The Effects and Meaning of a Person-centred and Health-promoting Intervention in Home Care Services

NCT02846246 | Completed DMC

• 1 other identifier: 2016/04-31Ö
• Study Type: interventional
• Target: 81
• Locations: 0 countries
• Sites: N/A

Brief Summary

Current home care service are to a large extent task oriented with a limited focus on care recipient's involvement. Furthermore, studies have shown that low care recipients' involvement might decrease older people's quality of life. Person-centred care focusing on involvement has improved the quality of life and the satisfaction with care for older people in health care and nursing homes but there is a lack of knowledge about the effects and meaning of a person-centred interventions in aged care at home. Present study describes the evaluation of a person-centred and health-promoting intervention.

Conditions

Staff and Older Persons With Home Care Service

Keywords

aged care; health; home care services; person-centred care

Outcome Measures

Primary Outcomes (2)

• Change of Quality of Life assessed with the Nottingham Health Profile scale

  The Nottingham Health Profile scale will be used to assess quality of life. Nottingham health profile includes 38 items in six dimensions: energy level, pain, emotional reaction, sleep, social isolation, and physical abilities. Each item is answered through Yes/No statements and range from best (0) to worst (100) possible score. The Nottingham Health Profile has been found to be sensitive for changes, valid and reliable.

  Baseline, 12 and 24 month follow-up

• Change of Quality of Life assessed with the EQ-5D

  As a complement, the EQ-5D will also be used to assess quality of life. The EQ-5D consists of two parts, a health state description and a visual analogue scale. The health state description comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has five levels on a Likert-scale: none (0) to extreme (4). The visual analogue scale rates participants overall health between endpoints, worst imaginable health (0) and best imaginable health (100). EQ-5D has been found to be sensitive for changes and valid.

  Baseline, 12 and 24 month follow-up

Secondary Outcomes (2)

• Change in thriving assessed with the Thriving of Older People Assessment Scale

  baseline, 12 and 24 month follow-up

• Change in satisfaction with home care service assessed with the Quality of Care from the Patients' Perspective

  baseline, 12 and 24 month follow-up

Other Outcomes (5)

• Change in informal caregiver strain assessed with the Caregiver Burden Scale

  baseline, 12 and 24 month follow-up

• Change in informal caregiving engagement assessed with the Resource Utilization in Dementia instrument

  baseline, 12 and 24 month follow-up

• Change in satisfaction with care for relatives assessed with the Pyramid questionnaire

  baseline, 12 and 24 month follow-up

Study Arms (2)

Intervention

EXPERIMENTAL

The experimental group will be introduced to a person-centred care model that involves shared decision making where the person with home care service and family together with contact nurse prioritise care content and make rearrangements to make sure the provided home care service maximises health.

Other: Person-centred and health-promoting home care service

Control

SHAM COMPARATOR

A usual care paradigm will guide the control units, i.e. a continuation with practice as usual.

Other: Care as usual

Interventions

Person-centred and health-promoting home care service OTHER

Firstly, staff will take part in an educational program on the content and operationalization of the central theoretical components person-centeredness and health exploratory conversation. Secondly, staff will participate in supervised skill training in how to accomplish person-centered and health exploratory conversation. Thirdly, the staff will have a person-centred and health exploratory conversation with purpose to evaluate the extent to which current home care service practice meet the older person´s need and maintain or make rearrangement in provided care to maximise older people's health. Finally, staff will participate in clinical supervisory sessions with an aim to support and facilitate ongoing operationalization phase.

Intervention

Care as usual OTHER

The control group will be offered a lecture about dementia based on staff wishes and a usual care paradigm will guide the control units, i.e. a continuation with practice as usual. Control units will receive the intervention protocol and study results at the end of the study.

Control

Eligibility Criteria

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

You may qualify if:

• persons 65 years or older
• living at home with granted HCS
• have at least two visits per month, and
• be Swedish speaking
• be defined by the care recipients as his/her family member, and
• Swedish speaking
• have an employment for more than 6 month in the HCS district at baseline, be a contact staff and
• Swedish speaking
• Care recipients who apply for HCS in the district during the study period will be offered the intervention but not be included in the evaluation

Sponsors & Collaborators

• Umeå University: lead

Related Publications (3)

• Lamas K, Bolenius K, Sandman PO, Lindkvist M, Edvardsson D. Effects of a person-centred and health-promoting intervention in home care services- a non-randomized controlled trial. BMC Geriatr. 2021 Dec 18;21(1):720. doi: 10.1186/s12877-021-02661-5.

  PMID: 34922494 DERIVED

• Bolenius K, Lamas K, Sandman PO, Lindkvist M, Edvardsson D. Perceptions of self-determination and quality of life among Swedish home care recipients - a cross-sectional study. BMC Geriatr. 2019 May 24;19(1):142. doi: 10.1186/s12877-019-1145-8.

  PMID: 31126243 DERIVED

• Bolenius K, Lamas K, Sandman PO, Edvardsson D. Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial. BMC Geriatr. 2017 Feb 16;17(1):57. doi: 10.1186/s12877-017-0445-0.

  PMID: 28209122 DERIVED

Study Officials

• David Edvardsson, Professor

  Umea University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: July 12, 2016
• First Posted: July 27, 2016
• Study Start: September 1, 2015
• Primary Completion: May 1, 2018
• Study Completion: June 1, 2018
• Last Updated: January 19, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share