Frank Spichiger PhD, RN , Andrea L. Koppitz PhD, RN , Florian Riese MD , Stephanie Kipfer PhD, RN , Martin Nagl-Cupal PhD, RN , Andreas Büscher PhD, RN , Thomas Volken PhD , Philip Larkin PhD, RN , André Meichtry MSc
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Koppitz PhD, RN , Florian Riese MD , Stephanie Kipfer PhD, RN , Martin Nagl-Cupal PhD, RN , Andreas Büscher PhD, RN , Thomas Volken PhD , Philip Larkin PhD, RN , André Meichtry MSc","doi":"10.1016/j.jamda.2024.105351","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to assess the efficacy of a person-centered care intervention in improving quality of life (QoL) for people with dementia in long-term care facilities.</div></div><div><h3>Design</h3><div>This study was a stepped-wedge cluster-randomized clinical trial of monthly person-centered outcome measurements, followed by collaborative nurse-led person profile interventions involving nursing staff and family members, compared with monthly person-centered outcome measurements alone.</div></div><div><h3>Setting and Participants</h3><div>We included people with a medical diagnosis of Alzheimer's disease or vascular dementia or with clinical symptoms of dementia from 23 long-term care facilities in the German-speaking part of Switzerland.</div></div><div><h3>Methods</h3><div>The primary outcome was QoL, as assessed using the QUALIDEM. Secondary outcomes were the QUALIDEM subscales and the Integrated Palliative Care Outcome Scale for People with Dementia subscales. The study duration was 15 months, and linear mixed-effect models were used for the analysis.</div></div><div><h3>Results</h3><div>We recruited 240 people with dementia from 23 long-term care facilities. Modeling 1143 observations, we found a statistically significant positive intervention effect of 2.6 points according to the QUALIDEM (95% CI, 1.34–3.86; <em>P</em> < .001; total QUALIDEM intervention: 67; 95% CI, 64.8–69.1 vs 64.4; 95% CI, 62.3–66.4 for the control). We also found positive effects of the intervention on all secondary outcomes.</div></div><div><h3>Conclusions and Implications</h3><div>Once-a-month person profile interventions based on person-centered outcome measurements provided a small but significant improvement in QoL. Thus, our findings suggest a potential benefit to the broader implementation of person profiles involving nursing staff and family members in long-term care facilities.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105351"},"PeriodicalIF":4.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Person Profile Dementia Intervention in Long-Term Care: A Stepped-Wedge Cluster-Randomized Trial\",\"authors\":\"Frank Spichiger PhD, RN , Andrea L. 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Secondary outcomes were the QUALIDEM subscales and the Integrated Palliative Care Outcome Scale for People with Dementia subscales. The study duration was 15 months, and linear mixed-effect models were used for the analysis.</div></div><div><h3>Results</h3><div>We recruited 240 people with dementia from 23 long-term care facilities. Modeling 1143 observations, we found a statistically significant positive intervention effect of 2.6 points according to the QUALIDEM (95% CI, 1.34–3.86; <em>P</em> < .001; total QUALIDEM intervention: 67; 95% CI, 64.8–69.1 vs 64.4; 95% CI, 62.3–66.4 for the control). We also found positive effects of the intervention on all secondary outcomes.</div></div><div><h3>Conclusions and Implications</h3><div>Once-a-month person profile interventions based on person-centered outcome measurements provided a small but significant improvement in QoL. 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Person Profile Dementia Intervention in Long-Term Care: A Stepped-Wedge Cluster-Randomized Trial
Objectives
We aimed to assess the efficacy of a person-centered care intervention in improving quality of life (QoL) for people with dementia in long-term care facilities.
Design
This study was a stepped-wedge cluster-randomized clinical trial of monthly person-centered outcome measurements, followed by collaborative nurse-led person profile interventions involving nursing staff and family members, compared with monthly person-centered outcome measurements alone.
Setting and Participants
We included people with a medical diagnosis of Alzheimer's disease or vascular dementia or with clinical symptoms of dementia from 23 long-term care facilities in the German-speaking part of Switzerland.
Methods
The primary outcome was QoL, as assessed using the QUALIDEM. Secondary outcomes were the QUALIDEM subscales and the Integrated Palliative Care Outcome Scale for People with Dementia subscales. The study duration was 15 months, and linear mixed-effect models were used for the analysis.
Results
We recruited 240 people with dementia from 23 long-term care facilities. Modeling 1143 observations, we found a statistically significant positive intervention effect of 2.6 points according to the QUALIDEM (95% CI, 1.34–3.86; P < .001; total QUALIDEM intervention: 67; 95% CI, 64.8–69.1 vs 64.4; 95% CI, 62.3–66.4 for the control). We also found positive effects of the intervention on all secondary outcomes.
Conclusions and Implications
Once-a-month person profile interventions based on person-centered outcome measurements provided a small but significant improvement in QoL. Thus, our findings suggest a potential benefit to the broader implementation of person profiles involving nursing staff and family members in long-term care facilities.
期刊介绍:
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality