Investigating the implementation of education with a focus on person-centered communication in homecare services targeting nursing assistants
| ISRCTN | ISRCTN64890826 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN64890826 |
- Submission date
- 04/01/2022
- Registration date
- 10/01/2022
- Last edited
- 27/02/2023
- Recruitment status
- No longer recruiting
- Overall study status
- Ongoing
- Condition category
- Other
Plain English summary of protocol
Background and study aims
In this study, the researchers focus on how to support key competence development needed for in-home nursing assistants. The care of older persons in clinical practices, i.e. in the older person’s home, can be challenging with regard to the nature of the interpersonal interactions and communication needed to care for and respond to diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. The researchers therefore developed A Person-centred CommunicaTION (ACTION) program, a web-based educational intervention aimed to support key competence development for nursing assistants. The aim of this study is to evaluate the ACTION program with respect to participants’ responses to and the effect of the intervention.
Who can participate?
Nursing assistants working within home care for older persons and older persons who are 65 years and older and are receiving home care.
What does the study involve?
The ACTION contains the implementation and testing of an education intervention in person-centred communication, targeting nursing assistants within home care for older persons. ACTION program will be implemented in home care organisations in two different geographic areas in Sweden. Assessments will be performed before and after the program with data collected using: a) audio recordings of communications, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation form, field notes and observations, and d) interviews.
What are the possible benefits and risks of participating?
Possible benefits include contributing to a flexible and easily accessible, web-based education within a complex and multifaceted care context, and competence development on person-centred care for nursing assistants, caring for frail older people in the community.
There are few risks connected to the study; however, both audio recordings of home visits and interviews can be perceived as violating privacy. For example, audio recordings can be sensitive and it can feel uncomfortable to be audio-recorded, for both nursing assistants and older persons who receive home care. In connection with interviews with older persons, a situation may arise where the informant is emotionally affected in the dialogue and discloses information that the person in question did not really want to share.
Where is the study run from?
The University of Borås and the Mälardalen University (Sweden)
When is the study starting and how long is it expected to run for?
March 2021 to December 2025
Who is funding the study
The University of Borås and the Mälardalen University (Sweden)
Who is the main contact?
Prof. Annelie J. Sundler
annelie.sundler@hb.se
Contact information
Scientific
Faculty of Caring Science, Work Life and Social Welfare
Department of Caring Science
University of Borås
Borås
S-501 90
Sweden
 ORCID ID |
0000-0002-9194-3244 |
|---|---|
| Phone | +46 (0)33 435 47 44 |
| annelie.sundler@hb.se |
Study information
| Study design | Cluster randomized trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | Home |
| Study type | Other |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet in Swedish |
| Scientific title | Implementing A person-centered CommunicaTION (ACTION) educational intervention for in-home nursing assistants |
| Study acronym | ACTION |
| Study objectives | The research objective is to evaluate the full-scale implementation of the ACTION program with respect to participants’ responses to and the effect of the intervention. The hypothesis is that nursing assistants in the intervention group will have a greater number of empathic responses after intervention than those in the control group. |
| Ethics approval(s) | Approved 02/11/2021, The Swedish Ethical Review Authority (Etikprövningsmyndigheten, Box 2110, 750 02, Uppsala, Sweden; +46 10-475 08 00; registrator@etikprovning.se), ref: 2021-05233 |
| Health condition(s) or problem(s) studied | Competence development by implementing a training intervention in person-centered communication, aimed at nursing assistants working within in-home care for older people |
