title: Comparison of the effectiveness of two protocols for treating nursing home residents with advanced dementia.
abstract: The Serial Trial Intervention (STI) is a decision support tool to address the problem of underassessment and undertreatment of pain and other unmet needs of people with dementia. This study compared the effectiveness of the 5-step and 9-step versions of the STI using a two-group repeated measures quasi-experimental design with randomization of 12 matched nursing homes. The sample consisted of 125 residents with moderate to severe dementia. Both the 5- and 9-step STIs significantly decreased discomfort and agitation from pre- to posttest (effect sizes = 0.45 to 0.90). The 9-step version was more effective for comorbid burden and increased cortisol slope (effect sizes = 0.50 and 0.49). Process variables were all statistically significantly improved using the 9-step STI. Nurse time was not different between the two groups. The clinical decision support rules embedded in the STI, particularly the 9-step version, helped nurses change practice and improved resident outcomes.
authors.affiliation: Self-Management Science Center, University of Wisconsin, Milwaukee, WI, USA. ckovach@uwm.edu
authors.forename: Christine R
authors.initials: CR
authors.lastname: Kovach
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Simpson
authors.forename: Laura
authors.initials: L
authors.lastname: Joosse
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Noonan
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Reynolds
authors.forename: Diana Lynn
authors.initials: DL
authors.lastname: Woods
authors.forename: Hershel
authors.initials: H
authors.lastname: Raff
mesh_terms: D002985:Clinical Protocols; D003704:Dementia / Q000451:nursing*; D004311:Double-Blind Method; D006801:Humans; D007297:Inpatients; D009735:Nursing Homes