“The educating nursing staff effectively (TENSE) study”: design of a cluster randomized controlled trial

Abstract

BackgroundChallenging behavior exhibited by people with dementia can have adverse outcomes, like stress, low morale, low work satisfaction and absenteeism for nursing staff in long-term care settings. Training nursing staff to manage challenging behavior may reduce its impact. Although much of the research into training nursing staff shows methodological limitations, several studies find some effect of training programs on knowledge about and on management of challenging behavior. Effects on stress or burnout are almost not found.Methods/DesignThe TENSE-study is a randomized controlled study on 18 nursing home units (9 control, 9 intervention) investigating the effects of a continuous educational program for nursing staff about managing challenging behavior. Nursing staff of intervention units receive the program, nursing staff of control units do not and continue usual care. The primary outcome is stress experienced by nursing staff (N = 135). Secondary outcomes are: emotional workload, work satisfaction, stress reactions at work and knowledge about challenging behaviour of nursing staff; and frequency of challenging behavior, quality of life and social engagement of residents (N = 135). Because there are many unknown factors influencing the effect of the training, a process evaluation to evaluate sampling-, implementation- and intervention quality as well as barriers and facilitators to implementation will also be included in the analysis. Nursing staff could not be blinded to the intervention, but were blinded for the outcomes.DiscussionStrengths of this study are the (good) description of the intervention complemented by a process evaluation and the tailoring of the intervention to the wishes and needs of the nursing homes at any moment during the study. Sustaining the effects of the intervention by using follow up sessions is another strength. Possible drawbacks may be dropout because of the frailty of the elderly population and because nursing staff might move to another job during the study.Trial registrationNTR (Dutch Trial Registration) number NTR3620

Determining the Impacts of Educational Intervention based on PLST Extended Care model on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

“…Educational programs for nursing staff, who take care of these patients for a long time, may reduce these effects and help the caregivers manage the CB (20,21). The common behavioral and psychological symptoms of dementia are very stressful and challenging for family caregivers.…”

Determining the Impacts of Educational Intervention based on PLST Extended Care on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

“…CBPWD may have adverse consequences such as stress, weakness of spirituality, job dissatisfaction, and sequential absences of nurses working in health care centers taking care of patients with dementia. Educational programs for nursing staff who take care of these patients for a long time may reduce these effects and help caregivers manage the CB (20,21). The common behavioral and psychological symptoms of dementia are very stressful and challenging for family caregivers.…”