Clinical trial NCT02846246: The Effects and Meaning of a Person-centred and Health-promoting Intervention in Home Care Services
Official title: The Effects and Meaning of a Person-centred and Health-promoting Intervention in Home Care Services: Study Protocol of a Non-randomised Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Staff and Older Persons With Home Care Service
Keywords: aged care
health
home care services
person-centred care
Lead sponsor: Umeå University
Sponsor class: OTHER
First posted: 2016-07-27
Enrollment: 81
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Current home care service are to a large extent task oriented with a limited focus on care recipient's involvement. Furthermore, studies have shown that low care recipients' involvement might decrease older people's quality of life. Person-centred care focusing on involvement has improved the quality of life and the satisfaction with care for older people in health care and nursing homes but there is a lack of knowledge about the effects and meaning of a person-centred interventions in aged care at home. Present study describes the evaluation of a person-centred and health-promoting intervention.

Detailed description: This is a non-randomised controlled trial with a before-after approach. The investigators will include 270 home care recipients \>65 years, 270 family members and 65 staff in intervention group and control group respectively. Participants will be recruited from a municipality in northern Sweden. The intervention involves letting the person and family together with contact nurse prioritise care content and make rearrangements to make sure the home care service maximises the potential to satisfy psychosocial, physical, and functional needs and increasing health. Outcome assessment will focus on; a) quality of life (primary outcomes), thriving and satisfaction with care for older people, b) caregiver strain, informal caregiving engagement and satisfaction with care for relatives, c) job satisfaction and stress for care staff. Evaluation will be performed by questionnaires and interviews.

Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services and the study result will hopefully lead the way in establish a person-centred and health-promoting model in aged care and living conditions for older people.

Eligibility criteria: Inclusion Criteria:

Inclusion criteria for care recipients will be:

* persons 65 years or older
* living at home with granted HCS
* have at least two visits per month, and
* be Swedish speaking

Inclusion for family members:

* be defined by the care recipients as his/her family member, and
* Swedish speaking

Inclusion for staff:

* have an employment for more than 6 month in the HCS district at baseline, be a contact staff and
* Swedish speaking
* Care recipients who apply for HCS in the district during the study period will be offered the intervention but not be included in the evaluation

Exclusion Criteria

* No exclusion criteria

Primary outcomes:
measure: Change of Quality of Life assessed with the Nottingham Health Profile scale
timeFrame: Baseline, 12 and 24 month follow-up
measure: Change of Quality of Life assessed with the EQ-5D
timeFrame: Baseline, 12 and 24 month follow-up
Secondary outcomes:
measure: Change in thriving assessed with the Thriving of Older People Assessment Scale
timeFrame: baseline, 12 and 24 month follow-up
measure: Change in satisfaction with home care service assessed with the Quality of Care from the Patients' Perspective
timeFrame: baseline, 12 and 24 month follow-up
Other outcomes:
measure: Change in informal caregiver strain assessed with the Caregiver Burden Scale
timeFrame: baseline, 12 and 24 month follow-up
measure: Change in informal caregiving engagement assessed with the Resource Utilization in Dementia instrument
timeFrame: baseline, 12 and 24 month follow-up
measure: Change in satisfaction with care for relatives assessed with the Pyramid questionnaire
timeFrame: baseline, 12 and 24 month follow-up
measure: Change in job satisfaction assessed with the Measure of Job Satisfaction
timeFrame: baseline, 12 and 24 month follow-up
measure: Change in stress of conscience assessed with the Stress of Conscience scale
timeFrame: baseline, 12 and 24 month follow-up
Locations:
Study officials:
affiliation: Umea University
name: David Edvardsson, Professor
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lamas K, Bolenius K, Sandman PO, Lindkvist M, Edvardsson D. Effects of a person-centred and health-promoting intervention in home care services- a non-randomized controlled trial. BMC Geriatr. 2021 Dec 18;21(1):720. doi: 10.1186/s12877-021-02661-5.
citation: Bolenius K, Lamas K, Sandman PO, Lindkvist M, Edvardsson D. Perceptions of self-determination and quality of life among Swedish home care recipients - a cross-sectional study. BMC Geriatr. 2019 May 24;19(1):142. doi: 10.1186/s12877-019-1145-8.
citation: Bolenius K, Lamas K, Sandman PO, Edvardsson D. Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial. BMC Geriatr. 2017 Feb 16;17(1):57. doi: 10.1186/s12877-017-0445-0.