Development and testing of communication skills training for hospital healthcare practitioners caring for people living with dementia to avoid or resolve episodes of distress and challenging behaviour (VOICE2): a mixed-methods study
Study Code / Acronym
VOICEZAward Number
NIHR134221Programme
Health and Social Care Delivery ResearchStatus / Stage
ActiveDates
3 January 2022 -31 December 2024
Duration (calculated)
02 years 11 monthsFunder(s)
NIHRFunding Amount
£829,900.19Funder/Grant study page
NIHRContracted Centre
The University of NottinghamPrincipal Investigator
Professor Rowan HarwoodPI Contact
Rowan.Harwood@nottingham.ac.ukPI ORCID
0000-0002-4920-6718WHO Catergories
Models across the continuum of careDisease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 12 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Study Code / Acronym | VOICEZ |
|---|---|
| Award Number | NIHR134221 |
| Status / Stage | Active |
| Start Date | 20220103 |
| End Date | 20241231 |
| Duration (calculated) | 02 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | The University of Nottingham |
| Funding Amount | £829,900.19 |
Abstract
Research question: Can we identify and teach communication skills to help healthcare practitioners (HCPs) avoid or resolve episodes of distress and challenging behaviour amongst hospital patients living with dementia (PLWD)? Background: PLWD often become distressed, especially when admitted to acute hospitals, which can lead to ‘behaviours that challenge’, such as agitation or aggression. We recently used a socio-linguistic research method called conversation analysis (CA) to reveal effective communication techniques around negotiating requests and ending an interaction with a PLWD. We developed a communication skills training course based on these findings. Trainees told us that they needed additional skills in managing distress and that a critical mass of staff on a ward should be trained for greatest effectiveness. Methods: We will undertake research in three phases: 1) We will use CA to identify specific and teachable communication practices that HCPs use to avoid, de-escalate or resolve distress and challenging behaviour. We will video record 50 interactions on 10 wards at 2 hospitals, involving PLWD in distress, who are prone to distress, or engaged in activities that may cause distress. CA will be used to reveal systematic patterns in the interactions and identify successful practices that HCPs use. 2) We will co-produce theory-based learning resources including interactive digital teaching, appropriate for registered and non-registered HCPs, which can be used face-to-face or in facilitated on-line courses. This will involve researchers, PPI, clinicians, staff representatives and educationalists. We will develop a portfolio of educational resources which will form a flexible communication skills training course and a train-the-trainers course to enable Trust clinical educators to deliver the training. 3) We will deliver the training in 3 NHS acute Trusts, recruiting and training 3 dementia educators from each, and evaluating the effectiveness of the training that they deliver, using mixed method, multiple case study methodology. We will evaluate at the levels of knowledge, confidence, communication behaviours, impact on patients, and family carer views. About 150 HCPs will be trained, focusing on 2 wards in each Trust. We will explore development of a ‘critical mass’ of trained staff and identify barriers and facilitators to delivering training and implementing the skills in practice. Evaluation will use a combination of questionnaires, interviews with educators, HCPs and ward managers, structured observations of care, and family questionnaires and conversations. Dissemination and impact: We will deliver new socio-linguistic knowledge, which will be presented at conferences and published in high impact journals. We will produce a website with digital teaching and learning resources to support dementia educators to deliver communication skills courses and a ‘train-the-trainers’ course. This has the potential for widespread and low-cost uptake. There is high demand for this type of training, with the potential for substantial impact on patient experience and wellbeing. We will identify and address factors that may help or hinder implementation. Timelines: Phase 1 (CA) over months 0-12, phase 2 (development) over months 7-16, and phase 3 (implementation and evaluation) over months 13-30, with 3 months analysis, reporting, disseminating and contingencies.
Aims
We want to see what sort of communication helps avoid or resolve distress and challenging behaviours for people in hospital who have
dementia, and then teach it to hospital staff.