Maintenance Cognitive Stimulation Therapy (CST) in practice: study protocol for a randomized controlled trial

  1. Streater, Amy 13
  2. Spector, Aimee 13
  3. Aguirre, Elisa 13
  4. Hoe, Juanita 13
  5. Hoare, Zoe 2
  6. Woods, Robert 2
  7. Russell, Ian 2
  8. Orrell, Martin 13
  1. 1 University College London
    info

    University College London

    Londres, Reino Unido

    ROR https://ror.org/02jx3x895

  2. 2 Bangor University
    info

    Bangor University

    Bangor, Reino Unido

    ROR https://ror.org/006jb1a24

  3. 3 Goodmayes Hospital
    info

    Goodmayes Hospital

    Ilford, Reino Unido

    ROR https://ror.org/00x0j8257

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Revista:
Trials

ISSN: 1745-6215

Año de publicación: 2012

Volumen: 13

Número: 1

Tipo: Artículo

DOI: 10.1186/1745-6215-13-91 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Trials

Resumen

BackgroundCognitive Stimulation Therapy (CST) is a psychosocial evidence-based group intervention for people with dementia recommended by the UK NICE guidelines. In clinical trials, CST has been shown to improve cognition and quality of life, but little is known about the best way of ensuring implementation of CST in practice settings. A recent pilot study found that a third of people who attend CST training go on to run CST in practice, but staff identified a lack of support as a key reason for the lack of implementation.Methods/designThere are three projects in this study: The first is a pragmatic multi-centre, randomised controlled trial (RCT) of staff training, comparing CST training and outreach support with CST training only; the second, the monitoring and outreach trial, is a phase IV trial that evaluates implementation of CST in practice by staff members who have previously had the CST manual or attended training. Centres will be randomised to receive outreach support. The primary outcome measure for both of these trials is the number of CST sessions run for people with dementia. Secondary outcomes include the number of attenders at sessions, job satisfaction, dementia knowledge and attitudes, competency, barriers to change, approach to learning and a controllability of beliefs and the level of adherence. Focus groups will assess staff members’ perceptions of running CST groups and receiving outreach support. The third study involves monitoring centres running groups in their usual practice and looking at basic outcomes of cognition and quality of life for the person with dementia.DiscussionThese studies assess the effects of outreach support on putting CST into practice and running groups effectively in a variety of care settings with people with dementia; evaluate the effectiveness of CST in standard clinical practice; and identify key factors promoting or impeding the successful running of groups.

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Información de financiación

Evaluation and comparison of the effectiveness of staff training in CST and its implementation in practice are part of the Support at Home – Interventions to Enhance Life in Dementia (SHIELD) project (Application no. RP-PG-0606-1083), which is funded by the NIHR Programme Grants for Applied Research funding scheme. The grant holders are Professors Orrell (UCL), Woods (Bangor), Challis (Manchester), Moniz-Cook (Hull), Russell (Swansea), Knapp (LSE) and Dr Charlesworth (UCL). The views and opinions expressed in this paper are those of the authors and do not necessarily reflect those of the Department of Health/NIHR.

