A Cluster-Randomised Trial of Staff Education to Improve the Quality of Life of People with Dementia Living in Residential Care: The DIRECT Study
Open accessAbstract
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. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12607000417482.
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Kales, H. C., Gitlin, L. N., & Lyketsos, C. G. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.05.022 · Cited by 76 · see citing works
Velasquez Reyes, D., Patel, H., Lautenschlager, N., Ford, A. H., Curran, E., Kelly, R., Lai, R., Chong, T., Flicker, L., Ekers, D., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-032421 · Cited by 5 · see citing works
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- Authors
- Beer, C., Horner, B., Flicker, L., Scherer, S., Lautenschlager, N. T., Bretland, N., Flett, P., Schaper, F., & Almeida, O. P.
- Affiliations
- Curtin University (AU)
- The University of Western Australia (AU)
- The University of Melbourne (AU)
- Bentley Health Service (AU)
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2011-11-30
- Volume
- 6
- Issue
- 11
- Pages
- e28155
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3227637
- OpenAlex
- W2073504091
- Cited by
- 35
- References
- 0
- Citations by year
- 2026: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 6 · 2015: 2 · 2014: 2 · 2013: 4 · 2012: 2
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eSpace (Curtin University) (submittedVersion, cc-by)
- Funders
- Medical Research Council
- National Health and Medical Research Council (458797)
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- dementia, nursing homes, quality of life, employee training, general practitioners, care staff training, intervention adherence, subjective quality of life, older adults
- MeSH terms
- Adult, Aged, Aged, 80 and over, Dementia, Demography, Humans, Medical Staff, Middle Aged, Quality of Life, Residential Facilities, Western Australia, Case-Control Studies, Health Care Surveys, Guideline Adherence
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