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    A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: The DIRECT study

    233779_233779.pdf (431.2Kb)
    Access Status
    Open access
    Authors
    Beer, C.
    Horner, Barbara
    Flicker, L.
    Scherer, S.
    Lautenschlager, N.
    Bretland, Nicholas
    Flett, P.
    Schaper, F.
    Almeida, O.
    Date
    2011
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Beer, C. and Horner, B. and Flicker, L. and Scherer, S. and Lautenschlager, N. and Bretland, N. and Flett, P. et al. 2011. A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: The DIRECT study. PLoS ONE. 6 (11): e28155.
    Source Title
    PLoS ONE
    DOI
    10.1371/journal.pone.0028155
    School
    Curtin Medical School
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/3.0/

    URI
    http://hdl.handle.net/20.500.11937/35070
    Collection
    • Curtin Research Publications
    Abstract

    Background: The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. Methodology/Principal Findings: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. Conclusion: The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit.

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