Informed Palliative Care in Nursing Homes Through the interRAI Palliative Care Instrument

Not Applicable

• Conditions: Nursing Home Residents With Palliative Care Needs
• Interventions: Other: interRAI PC

• Registration Number: NCT02281032
• Lead Sponsor: KU Leuven

Brief Summary

BACKGROUND Nursing homes are important locations for palliative care. Through comprehensive geriatric assessments (CGAs), evaluations can be made of the palliative care needs of nursing home residents. The interRAI Palliative Care instrument (interRAI PC) is a CGA that evaluates diverse palliative care needs of adults in all healthcare settings. The evaluation results in Client Assessment Protocols (CAPs: indications of problems that need addressing) and Scales (e.g. Palliative Index for Mortality (PIM)) which can be used to design, evaluate and adjust care plans. This study aims to examine the effect of using the interRAI PC on the quality of palliative care in nursing homes. Additionally, it aims to evaluate the feasibility and validity of the interRAI PC.

METHODS This study covers phases 0, I and II of the Medical Research Council (MRC) framework for designing and evaluating complex interventions, with a longitudinal, quasi-experimental pretest-posttest design and with mixed methods of evaluation. In phase 0, a systematic literature search is conducted. In phase I, the interRAI PC instrument is adapted for use in Belgium and implemented on the BelRAI-website and a practical training is developed. In phase II, the intervention is tested in fifteen nursing homes. Participating nursing homes fill out the interRAI PC during one year for all residents receiving palliative care. Using a pretest-posttest design with quasi-random assignment to the intervention or control group, the effect of the interRAI PC on the quality of palliative care is evaluated with the Palliative care Outcome Scale (POS). Psychometric analysis is conducted to evaluate the predictive validity of the PIM and the convergent validity of the CAP 'Mood' of the interRAI PC. Qualitative data regarding the usability and face validity of the instrument are collected.

DISCUSSION This is the first study to evaluate the validity and effect of the interRAI PC in nursing homes, following a methodology based on the MRC framework. This approach improves the study design and implementation and will contribute to a higher generalizability of results. The final result will be a psychometrically evaluated CGA for nursing home residents receiving palliative care.

Detailed Description

Not available

Study Timeline

• Study Start: 2013-11
• Status Verified: 2014-10
• Study First Submitted: 2014-10-30
• Study First Submitted QC: 2014-10-31
• Last Update Submitted: 2014-10-31
• Study First Posted: 2014-11-02
• Last Update Posted: 2014-11-02
• Primary Completion: 2015-02
• Study Completion: 2015-02

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 172

Inclusion Criteria

• 65+
• residing in a nursing home
• having palliative care needs (based on the 'surprise question': 'would you be surprised if this person was to die within 6 to 12 months?') (Hubard G, 2011)

Exclusion Criteria

• 65-
• not residing in a nursing home
• no palliative care needs

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
interRAI Palliative Care	interRAI PC	15 experimental nursing homes: * Caregivers of 15 participating nursing homes receive a training about the interRAI PC and the BelRAI webapplication * Caregivers of 15 experimental nursing homes fill out the interRAI PC multidisciplinary every three months during one year for all nursing home residents with palliative care needs. Based on the results (Client Assessment Protocols and Scales) of the interRAI PC instrument, care plans are being evaluated, adapted and designed.

Primary Outcome Measures

Name	Time	Method
The effect of using the interRAI PC instrument on the quality of palliative care in nursing homes evaluated by the Palliative care Outcome Scale (POS)	1 year	Using a pretest-posttest design with quasi-random assignment to the intervention or control group, the effect of the interRAI PC on the quality of palliative care is evaluated with the Palliative care Outcome Scale (POS)

Secondary Outcome Measures

Name	Time	Method
The validity of the interRAI PC for use in nursing homes assessed by Psychometric analysis	1 year	Psychometric analysis is conducted to evaluate the predictive validity of the Palliative Index for Mortality (PIM) of the interRAI PC and the convergent validity of the CAP 'Mood' of the interRAI PC. Qualitative data regarding the face validity of the instrument are collected through focus groups, interviews and field notes
The feasibility of the interRAI C for use in nursing homes assessed through focus groups, interviews and field notes	1 year	Qualitative data regarding the feasibility of the instrument are collected through focus groups, interviews and field notes

Trial Locations

Locations (1)

KU Leuven, LUCAS; 🇧🇪 Leuven, Vlaams-Brabant, Belgium