Efficiency of E-learning and Role-playing for the Training of Nursing Home Caregivers in the Support of Agitation in Neurodegenerative Diseases

Study Overview
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Brief Summary
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This study will investigate the effects of I-Learn cognition and behaviour training in the care in agitation in patients with neurodegenerative diseases. This training for caregivers, aims to reduce agitation and psycho-behavioral disorders of patients living in nursing home. In addition, amount of psychotropic drugs prescribed, as well as the number of hospitalizations during the study will be assessed.

Official Title
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Efficacité du E-learning et du Jeu de rôle Pour la Formation Des Soignants Des EHPAD à l'Accompagnement de l'Agitation Dans Les Maladies neurodégénératives : Essai randomisé en Cluster

Conditions
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Neuro-Degenerative Disease

Intervention / Treatment
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* Behavioral: I-LEARN training
* Other: usual care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of Major Neurocognitive Disorder according to DSM 5 With agitation and NPI agitation item score of 4 or more (frequency X severity) Information and verification of the non-opposition of the patient and his guardian / curator if he is under legal protection. Exclusion Criteria: Patient under court protection Inability to understand the French language Patient whose state of health is not stabilised at the time of inclusion and/or in palliative care
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental Group<br>The experimental group will be made up of patients from nursing homes whose carers have received I-Learn training. | Behavioral: I-LEARN training<br>* Training of psycho-behavorial disorders care in neurodegenerative diseases: including a theoretical part in e-learning and a practical part<br>Other: usual care<br>* usual care<br>|
| Control Group<br>The control group will consist of nursing homes patients whose caregivers have not received I-Learn training and will continue their usual care, regardless of the practices already implemented. | Other: usual care<br>* usual care<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of agitation of patients in the nursing home | Assessment of agitation using the Cohen-Mansfield Agitation Inventory (CMAI, 1989) by asking caregivers about the patients' behaviour. The minimum value is 0 and the maximum value is 203. the higher the score, the more intense the agitation | Baseline | 
| Measurement of agitation of patients in the nursing home | Assessment of agitation using the Cohen-Mansfield Agitation Inventory (CMAI, 1989) by asking caregivers about the patients' behaviour. The minimum value is 0 and the maximum value is 203. the higher the score, the more intense the agitation | 3 months | 
| Measurement of agitation of patients in the nursing home | Assessment of agitation using the Cohen-Mansfield Agitation Inventory (CMAI, 1989) by asking caregivers about the patients' behaviour. The minimum value is 0 and the maximum value is 203. the higher the score, the more intense the agitation | 6 months | 
| Measurement of agitation of patients in the nursing home | Assessment of agitation using the Cohen-Mansfield Agitation Inventory (CMAI, 1989) by asking caregivers about the patients' behaviour. The minimum value is 0 and the maximum value is 203. the higher the score, the more intense the agitation | 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency and severity of Psychobehavioural Symptoms associated with Dementia | Assessment using the Neuro Psychiatric Inventory, care team version (NPI-ES, 2000). 10 behavioural domains and 2 neurovegetative variables are considered. item score = frequency x severity frequency minimum = 1 and maximum = 4 severity minimum = 1 and maximum = 3 A score above 2 is pathological | Baseline, 3 months, 6 months and 9 months | 
| Quality of life of patients | Assessment using the Quality of Life-Alzheimer's Disease (QOL-AD, 2009) 13 questions focus on the patient's quality of life. the patient's current quality of life in each domain is assessed by choosing one of the following four words: poor, fair, good, excellent. | Baseline, 3 months, 6 months and 9 months | 
| Impact of I-Learn on psychotropic drug prescriptions | Changes in the prescriptions given to patients in terms of psychotropic drugs (addition or withdrawal of a neuroleptic, antidepressant, anxiolytic, etc.) | Baseline, 3 months, 6 months and 9 months | 
| Impact of I-Learn on psychotropic drug prescriptions | Changes in the prescriptions given to patients in terms of dosage (increase/decrease of the daily dose) | Baseline, 3 months, 6 months and 9 months | 
| Impact of I-Learn training on hospital admissions | number of transfers to acute or emergency departments | 3 months, 6 months and 9 months | 
| Impact of I-Learn training on hospital admissions | reasons for hospitalisation | 3 months, 6 months and 9 months | 
| Impact of Psychobehavioural Symptoms Associated with Dementia on the professional practice of health care teams | Assessment using the Neuro Psychiatric Inventory, care team version (NPI-ES, 2000) 10 behavioural domains and 2 neurovegetative variables are considered. item score = frequency x severity fequency minimum = 1 and maximum = 4 severity minimum = 1 and maximum = 3 A score above 2 is pathological | Baseline, 3 months, 6 months and 9 months | 
| Caregiver burnout at work | Assessment using the Maslach Burnout Inventory (MBI, 1986) 22 items For each item, the minimum value is 0 and the maximum value is 6 BURNOUT Questions 1.2.3.6.8.13.14.16.20 Degree of burn out Total below 17 = low Total between 18 and 29 = moderate Total above 30 = high DEPERSONALISATION Questions 5.10.11.15.22 Degree of burn out Total below 5 = low Total between 6 and 11 = moderate Total above 12 = high PERSONAL FULFILMENT Questions 4.7.9.12.17.18.19.21 Degree of burn out Total above 40 = low Total between 34 and 39 = moderate Total below 33 = high Moderate or even high scores are a sign of latent burnout that is taking hold. | Baseline, 6 months and 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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agitation, dependent elderly people, psycho-behavioral disorders, nursing home