Improving Pain Management in Nursing Homes: a Pilot Study

Overview

This study aims to improve pain management in Swiss nursing homes by addressing behavior change of the care workers with a multilevel intervention

Full Title of Study: “Identification and Development of Interfaces and Processes to Improve Quality of Life of Residents at Senevita ProQuaS 2- Improving Pain Management in Nursing Homes: a Pilot Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Sequential Assignment
    • Primary Purpose: Health Services Research
    • Masking: None (Open Label)
  • Study Primary Completion Date: November 15, 2018

Detailed Description

Pain management in nursing homes often is inadequate despite the availability of evidence- based pain management guidelines. Barriers to pain management in nursing homes occur on several levels including lack of knowledge and negative beliefs towards pain of care workers. For this embedded mixed-methods pilot study a convenience sample of maximum six nursing homes will be recruited. The planned intervention comprises the implementation of pain management policies, training of all care workers in pain assessment and management as well as training and introduction of a facility pain champion. Quantitative outcomes assessed at baseline, after three and six months include self-efficacy and attitudes to pain of care workers, functional interference from pain and pain intensity in residents. Feasibility and acceptability of the intervention and potential barriers to its implementation will be explored in focus groups and interviews.

Interventions

  • Other: ProQuaS 2 Intervention
    • Training and implementation of facility pain champions, comprehensive training of all care workers in pain assessment and management, implementation of pain management policies

Arms, Groups and Cohorts

  • Experimental: ProQuaS 2- Intervention

Clinical Trial Outcome Measures

Primary Measures

  • Self- efficacy in pain management
    • Time Frame: Change from baseline to 6 months
    • Care workers’ self-efficacy in pain management scale investigator-developed scale based on guide for constructing self-efficacy scales (Bandura 2006) numeric rating scale ranging from 0 =”not confident at all” to 100=”highly confident” total score will be computed by calculating a mean over single item scores (range: 0-100, higher scores indicating better self-efficacy)

Participating in This Clinical Trial

Inclusion Criteria

Care workers:

  • Registered nurses, licensed practical nurses/certified caregivers, nursing assistants, nurse aides and other care workers from the participating nursing home – Working in direct resident care – Participating care workers have to be employed for at least one month at the data collection – Students, apprentices and interns have to be employed at least six months in total – Speak and understand German – Older than 16 years Residents: – All residents living in a participating nursing home, older than 64 years – Written informed consent to participate in data collection signed by the resident or in case of severe cognitive impairment by his/her legally acceptable representative Exclusion Criteria:

Care workers:

  • Temporary employment for less than six months Residents: – Critical current health status or terminal life situation – Known life expectancy less than 3 months – Short term residents (length of stay <6 months)

Gender Eligibility: All

Minimum Age: 16 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of Basel
  • Collaborator
    • Senevita AG
  • Provider of Information About this Clinical Study
    • Principal Investigator: Franziska Zúñiga, University lecturer – University of Basel
  • Overall Official(s)
    • Franziska Zúñiga, PhD, Principal Investigator, University of Basel

References

Brunkert T, Ruppen W, Simon M, Zuniga F. A theory-based hybrid II implementation intervention to improve pain management in Swiss nursing homes: A mixed-methods study protocol. J Adv Nurs. 2019 Feb;75(2):432-442. doi: 10.1111/jan.13817. Epub 2018 Sep 6.

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