Does a personhood and citizenship training workshop delivered to residential care home staff have the potential to affect the wellbeing of residents with dementia? Intervention development and feasibility testing of a cluster randomised controlled trial

Corner, Jason (2020) Does a personhood and citizenship training workshop delivered to residential care home staff have the potential to affect the wellbeing of residents with dementia? Intervention development and feasibility testing of a cluster randomised controlled trial. Doctoral thesis, University of East Anglia.

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Abstract

Aim: To test the feasibility of a definitive cluster-randomised controlled trial, comparing the effect of a personhood and citizenship training intervention for care home staff, with training as usual, on the wellbeing of residents with dementia.

Background: A third of people with dementia live in residential care, a sector with high staff turnover challenging the continuity of care. Most care homes provide only basic mandatory training. It is important that training interventions are robustly tested, and that outcomes are relevant to care home residents with dementia.

Methods: Phase one: The PERSONABLE dementia workshop intervention was informed by four focused discussion groups consisting of residential care home staff (n=12) and family members (n=3). Subsequently, PERSONABLE was piloted with care staff (n=5) and further amendments made to the content and delivery. Phase two: Participants were (i) care home residents with dementia, and (ii) staff working in any role with at least weekly face-to-face contact with residents. Care homes were randomly allocated to (i) PERSONABLE, or (ii) training as usual. PERSONABLE comprised five reflective exercises facilitated by a mental health nurse. The primary outcome (residents) was the mean change from baseline in Dementia Care Mapping™ wellbeing/ill-being score. Secondary outcomes were recorded at the level of care home member of staff. The Personhood in Dementia Questionnaire measures staff attitudes to personhood. A perceived competence visual analogue scale assessed how able staff felt caring for residents who have dementia. Feasibility outcomes captured i) the recruitment and attrition of care homes, residents and staff members, ii) the acceptability of the intervention, iii) the acceptability of the chosen outcome measures.

Results: Six care homes were recruited and a total of 40 residents and 118 staff members. Four residents were lost to follow-up. In the PERSONABLE arm 26 staff completed both baseline and follow-up measurements compared to 21 in the training as usual arm. Twenty-nine staff attended PERSONABLE, comprising 20 care workers, seven ancillary staff and two administration staff. Although it is not possible to infer effectiveness from this feasibility study, the direction of effect moved towards slightly more positive wellbeing/ill-being scores for residents allocated to the PERSONABLE arm.

Discussion: Engagement of care homes, residents and staff in this trial was encouraging. Simplification of study methods may help retain sufficient staff in a definitive randomised controlled trial aiming to draw inferences about effectiveness. This study found that Dementia Care Mapping™ works effectively as an outcome measure but needs further refinement to accurately capture any possible effect of a training intervention.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Chris White
Date Deposited: 01 Sep 2020 08:54
Last Modified: 01 Sep 2020 08:54
URI: https://ueaeprints.uea.ac.uk/id/eprint/76714
DOI:

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