Effects of the Serial Trial Intervention on Discomfort and Behavior in Demented Nursing Home Residents

2.50
Hdl Handle:
http://hdl.handle.net/10755/161181
Type:
Presentation
Title:
Effects of the Serial Trial Intervention on Discomfort and Behavior in Demented Nursing Home Residents
Abstract:
Effects of the Serial Trial Intervention on Discomfort and Behavior in Demented Nursing Home Residents
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2005
Author:Kovach, Christine, PhD, RN
P.I. Institution Name:University of Wisconsin - Milwaukee
Title:Professor
Contact Address:Geriatric Nursing, 1921 East Hartford Ave., Milwaukee, WI, 53211, USA
Contact Telephone:414-229-6233
Purpose: To address the problems of physical and affective pain in
people with late-stage dementia, the effectiveness of an innovative
clinical protocol, the Serial Trial Intervention (STI), for comfort
assessment and management was studied. Theoretical/Conceptual Framework:
Recognizing behaviors of people with dementia as symptoms of unmet need,
as described in the Need-Driven Dementia-Compromised Behavior (NDB) model
provides the framework for the STI intervention. Subjects: The study was
conducted in 14 nursing homes with 114 subjects obtained through
nonprobability sampling. Method: A pretest-posttest experimental design
with double-blinded procedures was utilized. In order to control treatment
crossover effects, random assignment of facilities was used with the
facilities stratified based on size, for-profit/not-for profit status,
geographic location, and percentage of residents receiving Medicaid
benefits. Process variables measured were scope of assessment and
intervention and nurse persistence to intervene. Outcome measures were
discomfort and return of behavioral symptoms to baseline. Results: Using
mixed models for repeated measures, a significant group X time interaction
indicated the treatment group had less discomfort (p < .001). More
subjects in the treatment group had behavioral symptoms return to baseline
(p=.003), and received a broader scope of physical (p < .001) and
affective (p < .001) assessment at post testing than the control group.
The group of nurses utilizing the STI also showed more persistence to
assess and intervene than control group nurses (p < .001).There was not a
statistically significant difference in the use of nonpharmacological
comfort treatments between the treatment and control groups (p=.422).
There was a statistically significant difference in the use of
pharmacological comfort treatments between the groups (p < .001).
Conclusions: The results of this study support that the STI is more
effective than current care in decreasing discomfort and returning
behaviors to baseline. The effect size of the intervention was large (.89)
and adds to the growing body of evidence that effective treatment of
discomfort is possible for this population.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEffects of the Serial Trial Intervention on Discomfort and Behavior in Demented Nursing Home Residentsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/161181-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Effects of the Serial Trial Intervention on Discomfort and Behavior in Demented Nursing Home Residents</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kovach, Christine, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Wisconsin - Milwaukee</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Geriatric Nursing, 1921 East Hartford Ave., Milwaukee, WI, 53211, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">414-229-6233</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ckovach@uwm.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To address the problems of physical and affective pain in <br/> people with late-stage dementia, the effectiveness of an innovative <br/> clinical protocol, the Serial Trial Intervention (STI), for comfort <br/> assessment and management was studied. Theoretical/Conceptual Framework: <br/> Recognizing behaviors of people with dementia as symptoms of unmet need, <br/> as described in the Need-Driven Dementia-Compromised Behavior (NDB) model <br/> provides the framework for the STI intervention. Subjects: The study was <br/> conducted in 14 nursing homes with 114 subjects obtained through <br/> nonprobability sampling. Method: A pretest-posttest experimental design <br/> with double-blinded procedures was utilized. In order to control treatment <br/> crossover effects, random assignment of facilities was used with the <br/> facilities stratified based on size, for-profit/not-for profit status, <br/> geographic location, and percentage of residents receiving Medicaid <br/> benefits. Process variables measured were scope of assessment and <br/> intervention and nurse persistence to intervene. Outcome measures were <br/> discomfort and return of behavioral symptoms to baseline. Results: Using <br/> mixed models for repeated measures, a significant group X time interaction <br/> indicated the treatment group had less discomfort (p &lt; .001). More <br/> subjects in the treatment group had behavioral symptoms return to baseline <br/> (p=.003), and received a broader scope of physical (p &lt; .001) and <br/> affective (p &lt; .001) assessment at post testing than the control group. <br/> The group of nurses utilizing the STI also showed more persistence to <br/> assess and intervene than control group nurses (p &lt; .001).There was not a <br/> statistically significant difference in the use of nonpharmacological <br/> comfort treatments between the treatment and control groups (p=.422). <br/> There was a statistically significant difference in the use of <br/> pharmacological comfort treatments between the groups (p &lt; .001). <br/> Conclusions: The results of this study support that the STI is more <br/> effective than current care in decreasing discomfort and returning <br/> behaviors to baseline. The effect size of the intervention was large (.89) <br/> and adds to the growing body of evidence that effective treatment of <br/> discomfort is possible for this population.</td></tr></table>en_GB
dc.date.available2011-10-26T23:17:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:17:13Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.