Change in quality of life after a multidisciplinary intervention for people with dementia: A cluster randomized controlled trial

• Published in: International journal of geriatric psychiatry Vol. 33; no. 9; pp. 1213 - 1219
• Main Authors: Klapwijk, Maartje S., Caljouw, Monique A.A., Pieper, Marjoleine J.C., Putter, Hein, Steen, Jenny T., Achterberg, Wilco P.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.09.2018
• Subjects: Clinical trials; Dementia; dementia care; Dementia disorders; Emotions; Geriatric psychiatry; long‐term care; nursing home medicine; Pain; QUALIDEM; Quality of life; Social interactions; Social isolation; pain; long-term care; dementia; nursing home medicine; quality of life; dementia care; QUALIDEM
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.4912

Objective The objective of this study was to examine whether implementation of a stepwise multicomponent intervention (STA OP!) for challenging behavior and pain affects quality of life (QoL) of nursing home residents with moderate to severe dementia after 3 and 6 months. Methods A cluster randomized controlled trial was conducted in 12 nursing homes. Both control (n = 140) and intervention group (=148) received training, the intervention group was also treated using the STA OP! intervention. At baseline, 3 and 6 months QoL was assessed using the 6 QUALIDEM domains applicable to moderate and severe dementia. Linear mixed models were used to compare changes in QoL domains between the 2 groups over time. Results After both 3 and 6 months, there was no change, and no difference in change, between the 2 groups in the domains Care relationship, Positive affect, Negative affect, and Social relations. Between 0 and 3 months, a positive effect was seen in the domain Restless tense behavior with a regression coefficient of β: 0.95 (95% confidence interval [CI], 0.36‐1.54). Between 3 and 6 months, a negative effect was seen on the domain Restless tense behavior β: −0.98 (95% CI, −1.60 to −0.36) and a positive effect in the domain Social isolation, β: 0.64 (95% CI, 0.12‐1.17). Conclusions The stepwise intervention STA OP! affects the QUALIDEM domains in different ways: there was a lowering of Restless tense behavior in the short term, which reverted back to the initial level in the longer term, and a lowering of Social isolation in the longer term.