| Intervention | The ACTION program will be implemented in home care organisations in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited; 150 for the intervention group and 150 for the control group. The researchers will evaluate impact measures and the process. Home care organisations will be contacted in both urban and rural areas with a request to participate. Each participating home care organisation will be randomly assigned to either the control or the intervention group. The control groups will be offered the education after completion of all data collection, to compensate for their effort to gather data as controls. The education in ACTION is mainly web-based and the course is divided into six learning modules. The ACTION program has a blended learning approach, combining e-learning and face-to-face instructions, and each course is estimated to last for 6-8 weeks. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. Person-centred communication measured with audio recordings of communication during home care visits collected at baseline (e.g. before education) and after education (e.g. 8 weeks later), and analysed and coded by sequences of empathic statements and responses to emphatic opportunities, emotional communication and degree of person-centeredness: 1.1. Emphatic and emotional communication defined according to empathic opportunities, described by Suchman et al. and their model of emphatic communication 1.2. Emotional communication coded by the Verona Coding Definitions on Emotional Sequences (VR-CoDES) 1.3. Degree of person-centered communication coded by the Roter Interaction of Analysis (RIAS) The coding will be made by two independent coders after training, and interrater reliability will be calculated with Cohen’s kappa coefficient or with Pearson correlation analysis. |
| Secondary outcome measures | 1. Communication skills measured with the Self-efficacy questionnaire (SE-12) at baseline (e.g. before education) and after education (e.g. 8 weeks later) 2. Person-centred care measured with the Person-centered Care Assessment Tool (P-CAT) at baseline (e.g. before education) and after education (e.g. 8 weeks later) 3. Empathy measured with the Jefferson Scale of empathy (JSE) at baseline (e.g. before education) and after education (e.g 8 weeks later) 4. Job satisfaction measured with the Measure of Job Satisfaction at baseline (e.g. before education) and after education (e.g 8 weeks later) 5. Process evaluation with interviews, field notes and observations during the education with a focus on qualitative aspects and experiences of the implementation, weekly at weeks 1-6 during the education 6. Older persons’ perceptions measured with interviews about the meaning of and experiences from nursing assistant’s person-centred communication at weeks 6 - 8 |
| Overall study start date | 01/03/2021 |
| Completion date | 31/12/2025 |
Eligibility
| Participant type(s) | Mixed |
|---|---|
| Age group | Mixed |
| Sex | Both |
| Target number of participants | 300 nursing assistants and 25 older persons |
| Key inclusion criteria | Nursing assistants: 1. Permanent employment 2. Understand and speak Swedish Older persons receiving in-home care: 1. 65 years or older 2. Understand and speak Swedish 3. No cognitive impairment |
| Key exclusion criteria | Participants not able, or willing, to give their written informed consent to participate |
| Date of first enrolment | 01/03/2022 |
| Date of final enrolment | 31/12/2023 |
Locations
Countries of recruitment
- Sweden
Study participating centres
50190
Sweden
Västerås
72123
Sweden
Sponsor information
University/education
-
Borås
S-501 90
Sweden
| Phone | +46 (0)33 435 40 00 |
|---|---|
| registrator@hb.se | |
| Website | https://www.hb.se/en/ |
"ROR" |
https://ror.org/01fdxwh83 |
University/education
Box 883
Västerås
721 23
Sweden
| Phone | +46 (0)21 10 13 00 |
|---|---|
| info@mdh.se | |
| Website | https://www.mdh.se/en/malardalen-university? |
|
"ROR" |
https://ror.org/033vfbz75 |
Funders
Funder type
University/education
Government organisation / Universities (academic only)
- Alternative name(s)
- University of Borås, HB
- Location
- Sweden
Private sector organisation / Universities (academic only)
- Alternative name(s)
- Mälardalen University, Mälardalen University
- Location
- Sweden
Results and Publications
| Intention to publish date | 31/12/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not expected to be made available |
| Publication and dissemination plan | Planned publications in high-impact peer-reviewed journals. A study protocol will be available. |
| IPD sharing plan | Participant level data will not be shared publicly, i.e., outside the research group, due to directives in the ethical approval. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | 25/02/2023 | 27/02/2023 | Yes | No |
Editorial Notes
27/02/2023: Publication reference added.
05/01/2022: Trial's existence confirmed by the Swedish Ethical Review Authority.
