A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial
Open accessAbstract
Purpose This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial.Method All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit's manager. Half the units (n = 12) were randomly assigned to continue providing treatment as usual, and half (n = 11) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users' level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users' quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117).Results Knowledge acquired by the staff during the initial workshops increased significantly (p ≤ 0.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up.Conclusions The intervention increased the level of knowledge of staff without leading to an improvement in service users' engagement in activities, quality of life, or quality of care in the units.
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Cardoso et al. used the time budget to measure the effectiveness of a staff training program to improve the activity engagement of people with schizophrenia living in residential facilities.
“Based on a similar approach to the TUS, the previously described time budget (39) was used by Cardoso et al. (49) to measure the effectiveness of a staff training program to improve the activity engagement of people with schizophrenia living in residential facilities.”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [49]
The Primary outcome section says Cardoso et al. used the Time Use Diary to assess activity engagement in a staff-training trial, and the Service users’ characteristics section says participants mainly had schizophrenia or schizoaffective disorder. The paper does not identify the measure as the cited ‘time budget’; it names the Time Use Diary instead. The claim describes the program’s aim, not a demonstrated improvement—the Discussion reports that the intervention was not effective. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe interventions included staff training about activity engagement, Individual Placement and Support (IPS), cognitive remediation, Social Recovery Therapy (SRT), a befriending program, lifestyle modification and occupational therapy group programs.
“These interventions included staff training about activity engagement, its importance for addressing mental illness and approaches to encourage engagement (49); Individual Placement and Support (IPS) (45, 48); cognitive remediation (50); Social Recovery Therapy (SRT) (based on cognitive behavioral strategies) (52–54); a befriending program (56); lifestyle modification (51) and occupational therapy”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [49]
Cardoso et al. reported improvements in activity engagement, although these were not statistically significant when compared with the control group.
“They reported improvements in activity engagement, although these were not statistically significant when compared with the control group.”
From Contributions of a time use perspective in community mental health practice: a scoping review (2024) · cites this paper as [49]
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References 28 · Cited by 5
- Authors
- Cardoso, G., Papoila, A., Tomé, G., Killaspy, H., King, M., & Caldas-de-Almeida, J. M.
- Affiliations
- Universidade Nova de Lisboa (PT)
- University College London (GB)
- Corresponding author
- Cardoso, Graça
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2017-06-30
- Volume
- 52
- Issue
- 11
- Pages
- 1435-1445
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W2733672181
- Cited by
- 5
- References
- 28
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2021: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Direção Geral de Saúde, Ministério da Saúde
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- employee training, long-term mental illness, quality of care, quality of life, employee knowledge, rehabilitation care
- MeSH terms
- Adult, Mental Disorders, Clinical Competence, Female, Follow-Up Studies, Humans, Inservice Training, Male, Medical Staff, Middle Aged, Portugal, Quality of Health Care, Quality of Life, Residential Facilities, Cluster Analysis
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