Improving Pain Management in Nursing Homes: a Pilot Study

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

Detailed Description
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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.

Official Title
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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

Conditions
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Pain Management

Intervention / Treatment
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* Other: ProQuaS 2 Intervention


Participation Criteria
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Eligibility Criteria
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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)

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Sequential Assignment
Interventional Model Description: non- randomized incomplete stepped-wedge design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ProQuaS 2- Intervention<br> | Other: ProQuaS 2 Intervention<br>* Training and implementation of facility pain champions, comprehensive training of all care workers in pain assessment and management, implementation of pain management policies<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self- efficacy in pain management | 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) | Change from baseline to 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nursing Home