Process evaluation of the ACTION programme: a strategy for implementing person‐centred communication in home care

Abstract

Background There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary ().

Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol

“…The proposed study builds on a small-scale feasibility study [ 23 ] with promising results on the benefits of the web-based learning format being easy to use and the NAs appreciating the flexibility and accessibility. The present study has the potential to contribute to the evidence supporting key competence development required to offer individualised care for older persons and to meet upcoming needs for flexible and easily accessible competence development.…”

“…The intervention is designed to be flexible, accessible, and easy to implement. The programme was developed based on four core components: I) knowledge of key competence in communication and person-centred care, II) self-directed and reflective learning, III) flexibility and accessibility, and IV) efforts to stimulate and encourage participant activity [ 23 ].…”

“…The ACTION programme was first evaluated in a small-scale feasibility study [ 23 ]. The evaluation of the small-scale intervention showed promising results.…”

Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction

“…Data were collected as part of the ACTION project (Gustafsson et al, 2021 ). Two home‐care units were recruited from a medium‐sized municipality in western Sweden.…”

“…The modules were short and focused, aiming to be feasible with respect to the expected effort, time consumption and the home‐care work context. The program details and evaluation of the implementation process are earlier reported (Gustafsson et al, 2021 ).…”