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Referencias bibliográficas

  • Lutz W, Sanderson W, Scherbov S: The coming acceleration of global population ageing. Nature. 2008, 451: 716-719. 10.1038/nature06516.
  • Romanow RJ: Building on values, In The future of health care in Canada-Final report (electronic version). 2002, National Library of Canada, Ottawa, ON
  • Murdoch P: How might a crisis in long-term care of people with dementia be averted. Age Ageing. 2007, 36 (1): 6-7.
  • Living well with dementia: A National Dementia Strategy DH/SCLG&CP/SCPI/SR. 2009
  • Spector A, Thorgrimsen L, Woods B, Royan L, Davies S, Butterworth M, Orrell M: A randomised controlled trial investigating the effectiveness of an evidence-based cognitive stimulation therapy programme for people with dementia. Br J Psychiatry. 2003, 183: 248-254. 10.1192/bjp.183.3.248.
  • Spector A, Davies S, Woods B, Orrell M: Reality orientation for dementia: a systematic review of the evidence of effectiveness from Randomized Controlled Trials. Gerontologist. 2000, 40 (2): 206-212. 10.1093/geront/40.2.206.
  • Medical Research Council: A framework for the development and evaluation of RCT’s for complex interventions to improve health, Medical Research Council. 2000, [ http://www.mrc.ac.uk/Utilities/Documentrecord/index.htm? ]d=MRC003372
  • Knapp M, Thorgrimsen L, Patel A, Spector A, Hallam A, Woods B: Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis. Br J Psychiatry. 2006, 188: 574-580. 10.1192/bjp.bp.105.010561.
  • Woods B, Aguirre E, Spector AE, Orrell M: Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev. 2012, 1: CD005562-
  • National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (NICE-SCIE): Dementia: supporting people with dementia and their carers in health and social care, Clinical Guideline 42. 2006, NICE-SCIE, London
  • Orrell M, Spector A, Thorgrimsen L, Woods B: A pilot study examining the effectiveness of Maintenance Cognitive Stimulation Therapy (MCST) for people with dementia. Int J Geriatr Psychiatry. 2005, 20: 446-451. 10.1002/gps.1304.
  • Aguirre E, Spector A, Hoe J, Russell I, Knapp M, Woods R, Orrell M: Maintenance Cognitive Stimulation Therapy (CST) for dementia: a single-blind, multi-centre, randomized controlled trial of Maintenance CST vs. CST for dementia Trials. 2010, 11: 46-
  • National Audit Office: Improving Services and support for people with dementia. 2007, The Stationary office, London, UK
  • Spector A, Thorgrimsen L, Woods B, Orrell M: Making a difference: an evidence-based group programme to offer Cognitive Stimulation therapy (CST) to people with dementia. 2006, Hawker Publications, UK
  • Aguirre E, Spector A, Streater A, Hoe J, Woods B, Orrell M: Making a difference 2. 2012, Hawker Publications, UK
  • Spector A, Orrell M, Aguirre E: Translating research into practice: a pilot study examining the use of Cognitive Stimulation Therapy (CST) after a one-day training course. 2010, Non-pharmacological Therapies in, Dementia, 945-949.
  • Weiss DJ, Dawis RV, England GW, Lofquist LH: Manual for the Minnesota Satisfaction Questionnaire, In Minnesota Studies in Vocational Rehabilitation. 1967, XXII
  • Lintern T, Woods B: Approaches to Dementia Questionnaire. 1996, University of Wales, Bangor, UK
  • Shanahan N, Schepers A, Spector A, Orrell M: The development and evaluation of the DK20: A knowledge of dementia measure for care staf. in press
  • Schepers A: The Sense of Competence in Dementia Care Questionnaire for Staff (SCID-S): Development, reliability and validity. Volume 1; 2010, D. Clin. Psy thesis, University College London
  • Holton EF, Bates RA, Ruona WEA: Development of a generalized learning transfer system inventory. Hum Resour Dev Q. 2000, 11 (4): 333-360. 10.1002/1532-1096(200024)11:4<333::AID-HRDQ2>3.0.CO;2-P.
  • Holton EF, Bates R, Leimbach M: In Development and validation of a generalized potential for training transfer climate instrument, In Proceedings of the 1997 Academy of Human Resource Development Annual Meeting. Edited by: Torraco R. 1997, Atlanta, GA
  • Holton EF, Bates R, Seyler DL, Carvalho MB: “Toward construct validation of a transfer climate instrument”. Hum Resour Dev Q. 1997, 8 (2): 95-113. 10.1002/hrdq.3920080203.
  • Corrigan PW, Kwartarini WY, Pramana W: Staff perceptions of barriers to behaviour therapy at a psychiatric hospital. Behaviour Modification. 1992, 16: 132-144. 10.1177/01454455920161007.
  • Dagnan D, Grant F, McDonnell A: Understanding challenging behaviour in older people; the development of the controllability Beliefs Scale. Behav Cogn Psychother. 2004, 32: 501-506. 10.1017/S1352465804001675.
  • Morris JC: The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993, 43: 2412-2414.
  • Folstein MF, Folstein SE, McHugh PR: ‘Mini Mental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.
  • Logsdon RG, Gibbons LE, McCurry SM, Teri L: Quality of Life in Alzheimer’s Disease: patient and caregiver reports. Journal of Mental Health Aging. 1999, 5: 21-32.
  • Thorgrimsen L, Selwood A, Spector A: Whose quality of life is it anyway? The validity and reliability of the Quality of Life – Alzheimer’s Disease (QOL–AD) scale. Alzheimer’s Disease and Associated Disorders. 2003, in press
  • Office of Public Sector Information (OPSI): Mental Capacity Act. 2005, http://www.opsi.gov.uk/acts/acts2005/ukpga_20050009_en_11 ,
  • Spector A, Gadner C, Orrell M: The impact of Cognitive Stimulation Therapy groups on people with dementia: views from participants, their carers and group facilitators. In Aging & Mental Health. 2011