Change in quality of life after a multidisciplinary intervention for people with dementia: A cluster randomized controlled trial. (11th June 2018) - Klapwijk, Maartje S.
Abstract : 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.