions to foster and maintain independence for people with dementia to support community living, improve morale, and reduce stigma. We investigated a social intervention to promote living well and enhance independence for people with mild dementia.Methods: In this two arm parallel group, feasibility RCT at six sites in England, participants were randomized (1:1) to the PRIDE intervention (encompassing social, physical, and cognitive domains supported by a facilitator over three sessions) compared to usual care only. The main objective was to determine the feasibility of a main trial with respect to measures of recruitment, retention, and adherence to the intervention.Results: During a 7-month period, 402 people were invited to the trial, 148 were screened (37%, 95% confidence interval (CI)=32– 42%), 137 were eligible at pre-consent, 94 consented to the trial (69% of those eligible, 95% CI=60– 76%), and 92 were randomized (46 to each group). Of those allocated to the intervention, 42 (91%) received at least one of three intervention sessions. Outcome assessment follow-up visits were completed for 73 participants at 6 months (79%, 95% CI=70– 87%), and this was similar for both groups.Conclusion: A large multi-center trial of the PRIDE intervention in community-dwelling people with mild dementia is feasible using systematic recruitment strategies. The intervention was successfully delivered and well received by participants. Findings from this study will be used to refine the design and processes for a definitive RCT.Trial Registration: ISRCTN, ISRCTN11288961, registered on 23 October 2018

A Web-Based Self-management App for Living Well With Dementia: User-Centered Development Study

Background: Self-management, autonomy, and quality of life are key constructs in enabling people to live well with dementia. This population often becomes isolated following diagnosis, but it is important for them to feel encouraged to maintain their daily activities and stay socially active. Promoting Independence in Dementia (PRIDE) fosters social inclusion and greater dementia self-management through an interactive handbook. Objective: This study aimed to develop a paper-based PRIDE manual on a web-based platform. Methods: Two overarching stages were used to create the web-based version of PRIDE. The first was Preliminary Development, which encompassed tendering, preliminary development work, consultations, beta version of the website, user testing and consultation on beta version, and production of the final web-based prototype. The second stage was Development of the Final PRIDE App, which included 2 sprints and further user testing. Results: Through a lengthy development process, modifications were made to app areas such as the log-in process, content layout, and aesthetic appearance. Feedback from the target population was incorporated into the process to achieve a dementia-friendly product. The finished PRIDE app has defined areas for reading dementia-related topics, creating activity plans, and logging these completed activities. Conclusions: The PRIDE app has evolved from its initial prototype into a more dementia-friendly and usable program that is suitable for further testing. The finished version will be tested in a reach, effectiveness, adoption, implementation, and maintenance study, with its potential reach, effectiveness, and adoption explored. Feedback gathered during the reach, effectiveness, adoption, implementation, and maintenance study will lead to any further developments in the app to increase its applicability to the target audience and usability