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P197: Delirium in nursing homes (DeliA) - an interdisciplinary health services research project
- Vincent Molitor, Theresa Sophie Busse, Chantal Giehl, Romy Lauer, Alexandre Houdelet-Oertel, Jonas Dörner, Zafer Arslan, Petra Thürmann, Ina Otte, Horst Christian Vollmar, Bernhard Holle, Rebecca Palm
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 145-146
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- Article
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Background:
Delirium is a potential emergency with serious consequences. Little attention has been paid to residents of nursing homes, although they are at extreme risk for developing delirium. Health Care Professionals (HCPs) such as nurses and general practitioners are assumed to know little about delirium in nursing homes.
Objectives:The German project DeliA (delirium in nursing homes) comprises three sub- studies and two reviews. The sub-studies have the following objectives: (1) to determine the prevalence of delirium and its sub-types in German nursing homes; (2) to describe and assess the quality of delirium care practices (prevention, diagnosis, therapy) of HCPs in nursing homes; and (3) to develop a Technology Enhanced Learning (TEL) to increase the delirium- specific knowledge of HCPs in nursing homes. The reviews aim to (a) summarize the prevalence of delirium reported in international studies and (b) to find out how, why and under what context education for HCPs in nursing homes works.
Methods:A systematic review of the reported prevalence of delirium in nursing homes will be conducted (a). The prevalence study (1) will assess delirium and its proposed associated factors in at least 50 nursing homes using validated measurements. Medication schedules of participating residents will be analyzed to determine potential for delirium. To describe current practice, process-oriented semi-structured guided interviews will be conducted with 30 representatives of the (nursing home) medical service and the nursing service of nursing homes (2). As a theoretical basis for the TEL, a realist review will be conducted to understand the active ingredients of educational interventions and to develop an initial program theory (b). The curriculum for the proposed TEL will be developed based on a synthesis of existing curricula and evaluated by Delphi experts for relevance, comprehensiveness, and content. A final feasibility study will assess the potential increase in knowledge about delirium among HCPs (n = 50) in nursing homes (3).
Expected Results:It is expected that the project and the dissemination of its findings will raise awareness among HCPs and the public about delirium in nursing homes. The developed TEL and its underlying program theory will be further tested.
Intervention for sleep problems in nursing home residents with dementia: a cluster-randomized study
- Martin Nikolaus Dichter, Jonas Dörner, Denise Wilfling, Almuth Berg, Thomas Klatt, Ralph Möhler, Burkhard Haastert, Gabriele Meyer, Margareta Halek, Sascha Köpke
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- Journal:
- International Psychogeriatrics , First View
- Published online by Cambridge University Press:
- 08 January 2024, pp. 1-14
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Objective:
To reduce sleep problems in people living with dementia using a multi-component intervention.
Design:Cluster-randomized controlled study with two parallel groups and a follow-up of 16 weeks.
Setting:Using external concealed randomization, 24 nursing homes (NH) were allocated either to the intervention group (IG, 12 clusters, 126 participants) or the control group (12 clusters, 116 participants).
Participants:Participants were eligible if they had dementia or severe cognitive impairment, at least two sleep problems, and residence of at least two weeks in a NH.
Intervention:The 16-week intervention consists of six components: (1) assessment of sleep-promoting activities and environmental factors in NHs, (2) implementation of two “sleep nurses,” (3) basic education, (4) advanced education for staff, (5) workshops to develop sleep-promoting concepts, and (6) written information and education materials. The control group (CG) received standard care.
Measurements:Primary outcome was ≥ two sleep problems after 16 weeks assessed with the Sleep Disorders Inventory (SDI).
Results:Twenty-two clusters (IG = 10, CG = 12) with 191 participants completed the study. At baseline, 90% of people living with dementia in the IG and 93% in the CG had at least two sleep problems. After 16 weeks, rates were 59.3% (IG) vs 83.8% (CG), respectively, a difference of −24.5% (95% CI, −46.3% – −2.7%; cluster-adjusted odds ratio 0.281; 95% CI 0.087–0.909). Secondary outcomes showed a significant difference only for SDI scores after eight and 16 weeks.
Conclusions:The MoNoPol-Sleep intervention reduced sleep problems of people living with dementia in NH compared to standard care.