Changing Talk to Reduce Resistiveness to Care

NCT01324219 | Completed DMC

• 1 other identifier: 12146
• Study Type: interventional
• Target: 202
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators are interested in reducing problem behaviors of nursing home residents with dementia that make providing care difficult. The investigators call these behaviors resistiveness to care. Previous research has found that resistiveness to care occurs more frequently when staff use certain types of communication. An inservice program will be provided to all nursing staff in your nursing home to teach staff about communication practices to reduce resistiveness to care. The research study will see whether changing communication will reduce resident resistiveness to care. If effective, the communication training may then be used to improve care in other facilities. By doing this study, researchers hope to learn if changing communication practices will reduce resistiveness to care in nursing home residents with dementia.

Conditions

Dementia

Keywords

nursing staff; residents

Outcome Measures

Primary Outcomes (1)

• the effects of the nursing staff communication - change in frequency and duration of resident Resistiveness to Care behaviors.

  Test the effects of the CHAnging Talk (CHAT) nursing staff communication intervention on reducing the frequency and duration of resident Resistiveness to Care (RTC) behaviors.

  up to 6 months

Secondary Outcomes (1)

• Calculate the costs of nursing staff communication system

  up to 6 months

Study Arms (2)

Staff

ACTIVE COMPARATOR

Behavioral: Staff

Resident

EXPERIMENTAL

Behavioral: Resident

Interventions

Staff BEHAVIORAL

Your participation will involve participating in video recordings of nursing care for a participating resident for 2-hour periods on 8 to 10 days. Communication training will be provided to staff in participating nursing homes during paid work hours regardless of their participation in the video recordings. The nursing home you work in may be randomly selected to receive the communication training at the start of the study or after a 3-month delay.

Staff

Resident BEHAVIORAL

Your participation will involve participating in video recordings of nursing care for 2-hour periods on 8 to 10. Communication training will be provided to staff in participating facilities during paid work hours regardless of their participation in the video recordings. Your nursing home may be randomly selected to receive the communication training at the start of the study or after a 3-month delay.

Resident

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age 18 years old or greater (age of legal consent in Kansas and Missouri), signed informed consent,
• permanent employment in the NH,
• primary assignment to a specified unit,
• and English speaking
• Staff must have been assigned to care for the resident at least twice weekly in the past month (documented in NH staffing records). This will assure that staff-resident dyads have established relationships and will control effects of variability in contact between dyads during days when data are not being collected.
• a diagnosis of Alzheimer's disease or related dementia documented in their medical records,
• documentation of daily RTC over the past week,
• and ability to hear staff communication (from the most recent MDS).

You may not qualify if:

• non-English speaking,
• temporary employment, -and age under 18 years.
• If more than one CNA volunteers as a partner for a participating resident, a random selection will be made to determine which CNA will participate. Small variations in contact between staff and residents in dyads are anticipated due to PMMA policies for consistent CNA assignment to neighborhoods. Therefore dyads will have repeated contacts.
• diagnosis with Huntington's disease,
• alcohol-related dementias,
• schizophrenia,
• manic-depressive disorder,
• deafness,
• and mental retardation.

Sponsors & Collaborators

• University of Kansas Medical Center: lead

Study Sites (1)

University of Kansas Medical Center

Kansas City, Kansas, 66160, United States

Location

Related Publications (4)

• Liu W, Perkhounkova Y, Williams K, Batchelor M, Hein M. Mealtime nonverbal behaviors in nursing home staff and residents with dementia: Behavioral analyses of videotaped observations. Geriatr Nurs. 2022 Mar-Apr;44:112-124. doi: 10.1016/j.gerinurse.2022.01.009. Epub 2022 Feb 4.

  PMID: 35131660 DERIVED

• Liu W, Batchelor M, Williams K. Development and Psychometric Testing of the Mealtime Engagement Scale in Direct Care Providers of Nursing Home Residents With Dementia. Gerontologist. 2021 Nov 15;61(8):e410-e420. doi: 10.1093/geront/gnaa097.

  PMID: 32726447 DERIVED

• Jao YL, Liu W, Williams K, Chaudhury H, Parajuli J. Association between environmental stimulation and apathy in nursing home residents with dementia. Int Psychogeriatr. 2019 Aug;31(8):1109-1120. doi: 10.1017/S1041610219000589.

  PMID: 31241031 DERIVED

• Williams KN, Perkhounkova Y, Herman R, Bossen A. A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial. Gerontologist. 2017 Aug 1;57(4):707-718. doi: 10.1093/geront/gnw047.

  PMID: 27048705 DERIVED

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• Kristine Williams, RN, PhD, APRN, FNP-BC

  University of Kansas

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 16, 2011
• First Posted: March 28, 2011
• Study Start: March 1, 2011
• Primary Completion: June 1, 2014
• Study Completion: June 1, 2016
• Last Updated: February 13, 2017

Record last verified: 2017-02

Locations

US (1)