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一项基于理论的第II类混合实施干预,以改善瑞士护理院的疼痛管理:一项混合法研究方案
Author(s) -
Brunkert Thekla,
Ruppen Wilhelm,
Simon Michael,
Zúñiga Franziska
Publication year - 2019
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13817
Subject(s) - intervention (counseling) , nursing , medicine , pain management , focus group , protocol (science) , randomized controlled trial , research design , physical therapy , alternative medicine , business , social science , surgery , pathology , marketing , sociology
Aim To present a protocol for evaluating an implementation intervention to improve pain management in nursing homes by addressing behaviour change of the care workers. Background Pain management in nursing homes often is inadequate despite the availability of evidence‐based pain management guidelines. Barriers to pain management in nursing homes occur on several levels including lack of knowledge and negative beliefs towards pain of care workers. A comprehensive approach incorporating contextual and behavioural factors is needed to sustainably improve pain management practice. Design A hybrid type II effectiveness‐implementation design comprising an incomplete non‐randomized stepped‐wedge design and concurrent focus groups is proposed. Methods A convenience sample of six nursing homes will be included. Implementation of a facility pain management policy will be facilitated by introduction of a facility pain champion and training of all care workers in pain assessment and management. Quantitative outcomes assessed at baseline, after 3 and 6 months include self‐efficacy in pain management and attitudes to pain of care workers and functional interference from pain and pain intensity in residents. Feasibility and acceptability of the intervention and implementation strategies and potential barriers to implementation will be explored in focus groups and interviews. (Protocol approved in October 2017). Conclusion The proposed intervention implementation has been developed in a participatory approach involving relevant stakeholders. To further improve the contextual fit, development of implementation strategies was guided by the consolidated framework of implementation research. Findings of this research are expected to inform adaptions to the implementation of the intervention. Trial registration number ClinicalTrials.gov: NCT03471390.