The PaArticular Scales – A new outcome measure to quantify the impact of joint contractures on activities and participation in individuals in geriatric care: Development and Rasch analysis
“…Structured face-to-face interviews by blinded assessors were used to collect residents' data at baseline, then after three and six months. The primary outcome was de ned as the residents' participation and measured with the PaArticular Scales [23]. The secondary outcomes were de ned as residents' activities, instrumental activities of daily living, health-related quality of life, as well as falls and fall-related consequences to ensure the safety of the intervention.…”
Background: Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation.Methods: The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis.Results: Seven nursing homes (n=4 intervention groups, n=3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers. Conclusion: The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial. Trial Registration: German clinical trials register, DRKS00010037. Registered 12 February 2016.
“…Structured face-to-face interviews by blinded assessors were used to collect residents' data at baseline, then after three and six months. The primary outcome was de ned as the residents' participation and measured with the PaArticular Scales [23]. The secondary outcomes were de ned as residents' activities, instrumental activities of daily living, health-related quality of life, as well as falls and fall-related consequences to ensure the safety of the intervention.…”
Background: Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation.Methods: The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis.Results: Seven nursing homes (n=4 intervention groups, n=3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers. Conclusion: The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial. Trial Registration: German clinical trials register, DRKS00010037. Registered 12 February 2016.
“…In terms of reliability, the Cronbach's α values of the internal consistency of the Activity subscale and the Participation subscale were .96 and .92, respectively, and the McDonald's ω total were .98 and .95, respectively, indicating the high internal consistency. In terms of validity, the Pearson correlation coe cients of the 2 subscales (the Activity subscale and the Participation subscale) using the criterion validity of the visual analogue scale of the EQ-5D, which is one of the most frequently used generic health status measurement tools, demonstrated good validity and reliability at -.40 (p > .001) and -.30 (p > .001), respectively [12].…”
Section: Chinese Version Of the Paarticular Scalesmentioning
confidence: 99%
“…Third, individuals may already have one or more fully developed joint contractures or are at risk of developing joint contractures. Fourth, personal life situations are diverse, including different nursing care and assistance resources [12]. However, the WHODAS 2.0 is deigned to be applicable to all health conditions, including diseases, illnesses, injuries, mental or emotional problems, and alcohol or drug abuse.…”
Section: Introductionmentioning
confidence: 99%
“…It does not attempt to assign aetiology or apportion impairment or disability to any particular disorder [13]. The evaluation of activity and participation is complex, and the complex personal experience of impaired individuals must be acknowledged [12].…”
Section: Introductionmentioning
confidence: 99%
“…Therefore, an outcome questionnaire that quanti es the activity and participation of a particular population is particularly important. Thus far, no universally accepted scale can address the abovementioned key issues [12]. However, the International Classi cation of Functioning, Disability, and Health (ICF) is the common basis of the WHO's patient-centred measures and intervention plan and comprehensively classi es all health and health-related elds [5].…”
Background Joint contractures are common complications among elderly residents in long-term care facilities, causing activity limitations and participation restrictions and affecting quality of life (QOL). The aim of this study is to examine the psychometric properties of the Chinese version of the PaArticular Scales in joint contractures population.Methods A cross-sectional study design. A sample of elderly residents aged over 64 years with joint contractures in one important joint who have lived at a facility for more than 6 months in twelve long-term care facilities in Taiwan (N = 243). The Chinese version of the PaArticular Scales of joint contractures was generated through 5 stages: translation, review, back-translation, a panel of specialists, and a pretest. Test-retest reliability, internal consistency reliability, construct validity, and criterion validity were evaluated, and the results were compared with those for the WHOQOL-BREF and WHODAS 2.0–36 items.Results The Activities and Participation subscales had excellent internal consistency (α = .975; SD = 17.34). The correlation coefficients between the PaArticular Scales and the WHODAS 2.0–36 items (r = .770, p < .001) and WHOQOL-BREF were significant and highly correlated (r = − .553, p < .001).Conclusions The underlying theoretical model of the Chinese version of the PaArticular Scales functions well in Taiwan, and the Chinese version has acceptable levels of reliability and validity.Clinical trial registration:
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