Clinical trial NCT01324219: Changing Talk to Reduce Resistiveness to Care
Official title: Changing Talk to Reduce Resistiveness to Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dementia
Keywords: nursing staff
residents
Lead sponsor: University of Kansas Medical Center
Sponsor class: OTHER
First posted: 2011-03-28
Enrollment: 202
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: SUPPORTIVE_CARE

Brief summary: The investigators are interested in reducing problem behaviors of nursing home residents with dementia that make providing care difficult. The investigators call these behaviors resistiveness to care. Previous research has found that resistiveness to care occurs more frequently when staff use certain types of communication. An inservice program will be provided to all nursing staff in your nursing home to teach staff about communication practices to reduce resistiveness to care. The research study will see whether changing communication will reduce resident resistiveness to care. If effective, the communication training may then be used to improve care in other facilities.

By doing this study, researchers hope to learn if changing communication practices will reduce resistiveness to care in nursing home residents with dementia.


Eligibility criteria: Staff:Inclusion criteria for CNAs are:

* age 18 years old or greater (age of legal consent in Kansas and Missouri), signed informed consent,
* permanent employment in the NH,
* primary assignment to a specified unit,
* and English speaking
* Staff must have been assigned to care for the resident at least twice weekly in the past month (documented in NH staffing records). This will assure that staff-resident dyads have established relationships and will control effects of variability in contact between dyads during days when data are not being collected.

Resident inclusion criteria are:

* a diagnosis of Alzheimer's disease or related dementia documented in their medical records,
* documentation of daily RTC over the past week,
* and ability to hear staff communication (from the most recent MDS).

Exclusion criteria for CNAs include:

* non-English speaking,
* temporary employment, -and age under 18 years.
* If more than one CNA volunteers as a partner for a participating resident, a random selection will be made to determine which CNA will participate. Small variations in contact between staff and residents in dyads are anticipated due to PMMA policies for consistent CNA assignment to neighborhoods. Therefore dyads will have repeated contacts.

Exclusion criteria for residents include:

* diagnosis with Huntington's disease,
* alcohol-related dementias,
* schizophrenia,
* manic-depressive disorder,
* deafness,
* and mental retardation.

Primary outcomes:
measure: the effects of the nursing staff communication - change in frequency and duration of resident Resistiveness to Care behaviors.
timeFrame: up to 6 months
Secondary outcomes:
measure: Calculate the costs of nursing staff communication system
timeFrame: up to 6 months
Other outcomes:
Locations:
city: Kansas City
country: United States
facility: University of Kansas Medical Center
state: Kansas
Study officials:
affiliation: University of Kansas
name: Kristine Williams, RN, PhD, APRN, FNP-BC
role: PRINCIPAL_INVESTIGATOR
References:
citation: Liu W, Perkhounkova Y, Williams K, Batchelor M, Hein M. Mealtime nonverbal behaviors in nursing home staff and residents with dementia: Behavioral analyses of videotaped observations. Geriatr Nurs. 2022 Mar-Apr;44:112-124. doi: 10.1016/j.gerinurse.2022.01.009. Epub 2022 Feb 4.
citation: Liu W, Batchelor M, Williams K. Development and Psychometric Testing of the Mealtime Engagement Scale in Direct Care Providers of Nursing Home Residents With Dementia. Gerontologist. 2021 Nov 15;61(8):e410-e420. doi: 10.1093/geront/gnaa097.
citation: Jao YL, Liu W, Williams K, Chaudhury H, Parajuli J. Association between environmental stimulation and apathy in nursing home residents with dementia. Int Psychogeriatr. 2019 Aug;31(8):1109-1120. doi: 10.1017/S1041610219000589.
citation: Williams KN, Perkhounkova Y, Herman R, Bossen A. A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial. Gerontologist. 2017 Aug 1;57(4):707-718. doi: 10.1093/geront/gnw047.