Evaluating an In-home Multicomponent Program to Manage Concerns About Falling in Frail Community Dwelling Older People
9 juli 2012 uppdaterad av: Maastricht University Medical Center
Evaluating the Effectiveness of an In-home Self-management Intervention to Prevent Psychological Distress in Frail Older People Living in the Community
The main objectives of this study are:
- an effect evaluation of an in-home multicomponent cognitive behavioural program on concerns about falling and related avoidance of activity (primary outcomes), as well as disability, fall incidents (secondary outcomes) and several additional outcomes in frail community-dwelling older people,
- a process evaluation of the feasibility of the program, with the following main outcomes: population reached, performance according to protocol, exposure and engagement, opinion on the program of participants and facilitators, perceived benefit or achievement, and experienced barriers and potential solutions, and
- an economical evaluation on the impact of the program on healthcare utilization and related costs.
Studieöversikt
Status
Avslutad
Betingelser
Intervention / Behandling
Studietyp
Interventionell
Inskrivning (Faktisk)
389
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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Maastricht, Nederländerna, 6221 GT
- Maastricht University
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
70 år och äldre (Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Beskrivning
Inclusion Criteria:
- Aged 70 years or over
- At least some concerns about falling
- At least some associated avoidance of activity
- Fair or poor perceived general health
- Living independently in the community
- Written informed consent
Exclusion Criteria:
- Cognitive impairment (a score of less than 4 on the Abbreviated Mental Test 4)
- Language or hearing problems that impede completing an interview by telephone
- Sight problems that impede completing the intervention
- Confinement to bed
- Waiting for nursing home admission
- Permanent use of a wheelchair
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Cognitive behavioral program
an in-home cognitive behavioral program on managing concerns about falling and associated activity avoidance in frail community-dwelling older people facilitated by trained community nurses.
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The in-home cognitive behavioral program aims to learn older persons, living in the community, how to deal with concerns about falling and to increase physical, social and functional activity.
The principles of cognitive restructuring are used for shifting maladaptive in adaptive attitudes with respect to falling as well as increasing self efficacy beliefs and feelings of control.
The following themes are discussed during the program: concerns about falling, thoughts about falling, physical exercise, assert oneself, overcome personal barriers, recognizing fall-ty habits and managing concerns about falling.
Duration of the program is 10 weeks with 7 individual sessions (3 home visits (60, 60 and 75 minutes, respectively) & 4 telephone contacts (35 minutes each).
The program is facilitated by trained nurses qualified in the field of geriatrics and working for home care agencies.
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Inget ingripande: Control group
no program, only care as usual
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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concerns about falling
Tidsram: baseline, 5 months and 12 months
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Falls Efficacy Scale International (FES-I)
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baseline, 5 months and 12 months
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avoidance of activities due concerns about falling
Tidsram: baseline, 5 months and 12 months
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Falls Efficacy Scale International Avoidance Behaviour (FES-IAB)
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baseline, 5 months and 12 months
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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disability
Tidsram: baseline, 5 months and 12 months
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Groningen Activity Restriction Scale (GARS)
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baseline, 5 months and 12 months
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number of falls
Tidsram: continuous registration during the course of the trial for a period of 1 year
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Fall calendar
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continuous registration during the course of the trial for a period of 1 year
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catastrophic beliefs about falling
Tidsram: baseline, 5 months and 12 months
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Catastrophic beliefs about falling (CAFS)
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baseline, 5 months and 12 months
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perceived consequences of falling
Tidsram: baseline, 5 months and 12 months
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CoF - loss of functional independence subscale and damage to identity subscale
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baseline, 5 months and 12 months
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perceived control over falling
Tidsram: baseline, 5 months and 12 months
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Perceived control over falling (PCOF)
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baseline, 5 months and 12 months
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mastery
Tidsram: baseline, 5 months and 12 months
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Personal Mastery Scale
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baseline, 5 months and 12 months
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feelings of anxiety
Tidsram: baseline, 5 months and 12 months
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Subscale of the Hospital Anxiety and Depression Scale (HADS-A)
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baseline, 5 months and 12 months
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symptoms of depression
Tidsram: baseline, 5 months and 12 months
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Subscale of the Hospital Anxiety and Depression Scale (HADS-D)
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baseline, 5 months and 12 months
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social support interactions
Tidsram: baseline, 5 months and 12 months
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Social support interactions (SSL 12-I)
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baseline, 5 months and 12 months
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health-related quality of life
Tidsram: baseline, 5 months and 12 months
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SF-12 Health Survey
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baseline, 5 months and 12 months
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Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Samarbetspartners
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna publikationer
- Dorresteijn TA, Rixt Zijlstra GA, Van Eijs YJ, Vlaeyen JW, Kempen GI. Older people's preferences regarding programme formats for managing concerns about falls. Age Ageing. 2012 Jul;41(4):474-81. doi: 10.1093/ageing/afs007. Epub 2012 Feb 23.
- Dorresteijn TA, Zijlstra GA, Delbaere K, van Rossum E, Vlaeyen JW, Kempen GI. Evaluating an in-home multicomponent cognitive behavioural programme to manage concerns about falls and associated activity avoidance in frail community-dwelling older people: Design of a randomised control trial [NCT01358032]. BMC Health Serv Res. 2011 Sep 20;11:228. doi: 10.1186/1472-6963-11-228.
- Evers SMAA, Dorresteijn TAC, Wijnen BFM, van Haastregt JCM, Kempen GIJM, Zijlstra GAR. Economic evaluation of a home-based programme to reduce concerns about falls in frail, independently-living older people. Expert Rev Pharmacoecon Outcomes Res. 2020 Dec;20(6):641-651. doi: 10.1080/14737167.2019.1666714. Epub 2019 Sep 20.
- Dorresteijn TA, Zijlstra GA, Ambergen AW, Delbaere K, Vlaeyen JW, Kempen GI. Effectiveness of a home-based cognitive behavioral program to manage concerns about falls in community-dwelling, frail older people: results of a randomized controlled trial. BMC Geriatr. 2016 Jan 6;16:2. doi: 10.1186/s12877-015-0177-y. Erratum In: BMC Geriatr. 2016;16:108.
- Dorresteijn TA, Rixt Zijlstra GA, Van Haastregt JC, Vlaeyen JW, Kempen GI. Feasibility of a nurse-led in-home cognitive behavioral program to manage concerns about falls in frail older people: a process evaluation. Res Nurs Health. 2013 Jun;36(3):257-70. doi: 10.1002/nur.21534. Epub 2013 Mar 26.
Användbara länkar
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart
1 mars 2009
Primärt slutförande (Faktisk)
1 maj 2011
Avslutad studie (Faktisk)
1 maj 2011
Studieregistreringsdatum
Först inskickad
17 maj 2011
Först inskickad som uppfyllde QC-kriterierna
19 maj 2011
Första postat (Uppskatta)
23 maj 2011
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
10 juli 2012
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
9 juli 2012
Senast verifierad
1 juli 2012
Mer information
Termer relaterade till denna studie
Nyckelord
Andra studie-ID-nummer
- MEC 07-3-064
- ZonMw 120610001 (Annat bidrag/finansieringsnummer: ZonMw 120610001)
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