Anya Petyaeva1, Martine Kajander2, Vanessa Lawrence3, Lei Clifton4, Alan J Thomas5, Clive Ballard1,6, Iracema Leroi7, Michelle Briggs8, Jose Closs9, Tom Dening10, Kayleigh-Marie Nunez1, Ingelin Testad1,2, Renee Romeo3, Iskandar Johar1, Anne Corbett1,6. 1. Wolfson Centre for Age-Related Diseases, King's College London, London, UK. 2. Centre for Age-Related Medicine (SESAM), Stavanger University, Stavanger, Norway. 3. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. Centre for Statistics in Medicine, University of Oxford, Oxford, UK. 5. Institute for Neuroscience, Newcastle University, Newcastle, UK. 6. Exeter University Medical School, University of Exeter, Exeter, UK. 7. Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK. 8. Centre for Pain Research, Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK. 9. School of Healthcare, University of Leeds, Leeds, UK. 10. School of Medicine, University of Nottingham, Nottingham, UK.
Abstract
OBJECTIVES: The objective of this study was to establish the feasibility and initial effectiveness of training and support intervention for care staff to improve pain management in people with dementia living in care homes (PAIN-Dem). METHODS: PAIN-Dem training was delivered to care staff from three care homes in South London, followed by intervention support and resources to encourage improved pain management by staff over 4 weeks. Feasibility was assessed through fidelity to intervention materials and qualitative approaches. Focus group discussions with staff explored the use of the PAIN-Dem intervention, and interviews were held with six residents and family carers. Pain was assessed in all residents at baseline, 3 and 4 weeks, and goal attainment scaling was assessed at 4 weeks. RESULTS: Delivery of training was a key driver for success and feasibility of the PAIN-Dem intervention. Improvements in pain management behaviour and staff confidence were seen in homes where training was delivered in a care home setting across the care team with good manager buy-in. Family involvement in pain management was highlighted as an area for improvement. Goal attainment in residents was significantly improved across the cohort, although no significant change in pain was seen. CONCLUSIONS: This study shows good initial feasibility of the PAIN-Dem intervention and provides valuable insight into training and support paradigms that deliver successful learning and behaviour change. There is a need for a larger trial of PAIN-Dem to establish its impact on resident pain and quantifiable staff behaviour measures.
OBJECTIVES: The objective of this study was to establish the feasibility and initial effectiveness of training and support intervention for care staff to improve pain management in people with dementia living in care homes (PAIN-Dem). METHODS: PAIN-Dem training was delivered to care staff from three care homes in South London, followed by intervention support and resources to encourage improved pain management by staff over 4 weeks. Feasibility was assessed through fidelity to intervention materials and qualitative approaches. Focus group discussions with staff explored the use of the PAIN-Dem intervention, and interviews were held with six residents and family carers. Pain was assessed in all residents at baseline, 3 and 4 weeks, and goal attainment scaling was assessed at 4 weeks. RESULTS: Delivery of training was a key driver for success and feasibility of the PAIN-Dem intervention. Improvements in pain management behaviour and staff confidence were seen in homes where training was delivered in a care home setting across the care team with good manager buy-in. Family involvement in pain management was highlighted as an area for improvement. Goal attainment in residents was significantly improved across the cohort, although no significant change in pain was seen. CONCLUSIONS: This study shows good initial feasibility of the PAIN-Dem intervention and provides valuable insight into training and support paradigms that deliver successful learning and behaviour change. There is a need for a larger trial of PAIN-Dem to establish its impact on resident pain and quantifiable staff behaviour measures.
Authors: Francesca L La Frenais; Rachel Bedder; Victoria Vickerstaff; Patrick Stone; Elizabeth L Sampson Journal: J Am Geriatr Soc Date: 2017-12-23 Impact factor: 5.562