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The STAIR OF KNOWLEDGE-a codesigned intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes in Sweden: development of a complex intervention
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0002-8169-853X
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0001-5493-8334
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Cardiothoracic and Vascular Surgery, Skane University Hospital, Skanes universitetssjukhus Malmö, Malmö, Sweden.ORCID iD: 0000-0002-1437-5060
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 8, article id e072453Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To describe the development of a codesigned complex intervention intended to prevent the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes.

DESIGN: : Nursing homes in the municipality in southern Sweden.

PARTICIPANTS: End users (n=16) in nursing homes (n=4) codesigned the intervention together with the research group in workshops (n=4) in March-April 2022. Additionally, stakeholders (n=17) who were considered to play an important role in developing the intervention participated throughout this process. Data were analysed using reflexive thematic analysis.

RESULTS: Four workshops were conducted with end users (n=16) and 13 meetings with stakeholders (n=12) were held during the development process. The intervention aims to bridge the evidence-practice gap regarding the preventive care process of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The intervention is aimed at end users, lasts for 3 weeks and is divided into two parts. First, end users obtain knowledge on their own by following written instructions. Second, they meet, interact and discuss the knowledge acquired during part 1.

CONCLUSION: The intervention is robustly developed and thoroughly described. The study highlights the extensive process that is necessary for developing tailored complex interventions. The description of the entire development process may enhance the replicability of this intervention. The intervention needs to be tested and evaluated in an upcoming feasibility study.

TRIAL REGISTRATION NUMBER: NCT05308862.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023. Vol. 13, no 8, article id e072453
Keywords [en]
Aging, Nursing Care, PREVENTIVE MEDICINE
National Category
Nursing
Identifiers
URN: urn:nbn:se:mau:diva-62077DOI: 10.1136/bmjopen-2023-072453ISI: 001046594600007PubMedID: 37562934Scopus ID: 2-s2.0-85167737537OAI: oai:DiVA.org:mau-62077DiVA, id: diva2:1790665
Available from: 2023-08-23 Created: 2023-08-23 Last updated: 2024-05-24Bibliographically approved
In thesis
1. The stair of knowledge – prevention of pressure ulcers, malnutrition, poor oral healthand falls among older persons in nursing homes: development and evaluation of the feasibility of an educational intervention
Open this publication in new window or tab >>The stair of knowledge – prevention of pressure ulcers, malnutrition, poor oral healthand falls among older persons in nursing homes: development and evaluation of the feasibility of an educational intervention
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Evidence exists on how to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes, but these health risks still occur frequently, causing suffering. Aim: The overall aim of the thesis was to develop and evaluate the feasibility of an educational intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. Methods: By combining methods, four studies were conducted to develop and evaluate the feasibility of an educational intervention. The educational intervention was developed in studies I-III, and its feasibility was evaluated in study IV. In study I, a quantitative study was conducted to determine the prevalence of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons receiving municipal healthcare. In study II, a qualitative study was conducted to explore nurse aides’, registered nurses’ and managers’ experiences of preventive work regarding pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. In study III, a qualitativ estudy was conducted to co-design the educational intervention together with nurse aides, registered nurses and managers to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. Additionally, key persons in the municipality participated in co-designing the educational intervention. The development process and the educational intervention itself was also described in study III. In study IV, a mixed methods study was conducted to evaluate the feasibility of the educational intervention. Results: The risks of pressure ulcers, malnutrition, poor oral health and falls was approximately 28%, 56%, 34% and 74%, respectively, and approximately 90% had at least one health risk (study I). Nurse aides, registered nurses and managers experienced prevention of pressure ulcers, malnutrition, poor oral health and falls as important but challenging (study II). The lack of knowledge among them was reported as a major challenge (studies II and III). The educational intervention, the STAIR OF KNOWLEDGE, was co-designed with nurse aides, registered nurses and managers in nursing homes, and stakeholders in the municipality, to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The content, format and delivery of the STAIR OF KNOWLEDGE intervention was co-designed to fit the need for knowledge to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in a local context (study III), and was proven as feasible but with some refinements required for a perfect fit (study IV). Conclusion: The educational intervention, the STAIR OF KNOWLEDGE, was developed together with and for nurse aides, registered nurses and managers to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The STAIR OF KNOWLEDGE intervention is therefore likely to provide end users with the knowledge needed to accomplish preventive work in nursing homes. The STAIR OF KNOWLEDGE intervention was proven to be feasible but with some amendments necessary before continuing to a definitive trial.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2024. p. 106
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383, E-ISSN 2004-9277
Keywords
prevention, pressure ulcers, malnutrition, poor oral helath, falls, older persons, nursing homes, educational intervention
National Category
Nursing
Research subject
Care science
Identifiers
urn:nbn:se:mau:diva-67403 (URN)10.24834/isbn.9789178774043 (DOI)978-91-7877-403-6 (ISBN)978-91-7877-404-3 (ISBN)
Public defence
2024-05-17, Hälsa och samhälle aulan, Jan Walderströmsgata 25, Malmö, 09:00 (Swedish)
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Paper IV in dissertation as manuscript

Paper IV is not included in the fulltext online 

Available from: 2024-05-24 Created: 2024-05-24 Last updated: 2024-05-24Bibliographically approved

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Neziraj, MeritaAxelsson, MalinKumlien, ChristineHellman, Peter

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